
Class _I BM ia il 

Book /imj 



Copyright If. 



COPYRIGHT BEPOSIIi 



A TEXT-BOOK 



OF 



PHARMACOLOGY, THERAPEUTICS 

AXD 

MATERIA MEDICA. 



/ 



A TEXT-BOOK 



OF 



PHARMACOLOGY, THERAPEUTICS 

and ^J~^~~ 

MATERIA MEDICA. 



/ BY 

T. LAUDER BRUNTON, M.D., D.Sc, F.R.S., 

Fellow of the Royal College of Physicians ; Assistant Physician and Lecturer on Materia 

Medica at St. Bartholomeio 's Hospital ; Examiner in Materia Medica in the 

University of London, in the Victoria University, and in the 

Royal College of Physicians, London; Late Examiner 

in the University of Edinburgh. 



ADAPTED TO THE 

UNITED STATES PHARMACOPEIA 



BY 



FRANCIS H. WILLIAMS, M.D., Boston, Mass. 







PHILADELPHIA 

LEA BROTHERS & CO 

1885 



«>' 



^ 



&* 



Entered according to the Act of Congress, in the year 1885, by 

LEA BROTHERS cV CO., 

in the office of the Librarian of Congress. 

All rights reserved. 

A. T. ZEISIXG A (0., PRINTERS. 



TO 
THE MEMORY OF 

SIR ROBERT CHRISTISON, Bart., &c. 

HIS HONORED TEACHER, 
AND TO 

CARL LUDWIG, 

HIS EELOVED MASTER, 

This Book is gratefnlly Dedicated 

BY 

THE AUTHOR, 



PREFACE. 

Some apology is required for the long delay in the appearance of this 
work, for a number of years have now elapsed since it was advertised as 
being in the press. More than fifteen years ago, I had a work on Materia 
Medica completely written out and ready for the printer. Some time 
afterwards, all the arrangements had been made for its publication, and 
in the course of a few weeks it was to have been issued from the press. 
Just as I was about to send it to the printer, however, I asked for a little 
delay in order that I might make some improvements and remove some 
redundancies, for the work as it then stood was considerably larger than 
the present one. 

As I went through it, I found so many unsatisfactory statements and 
uncertainties regarding the mode of action of drugs, which I thought I 
could decide by a few experiments, that I wished for a little time in order 
that those doubtful points might be settled; but as I went on the labor 
grew, other engagements became pressing, and longer and longer delay 
was required. From greater experience as a teacher and examiner also, 
I came to the conclusion that the plan of the work might be altered with 
advantage ; and so finally the whole manuscript was thrown aside, and 
the book entirely rewritten. 

In the original work I discussed the physiological and therapeutical 
actions of each drug separately, in the same way as in the third part 
of the present work, though on a much more extended scale. I found, 
however, that this plan necessitated a good deal of repetition regarding 
the experimental methods by which the action of the drugs had been 
ascertained. 

Moreover, the physician does not want to know only what the actions 
of any one drug are ; he rather requires a knowledge of drugs, and of 

(?) 



8 PREFACE. 

the manner in which the actions of the individual members of a class 
differ from each other. He requires, in fact, a knowledge of the ways 
in which the various functions of the body can be influenced by drugs 
both in health and disease, in order that he may restore health to his 
patients. 

It has appeared to me, therefore, better to devote a complete section 
of the work to a discussion of the methods by which the action of drugs 
is determined ; to the manner in which each function of the body can be 
modified by drugs ; and to the general rationale of the use of drugs in 
disease, i.e., to devote a section to general pharmacology and general 
therapeutics. 

Considerable experience both in teaching and examining has shown 
me that students sometimes find a difficulty in applying physiology to 
pharmacology and therapeutics, and I find that many others are, like 
myself, apt to forget those parts of physiology which they are not con- 
stantly studying. I have therefore thought it well, for the sake both of 
students and practitioners, to give a short account of the normal functions 
of the different parts of the body, before I proceed to discuss the altera- 
tions which are produced in them by drugs, or which they undergo in 
disease. In the case of the heart and the kidneys also, where the action 
of drugs is complicated and difficult, I have found it necessary to enter a 
little more fully into the physiology of these organs than is done in the 
ordinary text-books. 

I have found that a similar difficulty occurs with pathology as with 
physiology, and I have therefore occasionally discussed pathological ques- 
tions when 1 have thought that by doing so I could render the action 
of drugs in disease more intelligible, and thus aid the student of rational 
therapeutics. 

In the second pari of the work on general pharmacy, I have classed 
her the various pharmaceutical preparations and given lists of them 
for reference. li is by no means my intention that these should be 
Learned by bearl by any student, and indeed I think it is well to take this 
opportunity of protesting against the injustice of the demands which are 
sometimes made upon the memories of students. 

It is probable thai the majority of the best and most successful prac- 
titioners would be yery much puzzled if they were required to state the 



PEEFACE. y 

exact quantity of every ingredient in each pill or each ointment that they 
prescribe, or the exact quantity of the crude drug from which the infu- 
sions or tinctures which they use have been made. They know the 
action of the pill or ointment, they know the action of the infusion or 
tincture, and they do not trouble themselves about details which are only 
useful to the chemist who is making up the preparation. 

It is very greatly to be regretted, for it is a stumbling-block in the 
way of true progress, that students who have afterwards to become med- 
ical practitioners and not pharmaceutical chemists, should be asked at 
examinations the quantities of crude drugs from which particular prepa- 
rations are made — quantities which even the manufacturing chemist him- 
self would never dream of carrying in his memory, but would obtain by 
reference to his books whenever he required them. As the late Pro- 
fessor Sharpey used very truly to say, "You may as well require of a 
medical student a knowledge of the whole art of cutlery before you set 
him to dissect." Medical science is now advancing in every direction, 
and unless we cut off some of the less useful kinds of information, which 
medical students were formerly obliged to acquire, it becomes impossible 
for them to learn all that is truly valuable. In Materia Medica we now 
oblige them to learn the physiological action of drugs, a subject regard- 
ing which, until quite recently, little or nothing was known, and to oblige 
them to learn all this, in addition to what they were formerly expected 
to know, is to treat them as Pharaoh treated the Israelites, and compel 
them to make the same number of bricks, while giving them no straw. 

I am so much impressed with the necessity of lessening the amount 
of unnecessary work sometimes required as a preparation for examina- 
tions, that at first I omitted from this book all reference to the compo- 
sition of pharmaceutical preparations. But as it is intended not only as 
a itxc-book for students, but also for the use of practitioners, I afterwards 
considered that it might be convenient to have the composition of some 
pharmaceutical preparations, at least, for the purpose of reference. I 
have omitted the composition of such preparations as are likely to be got 
ready made from a chemist, but have inserted the composition of infu- 
sions which often need to be prepared when required. I have also given 
the composition of various compound pills, but only for the purpose of 
reference. 



10 PREFACE. 

In the preparation of this work I have to acknowledge my obligations 
to the admirable works of Bartholow, Binz, Buchheim, Dujardin-Beau- 
metz. Edes, Husemann, Nothnagel, and Rossbach, Ringer, Schmiedeberg, 
and H. C. Wood. Messrs. Chapman, Soutter, Spencer, Steinthal, 
Stubbs, Wells, and Wright for the excellent notes. they took of my lec- 
tures; to Dr. D'Arcy Power for the verification of references; to Dr. 
Mitchell Bruce, Mr. T. W. Shore, and Mr. H. W. Gardner for much 
kind assistance in the preparation of the work, and to Prof. Matthew 
Hay, of Aberdeen, whose criticisms and suggestions have been invaluable. 
To Dr. Francis H. Williams, of Boston, Mass., I am indebted for the 
adaptation of this work to the United States Pharmacopoeia, which, by 
tending to familiarize medical men on each side of the Atlantic with the 
preparations employed in both countries, may, I trust, tend to facilitate 
the introduction of an International Pharmacopoeia. 

T. Lauder Bruntox. 

March, 16-5. 



CONTENTS. 



PAGE 

INTRODUCTION 33 

SECTION I. 
GENERAL PHARMACOLOGY AND THERAPEUTICS. 

CHAPTER I. 

General Relations between the Organism and Substances Affecting it, 

pp. 35-52. 

List of Elements 35 

Nature of Elements 37 

Classification of Elements 41 

Organic Radicals 47 

Chemical Reactions and Physiological Reactions 47 

Relation between Atomic Weight and Physiological Action .... 49 

Relation between Spectroscopic Characters and Physiological Action . . 49 

Relation between Isomorphism and Physiological Action . . . . 51 

CHAPTER II. 
Circumstances which Affect the Action of Drugs on the Organism, 

pp. 52-67. 

Interaction of Various Functions .52 

Direct and Indirect Action 53 

Local and Remote Action 53 

Relation of Effect to Quantity of Drugs 53 

Homoeopathy 54 

Dose 54 

Size .55 

Mode of Administration 55 

Cumulative Action 57 

Effect of Different Preparations 58 

Effect of Fasting . 58 

Effect of Habit 58 

Effect of Temperature 59 

Effect of Climate 62 

Effect of Time of Day 62 

Effect of Season 62 

Effect of Disease 63 

Use of Experiments 63 

Comparative Pharmacology 63 

Idiosyncrasy 64 

Objections to Experiment 65 

Erroneous Deductions from Experiments ' 67 

(ii) 



12 



CONTEXTS. 



CHAPTER III. 
Action of Drugs on Protoplasm, Blood, axd Low Organisms, pp. 68- 



Action of Drugs on Albumen 

Action of Drugs on Protoplasmic Movements .... 

Method of Experimentation 

Movements of Leucocytes in the Blood Vessels ... 

Movements of Red Blood Corpuscles 

Action of Drugs on Infusoria 

Relations of Motions and Oxidation 

Oxidation of Protoplasm 

Oxygen Carrying Power of Protoplasm 

Ozonizing Power of Protoplasm 

Action of Drugs on Oxidation 

Action of Drugs on Blood 

Catalysis — Fermentation — Inorganic Ferments 

Ferments. Organic and Organized 

Action of Drugs on Enzymes 

Zymogens 

Organized Ferments 

Feasts ........... 

Moulds 

Bacteria 

Actions of Drugs on the Movements of Bacteria 

Actions of Drugs on the Reproduction of Bacteria . 

Mode of Experimenting on the Action of Drugs on the Reproduction 

Actions of Drugs on Particular Species of Bacilli . 

Actions of Drugs on the Development and Growth of Bacilli 

Iniluence on Antiseptics of the Solvent . 

Influence on Antiseptics of the Admixture 

Iniluence on Antiseptics of the Temperature 

Alterations in Bacteria by Heat and Soil 

le Identity of Different Forms 
Action of Bacteria and their Products on the Animal 
Alkaloids formed bj Putrefaction — Ptomaines 

of Drugs on the Action of Bacteria in the Animal Body 
Antiseptics — Antizymotics — Disinfectants — Deodorizers 

i of Am iseptics . 

Disinfectants 



A m iix riodics 



Body 



of Bacteria 



-109. 

PAGE 

68 

70 

70 

72 

73 

73 

75 

77 

78 

78 

79 

79 

82 

83 

85 

87 

88 

89 

89 

91 

93 

93 

97 

97 

99 

100 

101 

101 

101 

102 

103 

103 

104 

105 

106 

108 

108 

108 



Action 
m <<r I tragi on Medusas 
mi <>t' I ►rage on Moll 

Ascidians 
on of I>i uiM "ii Annulosa 



CHAPTEE IV. 
r Dbugs on Invebtebbata, pp. 109-116. 



CHAPTEE V. 
Lcnos "i Dei os <>\ Mi bole, pp. 116 138. 

■ •: I tragi on Voluntary Muscle 

lit v <-i Muscle 



109 
114 
114 
115 



116 
117 



CONTENTS. 



13 



Contraction of Muscle 

Latent Period of Muscle 

Summation of Stimuli 

Curve of Muscular Contraction 

Effect of Fatigue and Temperature 

Contracture . . . 

Tetanus 

Muscular Poisons .... 



Propagation of the Contraction Wave in Muscle 

Ehythmical Contraction of Muscle . 

Connection between Chemical Constitution and Physiological Action in 

Action of Drugs on Muscle is Eelative and not Absolute 

Action of Drugs on Involuntary Muscular Fibre 

Effect of Stimuli 

Relation of Contractile Tissue to the Nerves 
Propagation of Contraction Waves 

Artificial Rhythm 

Hypothetical Considerations regarding the Action of Drugs on Muscle 



CHAPTER VI. 
Action of Drugs on Nerves, pp. 138-147. 
Action of Drugs on Motor Nerves . 
Paralysis of Motor Nerve-endings by Drugs . 
Irritation of Motor Nerve-endings . 
Action of Drugs on the Trunks of Motor Nerves 
Action of Drugs on Sensory Nerves 
Local Sedatives and Local Anaesthetics . 



CHAPTER VII. 

Action op Drugs on the Spinal Coed, pp. 147-167. 
Action on the Conducting Power of the Cord 
Action of Drugs on Reflex Action .... 
Direct, Indirect and Inhibitory Paralysis of the Spinal 
Indirect Paralysis .... 
Direct Paralysis .... 
Spinal Depressants and their Uses 
Inhibitory Paralysis 
Nature of Inhibition 
Interference in Nervous Structures 
Effect of Altered Rate of Transmission 
Opposite Conditions Produce Similar Effects 
The Same Conditions may Cause Opposite Effects 
Stimulation and Inhibition merely Consequences of Relation 
Test of the Truth of the Author's Hypothesis regarding Inhibition 
Explanation of the Action of Certain Drugs on this Hypothesis 
Stimulating Action of Drugs on the Reflex Powers of the Cord 
Localization of the Action of Strychnine by Magendie . 
Spinal Stimulants . . . 

CHAPTER VIII. 

Action of Drugs on the Brain, pp. 167-196. 

Functions of the Brain in the Frog 

Functions of the Brain in the Higher Animals 



PAGE 

. 117 

. 118 

. 120 

. 120 

. 121 

. 122 

. 123 

. 124 

. 128 

. 128 

. 128 

Muscle 130 

. 131 

. 132 

. 133 

. 134 

. 134 

. 135 

. 136 



138 
140 
143 
144 
144 
146 



Cord by Drugs 



147 
151 
151 
152 
152 
153 
153 
154 
156 
156 
157 
157 
157 
157 
158 
163 
163 
167 



167 
168 



11 



CONTEXTS. 



Action of Drugs on Motor Centres in the Brain 
Irritant Action of Drags on Motor Centres in the Brain 

Convulsions 

- on the Sensory and Psychical Centres in the Brain 
a which Increase the Functional Activity of the Brain 
ilantfl 

i 81 imnlants .... 

which Lessen the Functional Activity of the Brain 
Hypnotics or Soporifics .... 



Anodyne- or Analgesics .... 
Adjuncts to Anodynes .... 

Anaesthetics 

- of their Action .... 
81 • tdcs .... 

Mode of Administering Anaesthetics 

iic.-ia in Animals .... 
ofthe Discovery of Anaesthesia . 

Antispasmodics 

Actio: on the Cerebellum . 



PAGE 

171 
172 
172 
175 
176 
176 
176 
178 
179 
182 
183 
184 
185 
188 
189 
190 
191 
192 
193 
195 



CHAPTER IX. 
; Drugs on the Organs of Special Sexse, pp. 196-207 
Action of I h ogs on the Eye 
Action of DmgS on the Conjunctiva 

m of Drags on the Lachrymal Secretion 
I ction of thi Eyeball 

- on the Pupil . 
Action of Drags On the Accommodation . 
d of Drags on the Intra-ocnlar Pressure 

Ol Mydriatics and Myotics 

m ol Drags on the Sensibility ofthe Eye 
d of ! tarugs in Producing Visions 
on Bearing 

on Smell 



CHAPTER X. 

" N "' DBUGS ON RE8PIBATION, pp. 207-228. 

■ the Respiratory Centre 
piratory Centre 
ipiratorj Nervt 
bines 

nchia] Secretion 
[( onanism 






CHAPTER XI. 
" lM: LTION, pp. 229 300. 



196 
196 
196 
197 
197 
201 
202 
203 
204 
204 
205 
206 
206 



207 
214 
218 
219 
220 
220 
223 
225 
227 
228 



229 
229 



CONTENTS. 



Fainting and Shock 

Scheme of the Circulation . . . 

Circulation in the Living Body . 
Mode of Ascertaining the Blood-pressure 

Fallacies 

Alterations in Blood-pressure 

Relation of Pulse Rate and Arterioles to Blood-pressure 
Effect of the Arterioles on Pulse Curves . 
Investigation of the Action of Drugs on the Arterioles 
Method of Measurement by Rate of Flow 
Action of Drugs on Vaso-motor and Vaso-dilating Nerves 
Action of Other Parts on the Blood-pressure . 

Peflex Contraction of Vessels 

Action of Drugs on Reflex Contraction of Vessels . 

Comparative Effect of Heart and Vessels on Blood-pressure in Different Animals 

Influence of Nerves on Blood-pressure 

Causes of Alteration in Blood-pressure and Pulse Rate 

Action of the Heart on Blood -pressure . 

Effect of Drugs on the Pulse Rate .... 

Action of Drugs on the Cardio-inhibitory Action of the ' 

Reflex Stimulation of the Vagus .... 

Causes of Quickened Pulse 

Action of Drugs on Vagus Roots . . 
Action on Accelerating Nerves .... 

Stimulating Effect of Asphyxial Blood on the Medulla 
Stimulation of the Heart by Increased Blood-pressure 

Palpitation 

The Heart of the Frog 

Action of Drugs on the Heart of the Frog 
Action of Drugs on its Muscular Substance 
Differences Between the Heart Apex and the Heart 
Action of Drugs on Inhibition of the Heart 
Theories Regarding the Mode of Action of Drugs on the 
Drugs which Act on the Vagus Centre . 
Drugs which Act on the Accelerating Centre . 
Drugs which Act on the Vaso-motor Centre . 
Drugs which Act on the Vagus Ends in the Heart . 
Drugs which Act on the Inhibitory Ganglia . 
Drugs which Act on the Motor Ganglia . 
Drugs which Act on the Cardiac Muscle . 
Drugs which Act on the Vaso-motor Nerves . 
Drugs which Act on the Capillaries 

Stannius's Experiments 

General Considerations regarding the Heart . 
Regulating Action of the Nervous System 

Inhibition in the Heart 

Therapeutic Uses of Drugs acting ou the Circulation 

Cardiac Stimulants 

Vascular Stimulants 

Cardiac Tonics 

Risks Attending the Administration of Digitalis and other Cardiac Tonics 

Vascular Tonics 

Pathology of Dropsy . . . 



Heart 



15 

PAGE 

230 
232 
233 

234 
235 
236 
237 

240 
243 
246 
248 
249 
250 
251 
252 
253 
257 
258 
259 
260 
261 
261 
261 
262 
262 
262 
283 
263 
265 
269 
272 
274 
275 
279 
279 
279 
280 
280 
280 
281 
281 
282 
282 
285 
286 
290 
291 
291 
292 
293 
296 
297 
297 



16 

Cardiac Sedatives 
Vascular .Sedatives 



CONTEXTS. 



PAGE 

299 
300 



Remedies Acting on 

Irritants and Counter-irritants 
Rubefacients 

nta . 
Postulants 

Caustics .... 
Emollients and Demulcents 
Astringents 
Styptics .... 



CHAPTER XII. 
the Surface of the Body, pp. 301-310. 



CHAPTER XIII. 
on the Digestive System, pp. 



Action of Drugs 
Action of Drugs on the Teeth 
Bialagogues 

Hon by the Saliva . 

i rants 
Pathology of Thirst . 
Antisialics 
Gastric Tonics . 
Appetite .... 
Action of Drugs on Secretion in the Stomach . 
Action of Drugs on the Movements of the Stomach 
Absorption from the Stomach .... 

Antacids 

Emetics 

Gastric Sedatives and Anti-emetics . 

Carminatives 

Action of Drugs on the Intestines 
[ntestinal Movements and Secretion 

Paralytic Secretion 

Constipation 

Action of Drugs on Absorption from the Intestines 

: ill Astringents 

Purgatives 

A<tion of Purgatives ..... 

Uses of I'm 

Action of Irritant PoisOOJ .... 

the Action of differenl Irritant Poi 
mdary Effects of Irritanl Poisoning . 
Action ..; i )i age on the Liver .... 

Sepal i< Si imulants 

Cho 

me - o ( li<da^o^ncs ..... 

I [epatic Stimulants and Cholagogues 

..... 
i t he Pancreas 

. 



310-355. 



CONTENTS. 



17 



CHAPTEE XIV. 
Deugs Acting on Tissue Change, pp. 356-364. 

PAGE 

Tonics 356 

Hsematinics 357 

Alteratives 358 

Antipyretics — Febrifuges . - 361 



CHAPTEE XV. 
Action of Deugs on Exceetion, pp. 364-385 
Action of Drugs on the Kidneys 
Circumstances Modifying the Secretion of Urine 
Mode of Action of Diuretics . 
Adjuvants to Diuretics . 
Action of Drugs on Albuminuria 
Lithontriptics .... 
Action of Drugs on the Skin . 
Diaphoretics and Sudorincs 
Excretion by the Sweat Glands 
Relation between Sweat Glands and Kidneys 
Action of the Skin in Eegulating Temperature 
Antihydrotics or Anhydrotics . 
Pathology of Night Sweats 
Action of Drugs on the Bladder 
Urinary Sedatives and Astringents 



364 
369 
372 
375 
375 
376 
377 
377 
379 
379 
380 
381 
382 
383 
385 



CHAPTEE XVI. 
Action of Deugs on the Geneeative System, pp. 386-393. 



Aphrodisiacs and Anaphrodisiacs .... 


386 


Aphrodisiacs . 






. . .387 


Anaphrodisiacs 






388 


Emmenagogues 






390 


Ecbolics . 






391 


Action of Drugs 


upon 


Milk 


392 



CHAPTEE XVII 



Methods of Administebing 
Application of Drugs by the Skin 
Epidermic Application 
Baths 
Cold Bath 
Cold Pack 
Cold Spongin 
Cold Douches 
Local Application of Cold 
Cold Sitz Bath 
Cold Foot Bath 
Cold Compresses 
Tepid Bath 
Warm Bath 
Hot Bath 
9 



Dei 



gs, pp. 393-416. 



■J 4 



393 
394 
395 
396 
398 
398 
399 
'399 
399 
? 400 
400 
401 
401 
401 



18 



CONTEXTS. 



Hot Foot Bath . 

Hot Sitz Bath . 

Poultices .... 

Medicated Baths 

Sea Bathing 

Acid Bath 

Alkaline Bath . 

Sulphurous Bath 

Mustard Bath . 

Pine Bath 

Vapor Baths 

Calomel Fumigation 

Air Baths— Turkish Bath 

Friction and Inunction . 

Ma>-age .... 

Inunction 

Endermic Application of Drugs 

Hypodermic Administration of Drugs 

Objections to Hypodermic Injections 

Application of Drugs to the Eye 

Application of Drugs to the Ear 

Application of Drugs to the Nose . 

Application of Drugs to the Larynx 

Application of Drugs to the Lungs . 

Application of Drugs to the Mouth and Pharynx 

Masticatories — Gargles . 

Application of Drugs to the Stomach 

Stomach-pump .... 

< rflstric Syphon .... 

Application of Drugs to the Intestine 

Enemata 

Suppositories 

Application of Drugs to the Urethra 
Application of Drugs to the Vagina and Uterus 



PAGE 

402 
402 
402 
403 
403 
403 
403 
403 
403 
404 
404 
404 
404 
405 
406 
406 
407 
407 
408 
409 
409 
410 
411 
412 
413 
413 
414 
414 
414 
415 
415 
415 
415 
415 



CHAPTER XVIII. 
Antidotes, pp. 416-421. 

Antidotes to Poisonous Gases 

Antidotes to Acids 

Antidotes to Alkalies ...... 

Antidotes to Metallic Salts, Alkaloids, &c. 



416 

417 
417 
418 



CHAPTER XIX. 
An i ioonistic Action of Dkigs, pp. 422-425. 



CHAPTER XX. 
Dosage, p. 120. 



CONTENTS. 19 

SECTION II. 
GENERAL PHARMACY. 

CHAPTER XXI. 
Phaemaceutical Pkepakations, pp. 427-454. 

PAGE 

Abstracta — Abstracts . . 428 

Aceta — Vinegars 429 

Alkaloidea— Alkaloids 429 

Aquas — Waters 430 

Cataplasmata — Poultices 431 

Cerata — Cerates 431 

Chartse— Papers 431 

Coll odia— Collodions 432 

Confectiones — Confections — Electuaries 432 

Elixiria — Elixirs 433 

Emplastra — Plasters 433 

Enemata — Injections— Enemas — Clysters 433 

Essentia — Essences : 434 

Extracta — Extracts 434 

Glycerina — Glycerita — Glycerines 437 

Infusa — Infusions 437 

Injectio Hypodermica — Hypodermic Injection 439 

Linimenta — Liniments — Embrocations 439 

Liquores — Solutions 440 

Massse — Masses 441 

Mellita — Honeys 441 

Misturse — Mixtures 441 

Mucilagines — Mucilages ' 442 

Olea— Oils, Fixed and Volatile 442 

Oleata— Oleates 443 

Oleoresinse — Oleoresins 443 

Oxymel 444 

Pilulse— Pills 444 

Pulveres — Powders 444 

Resinre — Resins 445 

Spiritus — Spirits 445 

Suppositoria — Suppositories 446 

Succi — Juices 447 

Syrupi — Syrups 447 

Tincturse — Tinctures 448 

Triturationes — Triturations 451 

Trochisci — Lozenges 451 

Unguenta — Ointments 452 

Vapores — Vapors — Inhalations • . 453 

Vina — Wines 453 



20 



CONTENTS. 



SECTION III. 
INORGANIC MATERIA MEDICA. 

CHAPTER XXII. 
Hydrogex, Oxygex, Ozoxe, Caebox, Sulphur, axd the Halogexs, pp. 455-472. 

PAGE 

Hydrogen 455 

Oxygen . 

Ozone 

Peroxide of Hydrogen 

Carbon 

Sulphur . 

Sulphuretted Hydrogen 

Halogen Elements — General Source and Character 

General Action 

Chlorine . 

Chlorinated Lime 

Chlorinated Soda 

Bromine . 

Iodine 

Iodide of Sulphur 

Action of Iodine 



CHAPTER XXIII 
Acids, pp. 472-494 



General Characters of Acids 
General Preparation of Acids 
General Action of Acids 
Sulphuric Acid 
Sulphurous Acid 
Hydrochloric Acid . 
Nitric Acid 
NUro-hydrochloric Acid 

Acid 
Phosphoric Acid 
Tartaric Acid . 

I Acid 

d 

* Sallic Arid rid p. 877) 
Tain, 

•1 
'id . 

icid . 

. i 

p. 61 1 

I 



CONTENTS. 



21 



CHAPTER XXIV. 
Metals, pp. 495-546. 



General Classification of the Metals .... 

General Tests tor Acid Radicals in Metallic Salts . 

Metals of the Alkalis. Their Characters and Reactions . 

General Physiological Action of the Alkalis . 

General Physiological Action of the Alkaline Group of Salts 

General Physiological Action of the Chlorides Group of Salts 

General Physiological Action of the Sulphates Group of Salts 

Comparative Action of the Alkaline Metals 

Monad Metals, Group I., Potassium, Sodium, Lithium . 

Potassium, General Sources and Reactions of its Salts 

Preparation of Potash Salts 

General Action of Potash Salts 

Characters, Action and Uses of Officinal Potash Salts 
Sodium, General Sources and Reactions of its Salts 

Preparation of its Salts 

General Impurities, Tests and Action .... 

Characters, Actions and Uses of Soda Salts 

Lithium, Sources, Reactions, Impurities and Tests of its Salts 

Actions 

Characters, Actions, and Uses of Officinal Lithium Salts 
Monad Metals, Group II., Ammonium .... 

Nature of Ammonium Salts 

Sources, Reactions and Preparation .... 

Impurities, Tests and Actions 

Characters, Actions and Uses of Officinal Ammonium Salts 



PAGE 

. 495 
. 496 
. 498 
. 499 
. 499 
. 502 
. 504 
. 504 
. 505 
. 505 
. 506 
. 507 

508-522 
. 522 
. 523 
. 524 

524-534 
. 534 
. 535 

535, 536 
. 536 
. 537 

537, 538 
. 539 

540-546 



CHAPTER XXV. 

Metals (continued), Class II., Dyad Metals — Geoup I., Metals of the 
Alkaline Earths; Appendix, Metals of the Earths, pp. 546-562. 

Reactions of the Metals in Class II. 547 

Class II., Group I., Metals of the Alkaline Earths 547 

General Action of Metals of the Alkaline Earths 547 

Calcium, Reactions, Preparation, Impurities and Tests of its Salts . . 548, 549 
Characters, Action and Uses of Officinal Lime Salts .... 549-555 

Class II., Group I., Appendix — Aluminium ....... 555 

General Sources, Preparation, Reactions, Impurities and Tests of Alum Salts 555 
Characters, Actions and Uses of Officinal Alum Salts .... 555-558 

Cerium, Action and Uses of its Oxalate 558 

Class II., Group II., Magnesium 559 

Sources, Reactions and Preparation of Magnesium Salts 559 

Impurities, Tests- and Action of Magnesium Salts 560 

Characters, Actions and Uses of Magnesium Salts 560-562 



CHAPTER XXVI. 

Metals (continued), The Heavy Metals, Class II., Groups III. and IV. 

and Class IV., pp. 562-600. 

General Actions of Heavy Metals 562 

General Actions of Class II., Group III., Zinc, Copper, Cadmium and Silver . 565 
Zinc, its Sources 566 



22 



CONTEXTS. 



General Reactions and Preparation of Zinc Salts 
General Impurities, Tests and Action of Zinc Salts 
Characters, Action and Uses of Officinal Zinc Salts 
Copper, its Sources, Reactions, Impurities and Tests 
Characters, Actions and Uses of Officinal Salts of Copper 
Cadmium, Characters, Action and Use of its Iodide 
Silver, Characters, Action and Uses of its Salts 

Class II., Group IV., Mercury 

General Sources and Reactions of Salts of Mercury- 
General Impurities, Tests and Action of Salts of Mercury 
Characters, Actions and Uses of Officinal Salts of Mercury 
Class IV., Tetrad Metals, Lead and Tin .... 

General Actions 

Lead, its Sources, Reactions, Impurities, Tests and Action 
Characters, Actions and Uses of Officinal Salts of Lead . 
Tin. Action and Uses of its Chloride .... 



PAGE 

. 567 
. 568 
568-572 
. 572 
572-574 
. 574 
574-578 
. 578 
. 578 
. 579 
583-593 
. 593 
. 593 
. 594 
596-600 
. 600 



CHAPTER XXVII. 

Class V., Pentad Elements— Nitrogen, Phosphorus, Arsenic, 
and Bismuth, pp. 600-623. 

Nitrogen and its Compounds 

Nitrous Oxide 

Phosphorus, its Preparation, Characters and Action 

Uses of Phosphorus 

Arsenic, its Sources and Tests 

General Action of Arsenic 

Prohahle Mode of Action of Arsenic in Phthisis 

Characters, Actions and Uses of Officinal Preparations of Arsenic 

Antimony, its Sources and Reactions ..... 

Genera] Action 

Characters, Action and Uses of its Officinal Preparations 

Bismuth, its Action 

Sources, Reactions, Preparation and Uses of its Salts 
Character, Action and Uses of its Officinal Preparations 



Antimony, 

601 
601 
602 
605 
605 
606 
609 

611, 612 
613 
613 

617-621 
621 
621 

622, 623 



CHAPTER XXVIII. 
Metals (continued), Class VIII., Iron, Manganese, pp. 624,642 
Iron, it- Sources and Reactions .... 
Impurities, Tests and Preparation of its Salts . 

( teneral Action 

I racter, Action and Uses of its Officinal Preparations 
Manganese 



Class VIII., Group II., Gold and Platinum . 

Gold, Preparation and characters of its Chloride 
Platinum, Preparation, Uses and Action of its Chloride 



. 624 

. 625 

. 627 

629-640 

. 640 

640 

640 

641 



SECTION IV. 
ORGANIC MATERIA MEDIC A. 

(If \ITKK XXIX. 
Cabbok Compoi nds— Fatty Beeies, pp. 643-683. 

Chemistry of Carbon Compounds 

d Action of Carbon Compounds 



643 
644 



CONTEXTS. 23 

PAGE 

Bisulphide of Carbon 644 

Hydro-Carbons 645 

Benzin 646 

Petrolatum. (Vaseline) 647 

Alcohol 647 

Methyl Alcohol 649 

Alcohol, General Sources and Preparation 649 

General Impurities, Tests and Action 649 

Effect of Impurities on its Action 653 

Chronic Alcoholic Poisoning . 653 

Causes and Treatment of Alcoholism . . . 654 

Uses of Alcohol 655 

Officinal Alcoholic Preparations . . 657-660 

Aldehydes, Ethylaldehyde and Paraldehyde 660 

Simple Ethers, Ether 660 

Saline Ethers 663 

Ethereal Oil and Hoffman's Anodyne 663, 664 

Acetic Ether 664 

Nitrites of Ethyl and Amyl 664 

Nitro-glycerine 668 

Haloid Compounds 669 

Bromide of Ethyl . 669 

Iodide of Ethyl 669 

Chloral Hydrate, its Preparation and Characters 670 

Its Action 670 

Treatment of Chloral Poisoning 672 

Bromal Hydrate . ■ 673 

Butyl Chloral Hydate 673 

Bichloride of Methylene 673 

Chloroform, its Preparation, Characters, Impurities and Tests . . . 674 

Action of Chloroform 675 

Dangers of Chloroform 678 

Precautions in Using Chloroform . . 678 

Uses of Chloroform • 680 

Iodoform 681 



CHAPTEE XXX. 



Caebon Compounds — Aeomatic Seeies, 


pp. 


683-696. 






General Chemistry of the Aromatic Series . 683 


General Action of the Aromatic Series . 














687 


Carbolic Acid 
















687 


Creasote .... 


















690 


Eesorcin .... 


















1 691 


Hydroquinone . 

Pyrocatechin . 

Salicylic Acid . 

Naphthylin 

Naphthol 

Hydrochlorate of Eosanaline 

Chinoline 


















692 
692 
692 
694 
694 
695 
695 


Kairin .... 


















695 


Antipyrin 


















695 



24 



CONTENTS. 



SECTION V. 
VEGETABLE MATERIA MEDICA. 



CHAPTER XXXI. 

Sub-Kingdom I., Phanerogams. 

Class Exogens, Division I., Axgiospebms, Sub-Class I., Thalamifloe.e, 

pp. 697-752. 

Kanunculacea? 

Aconite 

Staphisagria . 

Pulsatilla 

Adonis Vernalis 

Cimicifuga 

Podophyllum 

Hydrastis 
Magnoleacese . 

Illicium 

Oil of Anise 
Menispermaceec 

Menispermuni 

Calumba 

Pareira 

Picrotoxin 
BerberidaceiC . 

Caulophyllum 
Papaveracese . 

Poppy Capsules 

Opium . 

Preparations of Opium 

Morphine 

Apomorphine 

Codeine 

Action of Opium 

Diagnosis of Opium Poisoning 

Treatment of Opium Poisoning 

Circumstances Modifying the Action of Opium 

Action of the Alkaloids of Opium 
<>!' Opium 

Rhoeas — Bed Poppy 
guinaria— Blood Boot 

lidoninm Celandine 

Crncifene .... 
Sinapie Mustard 
Armoracia Borseradish 



Viola Pansy 



Linseed 
Qeraniaceae .... 
ilium Cram -hill . 



CONTENTS. 



Polygalacese 

Senega . 

Krameria — Rhatany 
Sapindacese 

Guarana 
Erythroxylacese 

Erythroxylon — Coca — Cuca 
Malvaceae 

Gossypium — Cotton 

Pyroxylin — Gnn Cotton 

Collodion 

Althaea — Marshmallow 
Aurantiacese 

Orange . 

Oil of Bergamot 

Lemon . 

Bael Fruit 
Sterculiaceae (Byttneriacese) 

Theobroma — Cacao 
Ternstromiacese 

Tea 

Caffeine 
Guttiferse 

Cambogia — Gamboge 
Canellacese 

Canella Alba 
Vitaceas . 

Uv83 — Eaisins 

Vinum Xericum 

Vinnm Eubrum 
Zygophyllacese 

Guaiacnm 
Meliacese 

Azedarach 
Rutacese . 

Rutese . 

Oil of Sue 
Cusparia 

Diosmeae 

Buchu 

Xanthoxylese 

Xanthoxylum — Prickly 
Pilocarpus — Jaborandi 
Simarubacese . 

Quassia 



Ash 



25 

PAGE 

730 

730 
731 

732 
732 
732 
732 
734 
734 
735 
735 
736 
737 
737 
739 
739 
741 
741 
741 
742 
742 
742 
744 
744 
744 
744 
745 
745 
745 
745 
745 
745 
746 
746 
747 
747 
747 
747 
747 
747 
748 
748 
749 
752 
752 



CHAPTER XXXII. 
Class I., Exogenjs, Sub-Class II., Calyciflorje, pp. 753-792. 

Rhamnacese 753 

Rhamnus — Frangula — Buckthorn 753 

Cascara Sagrada . . . 753 

Celastracese 753 

Euonymus — Wahoo 753 



26 



CONTEXTS. 



Aquifoliacea? . 

Prinos — Black Alder 
Terebinthacece 

Anacardisa 

Mastiche 

Rhus Glabra — Sumach 

Rhus Toxicodendron — Poison Ivy 
Amyridacere or Burseracese 
Myrrh . 
Elemi 
Leguminosse 

Papilionacese . 

Glycyrrhiza — Liquorice 

Scoparius — Broom 

Tragacanth . 

Pterocarpus — Santalum — Red Sandal-wood 

Kiuo 

Balsam of Peru . 

Balsam of Tolu . 

Abrus — Jequirity 

Physostigma — Calabar Bean 

Hamatoxylon — Logwood 

Chrysarobinum — Chrysophanic Acid — Goa 
Caesalpinse .... 

Senna .... 

Cassia — Purging Cassia 

Tamarind . 

Copaiba — Copaiva 

Piscidia Erythrina — Jamaica Dogwood 
Mimoseaj 

Acacia 

Catechu 

Ery throphh cum — Casca — Sassy . 

Indigo 

Pomese 

Cvdonium— Qujnce 
Dryadeae 

Bubus— Blackberry 

liubus [daBus— Raspberry . 
Rosea 

Oil of Rose 

Rosa Centifolia — Cabbage Rose — Pale Rose 
i (tallica Red Rose 
Canina Dog Rose 

Cosbo Brayera .... 

Qaillaia -Soap Bark 
Amygdaleae 

Amygdala Dnlcia- Bweel Almond 

Amygdala Amara Bitter Almond 

Prune 

l'niiiiis Virginiana Wild Cherry 

r<auroceraauA Cherry Laurel 



Powder 



or Red Saunders 



CONTENTS. 27 

PAGE 

Papayacese (Passiflorse) 777 

Papayotin — Papain . . . 777 

Myrtaceae 778 

Caryophyllus— Cloves 778 

Pimenta — Allspice 779 

Cheken 779 

Oleum Myrti— Oil of Myrtle .780 

Oleum Cajuputi— Oil of Cajuput 780 

Eucalyptus 781 

Granatum — Pomegranate • • 782 

Cucurbitacese 782 

Colocynth 782 

Ecbalium — Elaterium 784 

Pepo — Pumpkin 785 

Bryonia — Bryony . . . 785 

Umbelliferse 785 

Campylospermae . . 785 

Conium 786 

Orthospermae 787 

Assafcetida — Asafetida • 787 

Galbanum 788 

Ammoniacum 788 

Foeniculum — Fennel .. • 789 

Anise 789 

Anethum— Dill 790 

Carum— Caraway . . 790 

Sumbul 791 

Ccelospermae 792 

Coriander . ■ . -. .792 



CHAPTER XXXIII. 

Class I., ExoGENiE (continued), Sub-Class III., Coeollifloe^, pp 

Caprifoliacese . 
Sambucus 
Cornacese .... 

Cornu s — Dogwood 
Rubiacese 

Cinchonese (Cinchonacese) 

Cinchona Pallida — Pale Cinchona 
Cinchona — Flava — Yellow Cinchona 
Cinchona — Rubra — Red Cinchona 
Quinine 
Coffese . . . 
Ipecacuanha 
Coffee . 
Pale Catechu 
Valerianacese . 
Valerian 
Caprifoliacese . 

Viburnum — Black Haw 
Composite 

Pyrethrum 



793-857. 



793 
793 
793 
793 

793 
793 
794 
794 
795 
796 
802 
802 
804 
804 
805 
805 
806 
806 
806 
806 



28 



CONTENTS. 



Composite — [continued). 

Absinthium — Wormwood 

Tanaceturn — Tansy 

Santonica — Santonin 

Anthemis — Chamomile . 

Matricaria — German Chamomile 

Eupatorium — Thoroughwort 

Taraxacum — Dandelion 

Lactuca — Lettuce . 

Arnica . 

Calendula — Marigold 

Grindelia 

Inula — Elecampane 

Lappa — Burdock . 
Lobeliacere 

Lobelia . 
Ericaceae 

Uva Ursi — Bearberry 

Chimaphila — Pipsissewa 

Oleum Gualtherise — Oil of Wintergreen 
Sopotacese 

Gutta-percha . 
Styraceae .... 

Benzoin — Benzoic Acid 
Verbenacere 

Lippia Mexicana . 
Oleaeere .... 

Olive Oil 

Hani Soap 

Soft Soap 

Glycerin 

Manna . 

iaceae 

Nux Vomica . 

[gnatia . 

Strychnine 

Grelseminm 

Bpigelia P ink root — Maryland Pink 
Apocynaceae .... 

Apocynnm— Canadian Hemp 

Quebracho 
Aaclepiadaces .... 

AjbcL piaa Pleurisy Root 
lepias [ncarnata White 

Hemidesmns 

Condorango . 
Grentianacea 

( lent Las . 

Chiretta 
Conrolvnla 

. 

Jalap 



Indian Hemp 



CONTENTS. 



Solanacese 

Dulcamara 

Capsicum 
Atropacese 

Belladonna — A tropine 

Hyoscyamus 

Stramonium 

Tobacco 
Scrophulariacese 

Digitalis 

Leptandra 
Labiata? . 

Rosemary 

Lavender 

Peppermint — Menthol 

Spearmint 

Thymol . 

Hedeoma — Pennyroyal 

Marrubrum — Horehound 

Melissa — Balm 

Origanum — Wild Marj 

Salvia — Sage . 

Scutellaria — Skull-cap 
PedalaceaB 

Oleum Sesami 



29 

PAGE 

834 

834 

835 
835 
835 
840 
841 
842 
844 
844 
851 
851 
851 
852 
853 
853 
854 
855 
855 
855 
856 
856 
856 
856 
856 



CHAPTER XXXI Y. 

Class I., Exogen^ (continued), Sub-Class IV., Apetal^, pp. 857-881. 

Polygonacese 857 

Rheum — Rhubarb 857 

Ruruex — Yellow Dock 858 

Phytolaccaceae 859 

Phytolacca — Poke Berry 859 

Chenopodiacese 859 

Chenopodium — American Wormseed 859 

Myristicacese 860 

Myristica — Nutmeg ' 860 

Macis— Mace 861 

Lauraceae 861 

Cinnamon 861 

Coto 862 

Camphor 862 

Monobromated Camphor 864 

Sassafras ■ 864 

Nectandra — Bebeeru 865 

Aristolochiaceie . . . . . . . . . . . . 865 

Serpentary 865 

Asarabacca . .- . 866 

Santalacese 866 

Oleum Santali . . . . . . . ■• . - .866 

Euphorbiacea? 866 

Cascarilla ............ 



30 



CONTEXTS. 



Euphorbiaceae — (continued), 
Stillingia 
Croton Oil $ . 
Castor Oil 
Kamala 
Piperaceae 

Pepper — Piperine 
Cubebs . 
Matico . 
Salicaceae . 

Salix — Salicin 
Juglandaceie 

Jaglans — Butternut 
Hamamelaceae . 

Hamamelis 
Balsamilhue 

Styrax . 
Cupuliierse 

Quercus — Oak 
Galls . 
Tannic Acid . 
Gallic Acid . 
Castauea — Chestnut 
Urticaceae 

Ulmese . 

Ulmus 
Mores . 

Morns — Mulberry 
Artocarpeae 

Ficus — Fig 
Caunabinese . 

Cannabis Indica — Indian Hemp 
Cannabis Americana — American Cannabis 
Hamulus — Lirpulus — Hop 



PAGE 

867 

867 
868 
869 

870 

870 

871 

872 

872 

872 

873 

873 

873 

873 

874 

874 

874 

874 

875 

875 

877 

878 

878 

878 

878 

878 

878 

879 

879 

879 

879 

879 

880 



CHAPTER XXXV. 
EXOGENS (continued), DIVISION II., GYMNOSPEEMS 

Conifers 

Terebinthina Canadensis — Canada Balsam 
Thii> Americannm — Common Frankincense 
Turpentine 

' )il of Turpentine . 



Oil of Scotch Fir . 

Sanitaa ■ 

Oleum Succini— Oil of 

Resin 

Larch Bark 

Burgundy I'itcli . 

( lanada Pitch 

Tar 

oil of Tar 

Thuja Arbor Vii.r 



lllll 



882 
882 
882 
882 
882 
884 
884 
884 
884 
885 
885 
885 
886 
886 
886. 



CONTENTS. 



31 



Coniferse — (continued 
Juniper . 
Savin 



PAGE 

887 
887 



CHAPTEE XXXVI. 



Class II., Endogexs. 



Smilacere .... 

Sarsaparilla . 
Liliacere .... 

Allium — Garlic 

Squill . 

Aloe . . . 

Veratruin Viride . 

Cevadilla — Sabadilla — Veratrine 

Colchicum 
Orchidacese 

Vanilla 

Cypripedium 
Zingiberaceae . 

Zingiber— Ginger . 

Turmeric 
Iridacese .... 

Crocus — Saffron 

Iris 
Palmacese 

Areca 
Aracese .... 

Calamus — Sweet Flag 
Graminaceaa 

Wheat — Flour — Bread — Starch 

Couch Grass . 

Pearl Barley- 
Malt 

Sugar 

Treacle . 

Oatmeal 



888 



890 
890 
893 
895 
897 
899 
899 
899 
900 
900 
901 
902 
902 
902 
903 
903 
903 
903 
903 
903 
904 
904 
905 
905 
906 
906 



CHAPTER XXXVII. 
Sub-Kixgdom II., Cryptogams. 
Filices 

Male Fern 
Lichenes . 

Cetraria — Iceland Moss 

Litmus . 
Fungi 

Ergot 

Ustilago 

Beer Yeast 
Algse 

Chondrus — Irish Moss 



907 
907 
907 
907 
908 
908 
908 
911 
912 
912 
912 



32 



CONTENTS. 



SECTION VI. 



ANIMAL KINGDOM. 



CHAPTEE XXXVIII. 



Class Mammalia .... 
Order Rodentia 

Castor .... 
Order Euminantia 

Musk .... 

Suet .... 

Curd Soap . 

Milk — Koumiss — Milk Sugar 

Pepsin 

Ox Gall 

Keratin 
Order Pachydermata 

Lard .... 
Order Cetaceae 

Spermaceti 

Class Aves 

Order Gallinae 

Egg Albumen and Yolk 

Class Pisces 

Order Sturiones . 

Ichthyocolla — Isinglass 
Order Teleosteae— Family Gadidse 

Cod-liver Oil 

Class Insecta 

Order Hymenoptera 

Honey 

Wax^ .... 
Order Hemiptera . 

Coccus — Cochineal 
order Coleoptera . 

Cantharis— Spanish Flies 
1 Lnnelida .... 

Hirudo— the Leech 

GENERAL [NDEX 

[NDEX or DISEASE8 AND REMEDIES 

BIBLIOGRAPHICAL [NDEX 



PAGE 

913 
913 
913 
913 
913 
914 
914 
914, 915 
916 
916 
918 
918 
918 
919 
919 
920 
920 
920 
920 
920 
920 
921 
921 
922 
922 
922 
923 
924 
924 
925 

927 

027 

!>31 

977 

1015 



MATERIA MEDICA AND THERAPEUTICS. 



INTRODUCTION. 



By Materia Medica we understand a knowledge of the remedies 
employed in medicine. This knowledge may be subdivided into several 
divisions : Materia Medica proper, Pharmacy, Pharmacology and Thera- 
peutics. 

By Materia Medica proper we mean an acquaintance with the 
remedies used in medicine, the places whence they come, the crude sub- 
stances or plants which yield them, the methods by which they are 
obtained, and the means of distinguishing their goodness or purity, or 
of detecting fraudulent adulteration. 

By Pharmacy we mean the methods by which drugs are prepared 
and combined for administration. 

Pharmacology is a knowledge of the mode of action of drugs upon 
the body generally, and upon its various parts. It is of comparatively 
recent growth, but is now one of the most important subdivisions of 
Materia Medica. 

By Therapeutics we understand a knowledge of the uses of medi- 
cines in disease. 

Therapeutics may be either empirical or rational. By empirical we 
mean that drugs are tried hap-hazard, or with little knowledge of their 
action in some cases, and, being found successful, are again administered 
in other cases which seem to be similar. 

Perhaps the best example of the empirical use of a remedy is that of 
quinine in ague. We do not know with certainty what the pathological 
conditions are in this disease, nor how quinine acts upon them; all we 
know is that it has proved useful in cases of ague before, and therefore 
we give it again. 

Rational therapeutics consists in the administration of a drug because 
we know the pathological conditions occurring in the disease, and know 
also that the pharmacological action of the drug is such as to render it 
probable that it will remove or counteract these conditions. 

As an example, we may take the use of nitrite of amyl in certain 
forms of angina pectoris. The obvious symptoms in this disease are 
3 (33) 



34 INTRODUCTION. 

intense pain in the region of the heart, and fear of impending death. 
Sphygmographic tracings of the pulse taken during this condition show 
that the tension within the heart and vessels begin to increase as the pain 
comes on. and reaches such a height that the heart can barely empty 
itself. Observations on animals have shown that nitrite of amyl lessens 
the tension of the blood in the vessels; and we therefore give it in 
angina pectoris with the expectation that it will diminish the tension 
and remove the pain, and we find that it succeeds. 

But this example shows us only the first stage of rational therapeu- 
tics. We have removed by a remedy the pathological condition which 
immediately gives rise to the pain and danger of the patient, but the 
antecedent alterations of the heart, blood-vessels, and nervous system, 
which led to the occurrence of the pain,' are unaltered by the remedy. 
In order that our therapeutics should be completely successful, we must 
seek still further for something which will restore the circulation and 
nervous system to its normal condition and bring the patient back to a 
state of perfect health. But sometimes this is impossible. The organic 
changes which have occurred in the course of the disease may be so 
great, that we can hardly hope that any remedy will ever be discovered 
sufficiently powerful to remove them. We must therefore try to pre- 
vent them. 

Preventive medicine, or prophylaxis, is daily becoming more im- 
portant, and, probably before the end of this century, medical men will 
be employed more to prevent people from becoming ill than to cure 
them when disease has become fairly established. 

The advance of this branch of medicine has been greatly aided by 
the recent increase in our knowledge of the life-history of microbes 
and their action in causing disease. Our power to prevent disease will 
become greater when we know accurately the action of various drugs in 
destroying these microbes or preventing their growth. 

Pharmacology has made such rapid advances of late years that it 
is exceedingly difficult for many men who are engaged in practice to 
understand thoroughly either the methods by which it is studied, or its 
results. Many students also, although they may be able to pass a good 
examination in physiology, find it difficult to apply their physiological 
knowledge to pharmacology; and therefore in discussing the action of 
drugs upon the various functions of the body, I have sometimes entered 
more fully into the physiology of those functions than may seem to some 
at all either necessary or advisable. 

In discussing pharmacological questions, we are accustomed to speak 

of the action of a drug on the body, or on its various parts, but we 

remember the effect produced is not due to a one-sided action — 

that what we actually mean is the Re-action between the drug and the 

Various part- of the body. 

In some instances we know that the drug itself is changed in the 

body, as well as the function of the body modified by the drug; and 

in thoa where the drug itself is eliminated from the body 

apparently unaltered, it is probable that it lias entered into various 

chemical combinations within the body while circulating in the blood or 

:it in the tissues. 



SECTION I. 



GENERAL PHARMACOLOGY & THERAPEUTICS. 



CHAPTER I. 

GENERAL RELATIONS BETWEEN THE ORGANISM AND 
SUBSTANCES AFFECTING IT. 

In discussing the inter-action between the animal organism and the 
substances which act upon it, it may be well to take a slight glance first 
at the substances which compose its environment, although these will be 
afterwards considered more in detail. 

Of the elements composing the earth on which we live we at present 
know about seventy whose existence appears well established. They are 
as follows : — l 



Name of Element. 


Symbol. 


Atomic 
weight. 


Atomic 
weight very 
accurately 
determined. 


* 2 Aluminum, ^H 


Al 


27 


27-009 


s Antimony, 
A?°senic, 








Sb 

As 


120 

75 


119-955 

74-918 


Barium, 










Ba 


136-8 


136-763 


4 Bismuth, 










Bi 


207-5 


207-523 


5 JBoron, 










B 


10-9 


10-941 


6 Brornme, 










Br 


79-8 


79-768 


7 Cadmium, 










Cd 


111-8 


111-835 


8 C8esium, 










Cs 


132-6 


132-583 












•„.*.„„ CIA T?A 


• •• rnj,„ ^, 


. 



1 From Remsen's Theoretical Chemistry, 2d Ed., xi-xii. The non-metallic ele- 
ments are distinguished by italics. 

*The following atomic weights accepted in Great Britain differ from those 
adopted in the United States : 2 27'3— 3 122-0— 4 210'0— 5 11'0— 6 79'75— 7 111'6— 8 133-0. 

(35) 



36 PHARMACOLOGY 


AND THERAPEUTICS. 










Atomic 


Name of Element. 


Symbol. 


Atomic 
weight. 


weight very 
accurately 
determined. 


* Calcium, .... 


Ca 


40 


39-99 


Carbon, 








C 


12 


11-9736 


l) Cerium, 








Ce 


140-4 


140-424 


Chlorine, . 








CI 


35-4 


35-37 


10 Chromium, 








Cr 


52 


52-009 


"Cobalt, 








Co 


58-9 


58-887 


Columbium, 








Cb 


93-8 


93-812 


l2 Copper, 








Cu 


63-2 


63-173 


l3 Didvmium, 








Di 


145-4 


145-4 


14 Erbium, . 








E 


166 


165-891 


lr> Fluori?ie, . 








F 


19 


18-984 


1(i Galliuni, . 








Ga 


70 


69-9 


17 Glucinum, (Beryl 


lium) 






Gl(Be) 


9 


9-085 


Gold, 








Au 


196-2 


196-155 


Holmium, . 








— 


— 


— 


Hydrogen, . 








H 


1 


1 


Indium, 








In 


113-4 


113-398 


Iodine, 








I 


126-6 


126-557 


13 Iridium, 








Ir 


192-7 


192-651 


Iron, 








Fe 


56 


55-913 


19 Lanthanum, 








La 


138-5 


138-526 


Lead, 








Pb 


206-5 


206-471 


Lithium, 








Li 


7 


7-0073 


Magnesium, 








Mg 


24 


23-959 


20 Manganese, 








Mn 


54 


53-906 


Mercury, 








Hg 


199-7 


199-712 


Molybdenum, 








Mo 


95-5 


95-527 


21 Nickel, 








Ni 


58 


• 57-928 


Niobium, . 








Nb 


94-0 





Nitrogen, . 








N 


14 


14-021 


"'-'< Osmium, 








Os 


198-5 


198-494 


Oxygen^ 











16 


15-9633 


Palladium, . 








Pd 


105-7 


105-737 


Phosphorus^ 








P 


31 


30-958 


-'Platinum. . 








Pt 


194-4 


194-415 


-'Potassium, . 








K 


39 


39-019 


Rhodium, . 








Rh 


104 


104-055 


Rubidium, . 








Rb 


85-3 


85-251 


^Ruthenium, 








Ru 


104-2 


104-217 


Samarium, , 








Sm 


150 


150-021 


Scandium, . 








Sc 


44 


43-98 


S( h a I a in. . 








Se 


78-8 


78-797 


- Si 1 iron. 








Si 


28-2 


28-195 


The following atomic weights accepted Ln Great Britain differ firoi 


i those adopted 


in 1 lie United Slate- "1 1 12— 10 52'4— ' '58-6— 12 63'0— 13 147'0— u 1690— 


15 19-1— 1,! 68-?— 


1 '1!JG 7 — ly 1390- 


- w 54-( 


3— "58 


6- 


-"198-6— ' 23 196 


7— 2 '39-04— 25 1 


03-5— 2(5 78'0 — 



27 28-0. 



GENERAL RELATIONS. 



37 









Atomic 


Name of Element. 


Symbol. 


Atomic 
weight. 


weight very 

accurately 

determined. 


* Silver, 


Ag 


107-7 


107-7 


Sodium, 










Na 


23 


22-998 


28 Strontium, 










Sr 


87-4 


87-374 


Sulphur, 










S 


32 


31-984 


Tantalum, 










Ta 


182 


182-144 


Tellurium, 










Te 


128 


127-96 


Terbium, 
















— 


Thallium, 










Th 


203-7 


203-715 


29 Thorium, 










Th 


233-4 


233-414 


Thulium, 













— 


— 


30 Tin, . 










Sn 


117-7 


117-698 


31 Titanium, 










Ti 


49-8 


49-846 


32 Tungsten, 










W 


183-6 


183-61 


Uranium, 










U 


239-8 


239-8 


Vanadium, 










V 


51-3 


51-256 


Ytterbium, 










Yb 


172-8 


172-761 


^Yttrium, 










Y 


89-8 


89-816 


Zinc, . 










Zn 


65 


64-9045 


^Zirconium, 










Zr 


89-4 


89-367 



Nature of the Elements. 

Considerable additions have been made to the number of elements during late 
years. The reason of this is that the spectroscope has indicated the presence of 
metals previously unknown, and by the use of proper means they have been 
obtained in a separate condition. These substances are termed elements because 
we do not at present know how to split them up in such a manner as to prove 
that they are compounds. But it is not improbable that they are compounds, 
just as we now know that potash and soda are compounds; although before Sir 
Humphrey Davy split them up into oxygen and a metal, they were supposed to 
be elements. Indeed, recently much evidence has been brought to show that 
the substances which we call elements are really compounds. 

It is from an examination of the spectroscopic character of the elements at 
different degrees of temperature that Lockyer has been able to obtain sufficient 
data to justify the definite formulation of the hypothesis that all the 
elements we know are really compounds, or to speak perhaps more precisely, 
are really different forms of aggregation of one kind of matter. 1 Accord- 
ing to this hypothesis the matter of which the universe is composed was at one 
time equally distributed through space, and uniform in kind. The atoms then 
coalesced in various groups of two, three, or more ; and these, again grouping 
themselves together still further, formed aggregates of more and more complex 
composition. These aggregates are, it is supposed, the elements with which we 
are acquainted. Most of those complex molecules are perfectly stable at ordi- 
nary temperatures ; and so their composition remains constant under the condi- 
tions usual at the surface of this earth. 



*The following atomic weights accepted in Great Britain differ from those adopted 
in the United States: 28 87'2— 29 231'5— 30 117-8— 31 48'0— 32 184*0— 33 93-0— 34 90-0. 
1 Lockyer, Phil. Trans., 1874, p. 492, &c. 



38 PHARMACOLOGY AND THERAPEUTICS. 

But when they are subjected to increased temperatures in the laboratory, 
rising from that of the Bunsen lamp to the electric arc, and then to the electric 
spark or to still higher temperatures in the sun, their spectroscopic appearances 
give evidence of decomposition into simpler molecules. When the elements are 
subjected to cold and pressure the molecules which compose them come closer 
together, and we get them forming a solid substance. Heat tends by communi- 
cating vibrations to them to shake the molecules further apart, and to produce 
a liquid condition. Still greater heat shakes the molecules further apart still, 
and produces a gaseous condition. 

In all those conditions the molecules of the element become more complex 
by reduction of temperature or increase of pressure, and simpler by increase in 
temperature or reduction in pressure. 1 Exceedingly great heat or electricity 
appears to shake apart still further the constituents of the element, so as to 
resolve it into simpler combinations of the elementary substance of which, 
according to the hypothesis, it is composed. 

This shaking apart of the component elements is known to exist in compounds, 
and to it the name of dissociation has been given. Thus when chalk or 
limestone is exposed to the action of heat it becomes dissociated into carbonic 
acid and lime, CaC0 3 == CaO -j- C0 2 . This process is readily reversible by 
reversing the conditions. Thus the lime and carbonic acid which are dissociated 
by heat readily recombine in the cold CaO -j- C0 2 = CaC0 3 . 

When matter is solid the molecules of which it is composed are supposed to 
be large and close together. When in the state of vapor or gas, these mole- 
cules are smaller and much further apart. 

Solid, liquid, or densely gaseous matter, when its molecules are agitated by 
heat, gives a continuous spectrum. Gaseous and vaporous matters, when their 
molecules are agitated at lower pressures or higher temperatures by heat or elec- 
tricity, give a discontinuous spectrum consisting of bands or lines. 

Between those extremes we have, as a rule, three other intermediate kinds of 
spectra : first, a continuous spectrum in the red ; next, a continuous spectrum 
in the blue ; next, a fluted spectrum, and after that the line spectrum already 
mentioned. 

In all those kinds of spectrum, however, we are supposing that the elementary 
molecules are still intact, they are only more or less separated. 

Compound bodies, like simple bodies, give definite spectra. The spectrum 
of a simple metal consists of lines which increase in number and thickness as 
the pressure of the vapor or its quantity in a given space is increased. The 
Bpectrum of a compound body consists chiefly of channelled spaces and bands 
which increase in the same manner. The greater the number of molecules in a 
cubic inch or cubic millimetre, and the more violently they are agitated, the more 
complex is the Bpectrum until it becomes continuous. 

The smaller the number of molecules in a given space, the more simple is the 
spectrum, which then consists of a few lines only. 

When a compound is exposed to heat, so as to dissociate it into its component 

parte, the spectroscopic bands characteristic of the compound become thinner, 

and the lines of* the metal increase in number, as shown in the accompanying 

d iagra m, where the bands exhibited by calcium chloride in the flame of a Bun- 

burner disappear, and are replaced by lines only, when an electric spark is 



ording to another hypothesis, bodies are supposed to have molecules of one 
degree of complexity, and the difference between solid, liquid, and gaseous bodies 
la supposed to depend on the difference in the free path of the molecule. But ac- 
cording to the new riew, the difference in Hie complexity of the molecule itself is 
sufflcienl to explain the phenomena. 



GENERAL RELATIONS. 



39 



used. When an element is treated with more and more heat and electricity it 
likewise gives exactly the same kind of evidence of dissociation — bands dis- 



i m 




1 |j 1 



Fig. 1.— Spectrum of calcium chloride. (1) In the flame of a Bunsen's burner, showing the chan- 
nelled spaces and bands of a compound. (2) In an electric spark, showing the lines of the element 
calcium. (After Eoscoe). 

appearing, and lines becoming thinner. Besides this, new lines make their 
appearance with every large increase of temperature. 

This behavior of the element appears to show that it is also a compound, but 
that it is stable under ordinary conditions, and is only dissociated at a high 
temperature. 

Other proofs of this hypothesis are derived from a comparison of the spectra 
of the elements as observed in our laboratories with their spectra in the sun. 

A comparison of the two hypotheses shows us that as on the old 
hypothesis each element represents a species and is unvariable, its spectrum 
ought to be always the same in our laboratories and in the sun ; and the same 
in sun-spots as in prominences, and the same at all periods of the sun's activity. 

Under the new hypothesis the spectra of metals in our laboratories and in 
the sun should not resemble each other ; they should be different in sun-spots 
and in prominences, because the spot is cooler than the prominence ; and they 
should vary at the time of the sun's activity because the sun is hotter at the 
maximum of the sun-spot period, and therefore there should be a greater 
amount of dissociation amongst the elements at that period. 

As a matter of fact we find that the spectra in our laboratories and in 
the sun do not resemble each other (Fig. 2) ; that those of the same element 



§ 



Q 



FEEBLE SPARK 



Fig. 2. — Diagram of the spectrum of lithium under various conditions of temperature. (After 
Lockyer, Boy. Soc. Proc, Dec. 12, 1878). 

in the sun-spot and prominences are as dissimilar as of any two elements ; and 
that the spectra of the elements in the sun do vary with the maximum of the 
sun-spot period. 

On the old hypothesis the spectra of prominences should also consist of lines 
familiar to us in our laboratories, because solar and terrestrial elements are the 
same, while, according to the new hypothesis, the spectra of prominences should 
be unfamiliar, because the prominences represent outpourings from a body hot 
enough to prevent the atoms of which our elements are composed from coming 
together. 

As a matter of fact, the lines in the prominences, with the exception of those 
of hydrogen, magnesium, calcium, and sodium, are either of unknown origin, or 
are feeble lines in the spectra of known elements. Spectroscopic observation, 
therefore, leads to the belief that the so-called elements are really compounds, 
the component parts of which are kept apart by high temperatures in the sun 
and stars, but unite when the temperature decreases. 



40 PHARMACOLOGY AND THERAPEUTICS. 

By the powerful vibrations imparted to them by the electric spark, they may 
be dissociated in the laboratory, but, as no means has yet been devised of sepa- 
rating the components, they again unite to form the original body, just as 
hydrogen and oxygen, into which steam is dissociated by passing it through a 
strongly heated tube, almost instantly again combine to form water unless they 
are separated by means of the more rapid diffusion of hydrogen through a 
porous tube. 

The difficulty in accepting this evidence lies in the fact that we have hitherto 
been unable to isolate the substances into which the elements are supposed to be 
dissociated ; as these after their dissociation at once recombine and again form 
the original substance. 

One proof, however, that the supposed components of the element calcium 
may remain permanently separated, is afforded by the fact that in the spectra 
of two stars, Sirius (Fig. 3) and a Lyrae, which are very bright, and probably 
very hot, only one of the ultra-violet lines of calcium is represented. 

But we have also other evidence of the compound nature of the elements, 
which, although it was not sufficient of itself to force us to abandon our old 
ideas of their simple nature, is yet strongly corroborative of the spectroscopic 
evidence. Thus we find that oxygen is broken up by electricity, and that the 
atoms of which its molecules are composed, rearrange themselves so as to form 
what is to all intents and purposes a new element, ozone, having a much closer 
resemblance to chlorine than to oxygen in its activity, although its compounds with 
metals appear to be identical with those of oxygen. 



,i ARC 

I FLAME~ 



Fig. 3.— Diagram of the spectrum of calcium under various conditions of temperature. In the spec- 
trum of Sirius the line K is absent, while it is very strongly marked in the solar spectrum. 

At a high temperature its atoms are again dissociated, and recombine to form 
ordinary oxygen. When it combines with other substances, the heat of com- 
bination appears to be sufficient to dissociate the atoms of ozone (0 3 ), so that in 
the compound we meet with simple oxygen, 0. 

Phosphorus also affords us an example of an element which occurs in two 
forms, so different that we should call them distinct bodies, were it not that 
we find that one can be transformed into the other. 

The two forms, red and yellow phosphorus, differ from each other, not only 
in their color, but in their density, specific heat, readiness of combustion, 
and beat of combustion. They differ also in the yellow phosphorus being ex- 
ceedingly poisonous, whereas the red phosphorus is not poisonous. 

They arc in many respects, then, different bodies, but we have hitherto been 
content to call them allotropic forms of the same element. 

In combination we find that phosphorus is sometimes pentad and sometimes 
triad', that its compounds with oxygen are sometimes poisonous, at other times 
not. Thus orthophosphoric acid. BLP0 4 , is not poisonous; pyrophosphoric acid, 
II Pj0 7 j and metaphosphoric arid, III'O,, are both poisonous. 

The most striking example, however, is carbon, which we not only find in 
throe forms, differing enormously from each other, as diamond, charcoal, and 
graphite, but which we find in various compounds playing the most varied parts. 
This we .it preeenl explain by saying that carbon unites with itself in the form- 
ation of the various radicals: and thus comes to form what are practically new 
elements. 



GENERAL RELATIONS. 41 

Another example is afforded us by ammonia, the salts of which are just as 
well characterized as those of potash or soda. The amalgam which it forms 
with mercury possibly indicates that we have in it also a real metal, ammonium, 
corresponding to sodium or potassium, though this is uncertain. 

The three metals, sodium, potassium, and ammonium (if it exist), agree in 
the readiness with which they are oxidized, so that it is difficult to preserve the 
pure metal, although the oxide is stable. They differ, however, in the oxides of 
potassium and sodium being solid, and that of ammonium gaseous. Ammonium 
has not been isolated, and it is put down in the text-books as a hypothetical sub- 
stance, but ammonium salts are tangible enough, and the question which we 
have to keep before us is, whether potassium, sodium, and all the other so-called 
elements, are not in reality compounds like ammonium. 

Some people still regard species as immutable, and look upon Darwin's hy- 
pothesis of evolution as unproven. 

The evidence in favor of the evolution of elements from one simple form of 
matter, is as yet, perhaps, much less strong than that in support of the evolu- 
tion of species ; but it has this advantage, that it explains certain phenomena 
which have hitherto been very perplexing. 

It may be at least convenient in discussing the physiological action of drugs 
to bear this hypothesis in mind, and to remember that what we have hitherto been 
accustomed to call elements, may be really like the so-called organic radicals in 
constitution, with this difference, that we can split up organic radicals with toler- 
able facility, while we cannot do this — at least to any great extent — with 
elements. 

It also shows us that we must as pharmacologists pay attention to molecular 
as well as to empirical composition and take into consideration crystalline form and 
physical aggregation in all observations regarding the relations between elements 
or compounds and living organisms. It is not sufficient for example to speak of 
the action of phosphorus on the organism as if this were invariable, for it varies 
with the molecular composition of the body in the red or yellow form, and iso- 
meric organic substances may be utterly different in action. 



Classification of tlie Elements. 

The vegetable and animal kingdoms are divided into various groups. For- 
merly, men tried to arrange them in linear succession so that there should be an 
unbroken line from the lowest to the highest members of the vegetable king- 
dom, thence to the lowest member of the animal, and onwards up to the highest 
member of the animal kingdom. Such an arrangement as this, however, was 
found to be unnatural. Instead of the highest members of the vegetable king- 
dom being connected with the lowest members of the animal kingdom, it is found 
that the lowest members of each kingdom are closely connected, and that the 
divergence becomes greater as development proceeds towards the highest mem- 
bers in each kingdom. The doctrine of evolution at once rendered this ar- 
rangement natural and easily understood. 

Starting from one common point of origin in structureless protoplasm, the 
various organisms became more and more unlike in each successive stage of 
development, their resemblance being at all only recognizable in their embryonic 
condition. 

Yarious attempts have been made to arrange inorganic substances in natural 
orders. One mode of arrangement is according to their atomic weight 
— as in the following table : — 



42 



PHARMACOLOGY AXD THERAPEUTICS. 





it 
'3 






m 






3 






'So 




-• 


£ 


§ 




£ 


e 




£ 


% 

c 


^ 


^ 




= 


~ 


5 


p 





s 


— 





p 





























- 
















.0 




R 






C 




— 





Sp 


5 





03 




O 




























— 


<; 


"" 


— 


< 


" 


w 


< 


" 


S 


<; 


P 


H 


1 




Ca 


40 


1 


Ce 


92 


2-5 


V 


137 





Li 


7 


6 


Ti 


50 


10 


La 


92 





Ta 


138 


1 


Gor\ 
Be j 


9 




Cr 


52-5 


2-5 


Di 


96 


4 


W 


184 


46 




Mn 


55 


2-5 


Mo 


96 





Nb 


195 


11 


B 


11 


2 


Fe 


56 


1 


Eo 


104 


8 


Au 


196 


1 


C 


12 


1 


Co 


5S-5 


2-5 


Eu 


104 





Pt 


197 


1 


N 


14 


2 


Ni 


58'5 





Pd 


106-5 


2-5 


It 


197 








16 


2 


Cu 


63-5 





a 


108 


1-5 


Os 


199 


2 


Fl 


19 


3 


Y 


64 


0-5 


112 


4 


Hg 


200 


1 


Na 


23 


4 


Zn 


65 


1 


Sn 


11s 


6 


Tl 


203 


3 


Mg 


24 


1 


As 


75 


10 


U 


120 


2 


Pb 


207 


4 


Al 


27-5 


3-5 


Se 


79-5 


4-5 


Sb 


122 


9 


Bi 


210 


3 


Si 


23 


0-5 


Br 


80 


0-5 


I 


127 





Th 


238 


28 


P 


31 


3 


Rb 


85 


5 


Te 


129 


2 








S 


32 


1 


Sr 


S7'5 


2-5 


Cs 


133 


4 








CI 


35-5 


3-5 


Zr 


89-5 


2 


Ba 


137 


4 








K 


39 


3-5 





















From this it will be seen that the atomic weights of the different elements 
form a series, the members of which in most cases differ from one another by 
1, 2, 3. or 4. There are a few exceptions in which the differences are much greater, 
and these probably represent blanks which may yet be filled up as our knowledge 
of the elements increases. This mode of classification, however, reminds us of 
the Linnasan system in plants, and is artificial rather than natural. In it, the 
elements which are placed close together possess very different properties, whereas 
those which are separated from each other present considerable resemblances. 

The first important attempt at a natural classification of the elements 
was made by Xewlands in 1864. 1 He then arranged them in groups, between 
the members of which there was a close connection in regard to their chemical 
properties, and a curious relation in regard to their atomic weights. These 
presented differences which were generally multiples of the atomic weight of 
hydrogen, and generally equal to, or multiples of. that of oxygen. 







Difference. 


Member of a Group 


One immediately above 
the preceding. 






haviDgLowest Equivalent. 










H = I. 


= 1. 


Magnesium 24 


Calcium 40 


16 


1 


Oxygen 16 


Sulphur 32 


16 


1 


Lithium 7 


Sodium 23 


16 


1 


Carbon 12 


Silicon 28 


16 


1 


Fluorine 19 


Chlorine 355 


165 


1031 


Nitrogen 14 


Phosphorus 31 


17 


1062 


Lowt-M term of Triad 


Highest term of Triad. 






Lithium 7 


Potassium 39 


32 


2 


MaLMH-siuni 24 


Cadmium 112 


88 


55 


Molybdenum 96 


Tungsten 184 


88 


5*5 


Phosphorus 31 


Antimouv 122 


91 


5687 


Chlorine 35*5 


Iodine 127 


915 


5718 


Potassium '.'<■> 


1 -nun 133 


94 


5-875 


Sulphur 


Tellurium 129 


97 


6062 


Calcium 40 


Barium 137 


97 


6062 



New-lands, Chemical Jlfaw, July 30, 1864. 



GENERAL RELATIONS. 



43 



A curious relationship had also been pointed out by M. Dumas 1 between the 
members of the potassium group, their atomic weights being equal to multiples 
of those of lithium and potassium added together. 

Li + K = 2Na, or in figures, 7 + 39 = 46 
Li + 2K = Eb " " 7 + 78 = 85 

2Li + 3K = Cs " " 14 + 117 = 131 

Li + 5K = Tl " " 7 -f- 195 = 202 

3Li + 5K = 2Ag " " 21 + 195 = 216 

A similar relation was also pointed out by Mr. Newlands between lithium 
and the calcium group ; as follows : 

Li + Ca = 2Mg, or in figures, 7 + 40 = 47 

Li + 2Ca= Sr " " 7+80= 87 

2Li + 3Ca = Ba " " 14 + 120 = 134 

Li + 5Ca = Pb " " 7 -f 200 = 207 



But Mr. Newlands's most important table is the following one, in which he 



has arranged the elements in ten series : — 









Triad. 






Lowest 






Highest 










term. 






term. 




I. 




Li 7 


+ 17 -Mg 


24 


Zn 65 


Cd 112 




II. 




B 11 










Aul96 


III. 




C 12 


+ 16 = Si 


28 




Sn 118 




IV. 




N 14 


+ 17 =P 


31 


As 75 


Sb 122 


+ 88 = Bi 210 


V. 




O 16 


+ 16 = S 


32 


Se 79-5 


Te 129 


+ 70 = Os 199 


VI. 




F 19 


+ 16-5 = CI 


35-5 


Br 80 


T 127 




VII. 


Li 7 


4- 16 = Na 23 


+ 16 =K 


39 


Kb 85 


Cs 133 


+ 70 = Tl 203 


VIII. 


Li 7 


+ 17 = Mg 24 


+ 16 = Ca 


40 


Sr 87-5 


Ba 137 


+ 70 = Pb 207 


IX. 






Mo 


96 


V 137 


W 184 




X. 






Pd 


106-5 




Pt 197 





Seven of these series nearly correspond in their first members with those of 
Mendelejeff, to whom and to Lothar Meyer we owe the complete development 
of this mode of classification. Mr. Newlands also pointed out that the eighth 
element starting from a given one, was a kind of repetition of the first, like the 
eighth note of an octave in music. 2 

Mendelejeff has not only greatly developed this system of classification, but 
has afforded convincing proof of its value by not only predicting the existence 
of an unknown element, but actually describing its physical characters and 
chemical reactions — a prediction the correctness of which was proved by the 
discovery of gallium, and by the agreement of its characters and reactions with 
those which Mendelejeff had foretold. 

The various members of the animal kingdom can all be arranged in a few 
series: Protozoa, Coelenterata, Annuloida, Annulosa, Molluscoida, Mollusca, 
and Vertebrata. These series all differ^ more or less from one another, but a 
certain agreement is observed between their members, and similarly the 
elements may be arranged in series. 

Mendelejeff points out, that if we take those elements having the lowest 
atomic weight, and omit hydrogen, between which and lithium there is a great 



1 Dumas, quoted by Newlands, op. cit. 

2 Chem. News, Aug. 20th, 1864, p. 94. 



44 PHARMACOLOGY AND THERAPEUTICS. 

gap, the seven elements, lithium, glucinum, boron, carbon, nitrogen, oxygen, 
and fluorine, may be regarded as typical elements forming a series representing 
the lowest members of seven groups. The next seven elements may be arranged 
in a similar way : — 

Li = 7 : G = 9-4 : B = 11 : C = 12 : N = 14 : O = 16 : F = 19 
Na = 23 : Mg = 24 : Al = 2T3 : Si = 28 : P = 31 : S = 32 : CI = 35*5 

To each group of seven elements Mendelejeff gives the name of a sniall 
period or series. In each series the characters of the elements vary gradually 
and regularly as their atomic weights increase. This variation is periodical, 
i. e., varies in the same way in each series, so that the elements which have 
corresponding places in each series, correspond also to a certain extent in 
their properties, and form similar compounds. The atomicity is least in the 
first, and greatest in the last members of each series. Thus the first members 
of the series form monochlorides, the second dichlorides, the third trichlorides, 
and so on. 

In the accompanying table R represents radical or element, and R 1 indicates 
that the element is monatomic, so that one atom combines with one of CI to 
form a monochloride, RC1. R u indicates that the element is diatomic, and 
so on. 









-* CO 


"* 00 




i> C5 










to CO 


o o 




OS OS 










II II 


r-t r-l 




rH rH 










II II 


1 


II II 




1— 1 
1— 1 
1— 1 

> 








ss 


r-l * 


1 


"3 


1 


ft 


II 














1 


3 
2 


Pntf 






coos 

lO lO 


is 

" r-t 


1 


OS OS 
rH rH 










II II 


II II 


1 


II II 










O • -h 


P^H. 




CQ -+J 










fe£ 


KPh 




OPh 








V 3 


o 


i> 




1 








LO 


00 


<M 




1 




,_; 




CO 


- 1 


r-l 












Jl 

5 








ft : S i : p 

SPhPhPh 

2 

O 


OS 
tH 

II 


"5 a 

II 

p 


o w 

rH 

II 










fr 




3 


1 


1 


1 


1 






cm 


00 


lO 




1 1 








CO 


J> 


CM 




1 




l-H 

oiflOO 

=>-p 'P -p 

gpHp3tf 

O 


CO 
r-( 

II 


II 


II 
II 


Ci 03 

II H 

o 




00 

II 


O 
CM 

II 




o 






3 


1 


£ 


P 






T-i 


lO 


CM 




1 °° 








CO 


i> 


CM 




o 








II 

PL. 


II 

CO 


r-l 




CM 




MO O 
gpHpHpH" 


rH 


^ II 

II " 




a ! 

1 M 




o 


II 




II 










,Q 




c3 






fc 




> 


£ 


1 


H 


1 






00 


cm 


00 




1 *> 








CM 


}> 


rH 




o 








II 

w. 


II 

00 

II 


T-\ 




CM 




ftWoo 


CM 

r-t 


II 

s d 

II 


o 

II 


I II 

II S 


rH 
CO 
CM 

II 


e 


II 




03 


c8 








(H 


O 


J 


r3 




o 




H 


CsJ 


o- 


i>. 


H 






CO 


00 


CO 




1 "* 




i-5 


r-t 
tH 


CM 

II 

< 


CO 

II 

-* 1 

II 


00 II 

00 fl 

II M 


00 
CO 
r-i 

II 


o 

CM 

00 II 

- I 

II ^ 




O 


• II 




II 


4^ 


•iH 


S-l 








1 


!* 


P 


H 


1 




w 




1 


o- 


o-. 


c>- 


1 




"* 


•* 


lO 


CM 




1 ° 






di 


CM 


CO 

II 


T-{ 




1 s 




i— i 

ft -? 

s oo 

O :3 iS 


II 

pq 


II 


II 

oo O 


rH 


II 




5 «rt 


tl 

o 




II 


II 


II 






O 






tH 

m 


C3 

PQ 


i 


1 




r- 


CO 


^^ 


_, 




_ v t s 








CM 


CO 


00 




1 <?i 






II 

w 

II 




CO 


o 




05 




h-5 

ft Ort 

2 tftf 


1 


II 

7 a 


II ^ 


CO 
CO 
r-i 

II 


-* rH 

II 
* 

T <1 












rO W 


02 


"-- 


, 




13 




M 


M 


o 


1 


1 


•sauag 


tH CM 


CO 


■<* in 


CO 1> 


00 Ci O rH 
rH rH 


CM 



a 

02 »fH 

^^ 
.SO 

^° 

«+H >> 

d o 

O f« 
c3 © 
O^ 

^ Ph 
«^ 

OCfl 

02 a 

O 03 

i ^ 

%% 

■*= d 

p ce 

03 



bJD^ 



•S d 



p 


c3 


p 


03 


r^ 




a 


OS 


c8 


% 


d^ 


o 


-H 




r- 1 




1— 1 


p^ 


M 


o 


> 




Ph 


O 


P 




o 


p 






O 


^d 

03 


p 




"~ 


p 


OS 

42 
<13 


03 


P 


c5 


0) 
rP 


P 




< 


c 

+3 


'd 

p 

e8 


■V 
03 


tl 


Ph 


< 


03 






d 


k» 


u 


p 

o3 


* 


s 




p 



46 PHARMACOLOGY AND THERAPEUTICS. 

But a difference is to be observed between trie even and the uneven series. 
Corresponding members of even series, such as the fourth and sixth, agree with 
each other, and members of uneven series like the fifth and seventh agree. 
This agreement is greater than between the members of an even series, such 
as the fourth, and those of an uneven series like the fifth, although the fifth 
is more closely placed to the fourth than the sixth is. Thus Ca and Sr belong- 
ing to the fourth and sixth series, have a greater resemblance to each other than 
they have to Zn or Cd, which belong to the fifth and seventh series, and these 
metals on the other hand have a greater resemblance to each other than they 
have to Ca or Sr. The members of even series are less metalloidal or more 
metallic than those of uneven series, e. g., Mn of the fourth series is less metal- 
loidal than Br of the fifth series. In the even series the metallic or basic char- 
acter predominates, whilst the corresponding members of the uneven series 
rather exhibit acid properties. The members of the even series, so far as 
we know, form no volatile compounds with hydrogen or alcohol radicals, 
while the corresponding members of the uneven series do form such com- 
pounds. 

The last members of the even series resemble in many respects (in their 
lower oxides, etc.), the first members of the uneven series, thus chromium and 
manganese in their basic oxides are analogous to copper and zinc. But there 
are great differences between the last members of the uneven series (haloids) 
and the first members of the next even series (alkali metals). Now between the 
last members of the even series there occur, according to the order of atomic 
weights, all those elements which cannot be included in the small periods. 
Thus between Cr and Mn in the one series, and Cu and Zn in the next, 
there come the elements Fe, Co, Ni, and in a similar way after the sixth series 
come Ru, Rh, Pd, and after the tenth Os, Ir, Pt. Mendelejeff gives the name 
of a long" period to two such series with three intervening members, forming 
seventeen in all. 

From the difficulty of arranging all the elements in this system, it cannot 
be regarded as yet perfect, but the fact that Mendelejeff was able so correctly to 
foretell the properties of gallium, shows that it must contain a large element of 
truth. At the time that he drew up his table there was a blank in the third 
group of the fifth series. 

The relationships of the metal which Mendelejeff believed would fill this 
gap will be more easily seen by omitting the even series on either side of it, 
and taking only the odd series with which it will, as already mentioned, the more 
closely correspond. 



Series. 


Group II. 


Group III. 


Group IV. 


Group V. 


3 


Mg 


Al 


Si 


P 


5 


Zn 


— 


— 


As 


7 


Cd 


In 


Sn 


Sb 



Aa it -lands between zinc with an atomic weight of sixty-five, and arsenic 
with one of seventy-five, while it is separated from the latter by a blank, its 
atomic ireigkl mnsl be about sixty-eight. As it is atom-analogous with Al, its 
Balta Bhould have a similar constitution. It should form an oxide x„0 3 , and a 
sulphide s ■ S .. \t will bo precipitated from its solution by ammonium sulphide. 
The metal Bhould be easily reduced by carbon or sodium, it should have a spe- 
cific- gravity of 5*9, and decompose water at a red heat. As it belongs to an odd 
series, it Bhould, like /inc. form volatile compounds with organic radicals, and 
form also anhydrous chlorides. 

On the discovery of the metal gallium, it was found to agree in almost every re- 
Bpect with the predictioD of Mendelejeff, and this fact is not interesting to chemists 



GENERAL RELATIONS. 47 

only, but also to pharmacologists. For the great object of pharmacology 

is to obtain such a knowledge of the relations between the physical and chemi- 
cal characters of bodies, and their actions upon the living organism, that we may 
be able to predict their actions with certainty, and to know the modifications 
which alterations in their physical and chemical characters will produce on their 
physiological action. 

Mendelejeff's present classification is imperfect, because we find that by it 
the members of some natural groups, such as those of the earthy metals, are 
separated from one another, although they agree in their chemical characters. 

We find also that metals having similar pharmacological actions, as copper, 
zinc and silver, do not fall naturally together in this arrangement. But, on the 
other hand, we find also that by this classification, elements are brought together 
which do not at first seem to have any resemblance to each other, and are yet 
found by recent investigations to have a physiological connection. Thus mer- 
cury and calcium do not appear to resemble one another, yet Prevost has shown 
that in acute poisoning by mercury, the calcareous matter disappears from the 
bones, and in the process of elimination by the kidneys produces calcification 
of these organs. 1 

Organic Radicals. — Whether the so-called elements be compounds 
or not, it is certain that several of them have the power of uniting with 
themselves and with others in such a way as to form bodies called com- 
pound radicals, which resemble elements in many respects. These groups 
of atoms may enter into and again pass out of combination with other 
substances just as elements do. These radicals are not known in the 
free state. The chief of them are hydroxyl, OH, from which may be 
formed, by replacement of the hydrogen, potassoxyl, KO, and zincoxyl, 
OZnO; amidogen, NH 2 ; imidogen, NH; nitroxyl, N0 2 ; sulphuryl, 
S0 2 ; and phosphoryl, PO. Then come innumerable compounds of 
carbon, among which may be mentioned cyanogen, CN; the radicals of 

CO ] 
the marsh-gas series, methyl, CH 3 , etc. ; carbonyl, CO ; carboxyl, tt f 0, 

important in the formation of acids, &c. 

Chemical Reactions and Physiological Reactions. — Each 
element and each of its compounds has chemical reactions special to 
itself, by which it can be recognized and distinguished from all others. 
The number of these chemical reactions is therefore very great, but 
there are a few reactions which are common to a great number of the ele- 
ments. We shall find that something similar occurs in their physio- 
logical reactions. 

The number of possible actions which may be exerted on the body 
by the elements and their compounds is very great, yet we shall find 
that there are certain physiological reactions which are common to so 
many that their repetition under the head of each drug becomes monot- 
onous. 

Varied as the chemical reactions of the metallic elements are, 
we find that they can be at once divided into two groups by the use of 
hydrogen sulphide or ammonium sulphide, for all of them, with the 



1 Prevost, Eevue Medicale de la Suisse Bomande, p. 553, Nov. 15th ; p. 605, Dec. 
15th, 1882; p. 5, Jan. 15th, 1883. 



48 PHARMACOLOGY AND THERAPEUTICS. 

exception of ammonium, lithium, potassium, sodium, magnesium, barium, 
calcium, and strontium, are precipitated by one or other of these reagents. 
These groups can be subdivided by the use of other reagents into sub- 
groups. The small group, already mentioned, which is not precipitated 
either by hydrogen sulphide or ammonium sulphide, can be divided into 
two sub-groups by the use of carbonate of ammonia, which precipitates 
barium, calcium, and strontium, and does not precipitate the others. 

The other large group, which is precipitated by H 2 S or (NH 4 )HS, 
can also be subdivided in a similar manner. 

The individual members of each sub-group, again, can all be dis- 
tinguished from one another by further reactions. 

The physiological reactions which occur between the elements 
or other compounds and the tissues of the body can also be divided into 
large groups. 

Thus we find that a very great number of substances, when used in 
large quantity, paralyze muscles and motor nerves. This large group 
can again be subdivided into those which paralyze muscle, while affecting 
the nerves but slightly, or those which paralyze the nerves and leave 
muscle uninjured. 

Another large group is that which acts specially on nerve-centres, 
and has little effect either on muscles or motor nerves. This contains 
sub-groups of substances which affect the brain, medulla, or spinal cord 
by exciting, paralyzing, or disturbing the functions. 

Another group is that which affects the secretions, with sub-groups 
of substances affecting the secretions from the sweat and mammary 
glands, salivary, gastric, or intestinal glands, liver, or kidneys. 

Another group still is that which acts chiefly upon the circulation. 

These groups are all more or less distinct, although they, to a certain 
extent, may run into, or overlap, each other. 

Individual members of the same group may differ very widely in 
their physiological action, even when they all finally paralyze muscle, 
nerves, and nerve-centres. For while they may produce the same final 
result, the course of their action will be different, and the symptoms 
they occasion will depend very greatly upon the part of the organism which 
they affect first. Thus atropia and curare both completely paralyze 
motor or efferent nerves, but, while a very large dose of curare is re- 
quired to paralyze the cardiac and vascular nerves, a very small dose 
paralyzes those going to the muscles, and produces increasing weakness, 
gradually passing into death. On the other hand, an enormous dose of 
atropine ifl required to paralyze the motor nerves of muscles, but very 
small doses are sufficient to affect the nerves of the heart and other in- 
voluntary muscles, and thus we get rapid circulation, dilated pupil, and 
restless delirium. 

The physiological action of any drug depends to a great extent, not 
merely on its genera] affinities for classes of tissues, but upon its partic- 
ular affinity, or power of acting on one tissue or organ first. The organ 
firsl affected may, through its functional activity, greatly alter the effects 
of the drug upon the others. 

A- an example of this we may take the effects produced by very 
large and by moderate doses of veratrine on the frog. A moderate dose 



GENERAL RELATIONS. 49 

will produce great stiffness of the muscles, while a very large dose may 
have comparatively little effect. Yet if the large dose were applied 
directly to the muscles it would act more powerfully than the moderate 
dose. The reason that it does not do so in the living body is that the 
large dose paralyzes the heart so quickly that the circulation stops, and 
therefore the poison, not being conveyed to them, has no action on the 
muscles. 

Relation between Atomic Weight and Physiological Action. 

As long ago as 1841, Blake thought that the toxic action of inorganic sub- 
stances increased in proportion to their atomic weight, and this idea was again 
advanced by Rabuteau. Both of them afterwards qualified this when they 
found it was incorrect, by saying that the poisonous action increased with the 
atomic weight amongst elements belonging to the same group. Thus potassium 
is more poisonous than sodium, and barium than calcium. But it has been 
shown by Husemann that lithium is much more poisonous than sodium or potas- 
sium, and his results have been confirmed by Bichet. It is evident that the 
relationship between atomic weight and physiological action is no simple one. 
But indeed, on looking into the matter more closely, we could hardly expect 
it would be. For the toxic action of an element may depend upon its effect on 
the muscles, nerves, nerve-centres, blood, or on the digestive or excreting sys- 
tems. These differ from one another in their composition, and while it is possi- 
ble that the elements belonging to a certain group may have relations varying 
with their atomic weight to individual organs or structures, we can hardly expect 
those relationships to be the same to all organs. 

Thus an element with one atomic weight may prove fatal, by affecting the 
muscular power of an animal, while another with an atomic weight either 
higher or lower, may be still more deadly by affecting the nervous system 
or heart. 

What we want, therefore, is not a general relationship between atomic weight 
and toxic action, but a knowledge of the particular relationships of each group 
of elements to each organ and tissue of the body. 

Relation between Spectroscopic Characters and Physiological 

Action. 

The quickness with which a pendulum oscillates is greater or less in propor- 
tion to its length, a long one oscillating slowly, and a short one quickly. The 
vibrations of a string or pipe are also slow or quick, and the note which it yields 
is low or high, according as it is long or short. 

Similarly, according to Lecoq de Boisbaudran, the rate of vibrations of mole- 
cules, and the wave-lengths of the light which they emit, are determined by 
their weight. When the molecular weight is high, the vibrations of the mole- 
cules are slow, and the light which they emit has long wave-lengths, and is 
situated towards the red end of the spectrum. When the weight is low the 
vibration of the molecules is rapid ; and the light they emit lies towards the 
violet end of the spectrum. 

In the same family of elements the mean length of the wave of light which 
they emit is a function of their atomic weight, so that for bodies of the same 
chemical type the general form of the spectrum persists, but is gradually modi- 
fied by the mass of the molecules. As the atomic weight diminishes, the 
spectrum will tend to ascend towards the violet, and, as it increases, the spectrum 
will tend to descend towards the red. 
4 



50 PHARMACOLOGY AND THERAPEUTICS. 

Until recently, our observations on the spectra of bodies were limited to the 
visible spectrum, but the application of photography now enables us to extend 
our observations both above and below the visible spectrum, and to ascertain the 
presence of definite spectra in the ultra-red and ultra-violet, when nothing of 
the sort is visible to the eye. In most musical sounds besides the fundamental 
note we have a number of harmonics having a much greater rapidity of vibra- 
tion than it. Similarly, in the spectrum there appear harmonics as well as the 
fundamental spectral lines, and so instead of one line or band there may be a 
number. According to the author already quoted, the corresponding harmonies 
in a series of analogous spectra have mean wave-lengths which increase in pro- 
portion to the weight of the molecules. 

It might appear therefore, that a relation might be observed between the 
spectroscopic characters and physiological action of an element, and this idea was 
propounded by Papillon. His idea was, however, to a great extent based on the 
experiments of Kabuteau, already alluded to, and just as no definite relation can 
be at present traced between the atomic weight and the toxic action of a metal, 
so no definite relation can be observed between its spectroscopic characters and 
its physiological action. 

Further consideration, however, will show us that this is not at all to be 
wondered at, for in physiological experiments we are not working with the same 
molecules which yield the spectrum. 

In spectral analysis, when line spectra are in question, according to one view 
we are in presence of phenomena produced by the chemical atom, whereas this 
atom exists only molecularly combined at lower temperatures. According to 
another view, that put forward by Lockyer, we are in presence of phenomena 
pruduced by a series, possibly a long series, of simplifications, brought about by 
the temperature employed, and this simplification can begin at very low tempera- 
tures, and is indeed indicated by Dalton's law of multiple proportions. 

Such molecular simplifications and differences are represented by ozone and 
oxygen, ordinary and amorphous phosphorus, the various forms of sulphur and 
so on, and it is therefore at this lower range of temperature — one studied, chiefly 
by absorption, and not by radiation — that we must look for connections 
between molecular structure and physiological action if any such connections 
exist. 

Some of the absorption bands which occur in the spectra of bodies at ordinary 
temperatures may be in the visible spectrum, like those observed in alcoholic 
and aromatic substances; 1 but others may be quite invisible, and only recogniz- 
able by the aid of photography in the ultra-red or ultra-violet. 2 

Connection between Chemical Constitution and Physio- 
logical Action. — It has long been known that different metals 
exercise different actions on the body; that mercury, for example, 
causes salivation, and antimony sickness. But an immense step has been 
made of late years in our knowledge of the relation between chemical 
constitution and physiological action by the discoveries of Crum-Brown, 
Fraser, and Schroff, who have shown that by modifying artificially the 
chemical constitution of a drug, it is possible to modify also its physio- 
logical action. And not only so, but they have shown that similar 
modifications in the chemical constitution of various drugs induce similar 
modifications in the action of their derivatives ; thus they have found 
that by introducing methyl into tlic molecule of strychnine, brucine, and 



1 Russell and Lapraik, Journ. Chan. Soc, April, 1881. 
-' Abncy and Festing, Phil. Trans., 1882, p. 887. 



GENERAL RELATIONS. 51 

thebaine, the convulsive action exerted by these substances on the spinal 
cord was changed into a paralyzing one exerted on the ends of the motor 
nerves. Other alkaloids, also, which do not exhibit a convulsive action, 
nevertheless exhibit a paralyzing one when their constitution is altered 
by means of methyl; thus methyl-codine, methyl-morphine, methyl- 
nicotine, methyl-atropine, methyl-quinine, methyl-veratrine, and several 
others, all exhibit this paralyzing action. 

From a number of experiments on this subject by Cash and myself, 
we find as a general rule that most of the compound radicals formed by 
the union of amidogen with the radicals of the marsh-gas series possess 
a paralyzing action on motor nerves. 

The subject of the connection between chemical constitution and 
physiological action is the most important one in pharmacology, and we 
shall have to return to it in considering the actions of various groups of 
organic substances. 

Relation between Isomorphism and Physiological Action. 
— From a number of experiments made by Dr. Blake, he concluded that 
when inorganic salts were injected directly into the circulation, the in- 
tensity of their physiological action increased in proportion to their 
molecular weight, but only in those groups of elements where the salts 
were isomorphic, or, in other words, crystallized in the same forms. 
Thus groups whose salts were crystallized in different forms had quite 
different physiological actions. He divided the elements into nine 
groups, the physiological action of the different groups differing in kind, 
whilst that of the individual members of the same group agree in kind 
but differ in degree. Thus he states 1 that the salts of the first group 
increase in activity in the order mentioned, silver being the most active, 
and lithium the least. 

These groups are as follows : — 

Group 1. Lithium, sodium, rubidium, thallium, caesium and silver. Accord- 
ing to him they produce death by acting on the lungs and impeding the 
pulmonary circulation. None of them affect the nervous system excepting 
caesium ; nor do any affect the pulmonary circulation excepting silver. 

Group 2. Magnesia, ferrous salts, manganous salts, nickel, cobalt, copper, 
zinc and cadmium, are increasingly lethal in the order mentioned. They kill 
by arresting the action of the heart. 

Group 3. Beryllium, alumina, yttria, cerium and ferric salts both impede 
the systemic and pulmonary circulation. 

Group 4. Calcium, strontium, barium, and lead salts kill by paralyzing the 
ventricles of the heart. 

Group 5. Palladium, platinum, osmium, and iridium act on the heart, 
respiration, circulation, and blood. 

Group 6. Ammonia and potash paralyze the heart and cause convulsions. 

Group 7. Hydrochloric, hydriodic, bromic, and iodic acids impede the 
circulation and kill by arresting the circulation. 

Group 8. Phosphoric acid, arsenic acid, and antimony kill by arresting the 
pulmonary circulation. 

Group 9. Sulphuric and selenic acid impede the pulmonary circulation. 



1 Blake, American Journal of Science and Arts, vol. vii., March, 1874 (corrected 
reprint). 



52 PHARMACOLOGY AND THERAPEUTICS. 

These experiments are open to the same objections as those of 
Rabuteau. The author's statements regarding their mode of action, 
show that their physiological action has not been clearly investigated, 
and his results as to the lethal dose are probably only approximate and 
may want reinvestigation ; but while we cannot accept at present all his 
results or conclusions as final, yet his last and chief conclusion is one of 
great interest, viz. : — that in living matter we possess a reagent capable 
of aiding us in our investigations on the molecular properties of 
substances. 



CHAPTER II. 



CIRCUMSTANCES WHICH AFFECT THE ACTION OF DRUGS ON THE 

ORGANISM. 

The Inter -action of various functions in the body is one of 
the greatest difficulties in the way of our readily understanding the 
action of drugs. 

One function alters another, and the second reacts upon the first, so 
that in some cases it is almost impossible to say precisely how far the 
alteration in any function is due to the direct effect of the drug upon it, 
and how far to some indirect action. Thus curare when applied to a 
wound usually kills without producing any convulsion whatever. It 
paralyzes the ends of the motor nerves, so that all the muscles in the 
body become powerless. But when it is given by the stomach, and ex- 
cretion through the kidneys prevented, death is preceded by convulsions. 
These convulsions are not caused by any direct irritating action of the 
curare itself upon the nerve-centres, they are due to irritation of these 
centres by a venous condition of the blood. This venosity of the blood 
is due to imperfect respiration, produced by paralysis of the respiratory 
muscles through the action of curare on the motor nerves. 1 

The effect of curare is a purely paralyzing one, both when the ani- 
mal dies quietly and when it dies with convulsions. In both cases it 
paralyzes the motor nerves of the respiratory muscles and of the extrem- 
ities. In both cases it causes death by arresting the respiration and 
producing asphyxia. But in the latter case the motor nerves of the 
extremities being only partially paralyzed when asphyxia occurs, they 
respond by convulsive movements to the irritation of the nerve-centres, 
which the renous blood produces. In the former, the paralysis of the 
limbs being complete, the muscles remain perfectly quiet, notwithstand- 
ing the irritation of the nerve-cenl 

1 Hermann, Arch.f. Ann/, u. Physiol., 18G7, 64, 650. 



ACTION OF DRUGS ON THE ORGANISM. 53 

Convulsions also sometimes occur previous to death from narcotic 
poisons ; and in a description of the action of these poisons we frequently 
meet with the phrase, "coma, convulsions, and death." In such cases 
the convulsions are also caused by the irritation of the nerve-centres by 
asphyxial blood. 

The drug causes the coma ; the coma causes imperfect respiration ; 
imperfect respiration renders the blood venous ; and the venous blood 
causes convulsions. 

Direct and Indirect Action. — The direct action of a drug is 
the effect it produces on any organ with which it comes in contact. Thus 
sulphuric acid applied to the skin, or taken into the stomach, will, ac- 
cording to its degree of concentration, irritate or destroy the mucous 
membrane which it touches. Its direct action upon them is therefore 
that of an irritant or caustic. 

Curare, when applied to the ends of a motor nerve in a muscle, para- 
lyzes them. It does this either when the muscle is soaked in a solution 
of curare, or when the curare is carried through the substance of the 
muscle by means of the blood circulating in it. 

Paralysis is therefore the direct effect of curare on the motor nerves. 

Indirect Action. — The convulsions which sometimes occur in 
poisoning by curare are caused by its indirect action. It has no stimu- 
lating effect on the nerve-centres, when applied to them directly or car- 
ried to them by the blood, but by paralyzing the muscles of respiration, 
and thus causing asphyxia, it indirectly irritates the nerve-centres and 
causes convulsions. 

Local and Remote Action. — The local action of a drug is that 
which it exerts on the part to which it is applied. Thus sulphuric acid 
has a direct irritant or destructive action, and when applied to the skin 
or mucous membrane will produce local redness, inflammation, or slough- 
ing. When swallowed, it produces weakness of the circulation, stoppage 
of the heart, and death. 

This effect on the circulation is not due to the direct action of the 
acid upon the heart, the vessels, or the nervous system, after its absorp- 
tion : it is due to the reflex action exerted upon them by the irritation 
of the nerves of the stomach which the sulphuric acid produces. This 
action on different parts through the nervous system is termed its 
remote action, in contradistinction to the local action of the acid upon 
the gastric mucous membrane. 

Relation of Effect to Quantity of the Drug". — The effect 
of drugs varies very much according to the quantity employed. Some- 
times this is due to the inter-action of different parts of the body on one 
another as already mentioned in regard to veratrine (page 48). Some- 
times it is due to the different effects upon individual cells or tissues. 
Thus we find, very generally, that any substance or form of energy, 
whether it be acid or alkali, heat or electricity, which in moderate quan- 
tity increases the activity of cells, destroys it when excessive. 

But varying closes do not always produce opposite effects. We some- 
times find that exceedingly small and exceedingly large doses have a 
similar effect, which differs from that produced by moderate closes. Thus 
very minute quantities of atropia render the pulse somewhat slow:. 



54 PHARMACOLOGY AND THERAPEUTICS. 

larger quantities make it exceedingly rapid, and very large quantities 
again render it slow. 

Moderate quantities of digitalis slow the pulse, larger quantities 
quicken it, and still larger quantities render it slow again. We find a 
similar effect produced by variation in temperature. Great cold dis- 
turbs the mental faculties, so that men exposed to it present symptoms 
which cannot be distinguished from those of intoxication. Ordinary 
temperatures do not disturb the functions of the brain, but high tempera- 
tures do, as we see in the delirium of fever, which in many cases imme- 
diately ceases when the temperature of the patient is reduced by cold 
bath?. 

Homoeopathy. — This opposite action of large and small doses seems 
to be the basis of truth on which the doctrine of homoeopathy has been 
founded. The irrational practice of giving infinitesimal doses has of 
course nothing to do with the principle of homoeopathy — similia simili- 
bus curantur : the only requisite is that mentioned by Hippocrates, when 
he recommended mandrake in mania ; viz., that the dose be smaller than 
would be sufficient to produce in a healthy man symptoms similar to those 
of the disease. Now in the case of some drugs this may be exactly equiv- 
alent to giving a drug which produces symptoms opposite to those of the 
disease ; and then we can readily see the possibility of the morbid changes 
being counteracted by the action of the drug and benefit resulting from 
the treatment. For example, large doses of digitalis render the pulse 
extremely rapid, but moderate ones slow it. 1 The moderate administra- 
tion, when there is a rapid pulse, is sometimes beneficial : this might be 
called homceopatJdc treatment, inasmuch as the dose administered is 
smaller than that which would make the pulse rapid in a healthy man, 
but it might also be called antipathic, inasmuch as the same dose admin- 
istered to a healthy person would also slow the pulse. 

Homoeopathy can, therefore, not be looked upon as a universal rule 
of practice, and the adoption of any such empirical rule must certainly 
do harm by leading those who believe in it to rest content in ignorance, 
instead of seeking after a system of rational therapeutics. 

Dose. — The amount of a drug, which actually comes in contact with 
and affects the tissues, depends upon several conditions — (1) the quan- 
tity actually given; (2) its proportion to the body-weight; (3) the 
rapidity of its absorption by the blood from the place of introduc- 
tion ; (4) the condition of the circulation in various parts of the body, 
which determine the quantity of the drug carried to each ; (5) the 
rate of its absorption by the tissues ; (6) the rapidity of excretion. 

The word dose, as employed in medicine, usually means the quantity 
given mi one time, bul sometimes this maybe very different from what 
actually produces any effect. It is the amount of the drug existing in 
tin- blood iii any given time, or rather the proportion of it that actually 
comes in contad with or is absorbed by the tissues, which really acts. 
We must therefore consider more in detail the circumstances which affect 
this proportion. 

1 Vidi Traube, Med. Oenir. Ztg., w\.. p. 94,1861, and Brunton On Digitalis, p. 21. 



ACTION OF DRUGS OX THE ORGANISM. 55 

Size. — As the action which a drug has on the body is not dependent 
on its absolute amount, but on the proportion it bears to the body on 
which it is to act, an amount which is a small dose for one person is a very 
large one for another. 1 Thus if a grain of some active substance be in- 
jected at the same time into the veins of a full-grown man and into those 
of a boy of only half his weight, it will be distributed through twice as 
much blood in the man as in the boy, and each tissue will only receive 
half as much of it. The dose of a drug must therefore be regulated by 
the weight of the patient ; and thus women, being lighter, require a 
smaller amount than men, and children less than adults. Though it 
would be more exact, it is not always convenient, to weigh patients ; but 
in experiments on animals we usually weigh the animal carefully and 
describe the dose in terms of the body-weight. For example, in describ- 
ing the lethal dose of physostigmia, we do not say that it is so many 
grains for an animal, but that it is 0*0-1 grains per pound weight of a 
rabbit. This relation, however, is not always an exact one, and other 
circumstances must be taken into account. Thus the species of the 
animal must be considered, for the same dose which would kill one kind 
of animal will not kill another. In animals of the same species the 
state of nutrition must be taken into account, for two animals of the 
same species which would be nearly of the same size when equally nour- 
ished, may have very different weights if the one is fat and the other is 
lean. But the fat is a comparatively inner tissue, and if we give to each 
animal a dose regulated by its body-weight, the vital organs, brain, heart, 
and spinal cord of the fat animal will get a larger share in proportion 
than those of the lean one. 

In testing the action of poisons on frogs, also, it must be remembered 
that a female frog with a quantity of spawn will be very heavy, but the 
spawn, like the fat, is not to be reckoned as tissue ; and a dose given in 
proportion to the actual weight would be much larger than the same pro- 
portion given to the frog after spawning. 

Mode of Administration. — If a substance be injected into 
the veins, the whole of it mixes with the blood and becomes active im- 
mediately, and the maximum effect is thus at once obtained and will 
again diminish as the substance is excreted. But the case is different if 
it be injected suocutaneously, and if it be given by the stomach or 
any other mucous cavity the difference is still greater ; for as soon as 
some of it is absorbed excretion begins, and thus one portion of the drug 
is passing out of the blood while another portion is being taken in. The 
amount in the blood is, then, only the difference between that absorbed 
and that excreted in a given time, and absorption may be so slow, or 
excretion so quick, that there is never a sufficient amount of the sub- 
stance in the blood to produce any effect. Thus Bernard found that a 
dose of curare which would certainly paralyze an animal when injected 
into the veins, or even subcutaneously, would have no effect when intro- 
duced into the stomach ; 2 and showed that this was due to the kidneys 



1 Buchheini, Arzneimittellehre, 3d edit., p. 54. 

2 Bernard, Leeons sur les Effets des substances toxiques, p. 282. 



56 



PHARMACOLOGY AXD THERAPEUTICS. 



excreting the poison as fast as it was absorbed from the stomach, by ex- 
tirpating the kidneys, 1 when the animal became paralyzed as surely as if 
the poison had been introduced at once into the veins, though not so 
quickly. Hermann also discovered, without being acquainted with Ber- 
nard's observations, that curare taken into the stomach would produce 
paralysis if excretion were prevented by ligature of the renal vessels. 



Vessels of lung. 

Veins of general surface of — 
body. I 

Liver. 

Veins of stomach. —\..J& 

Biliary circulation 
Veins of intestines, 




Arteries going to nerve- 
centres. 

Arteries to muscles. 
Arteries to stomach. 

Arteries to intestines. 
Kidney. 

Excretion by kidney. 

FIG. 4.— Diagram to illustrate absorption and excretion. The arrows show the direction of the cur- 
rents. The absorbents from which the blood passes directly into the general circulation are repre- 
sented diagrammatically by the veins of the lungs and of the general body surface in the figure. 
The absorbents by which the drug must pass through the liver, and possibly be partly excreted or 
dest royed, are represented by the veins of the stomach and intestine. The excreting channels by 
which the drug may pass directly from the body without re-absorption occurring, are represented 
by the vessels of the lung and by the ureter. Those by which excretion takes place into cavities 
from which much re-absorption "may occur, are represented by the arteries to the intestine and 
the stomach. 

The absorption of drugs from the stomach and intestines may be 
considerably retarded, and their action diminished, by the liver. Before 
reaching the general circulation, drugs absorbed from the intestinal 
canal must all pass through the liver (Fig. 4). In their passage they 
may be partly arrested and excreted again into the intestine along with 
the bile. They may be also partially destroyed. A larger quantity of 
a drug may thus be necessary to produce similar effects when intro- 
duced by the stomach than when injected directly into the circulation or 
under the skin, (1) because it may be absorbed more slowly by the vessels 
of the gastric or intestinal mucous membrane, (2) because a part of it may 
be arrested in the liver and excreted into the intestine along with the 
bile, (3) because a part of it may be actually destroyed in the liver. 

The more rapid the absorption or the slower the excretion of any 
drug, the greater will be its effect. Thus the effect produced by the 
same dose of a medicine will be in proportion to the rapidity of its 
absorption from the different parts to which it has been applied, unless 
tin- differences be bo Blight that there has not been time for the excretion 
of any considerable quantity from the blood during the process. On this 
account we must diminish the dose of a medicine in order to obtain the 
cflcct. according to the rapidity of absorption from the place to 
which we apply it. Absorption is quickest from serous membranes, next 



Bernard, Rmu det Coura Scientiftques, 1865. 



ACTION OF DRUGS ON THE ORGANISM. 57 

from intercellular tissue, and slowest from mucous membranes. The 
vascularity and rate of absorption from intercellular tissue is greater on 
the temples, breast, and inner side of the arms and legs than on their 
outer surfaces, or on the back. 1 It should not be forgotten that any 
drug introduced into the stomach, but not absorbed into the blood, is 
as much outside the body as if it were in the hand, for any effect it 
will have on the system, provided always it have no local effect on the 
gastric walls. For if it act directly on the walls of the stomach, it may 
have an effect which it would not have when held in the hand or applied 
to the skin. Thus mustard, which would produce redness and burning 
of the skin, will cause vomiting when swallowed ; but opium, which does 
not act on the stomach itself, except by diminishing its sensibility, pro- 
duces no apparent effect until after it has been absorbed. 

By the difference between absorption and excretion under different 
circumstances or in different individuals, 2 the cumulative action of drugs, 
the effect of idiosyncrasy, habit, climate, condition of body, as fasting, 
&c, disease, and form of administration, can, to a certain extent, though 
not entirely, be explained ; but experiments on some of these points are 
deficient, and the explanations now given are to some extent theoretical. 

Cumulative Actiou. — If a substance be naturally so slowly ex- 
creted from the body that the whole of the dose in ordinary use is not 
excreted before another is given, the amount present in the body will 
gradually increase, just like the curare in Hermann's experiment, and 
will produce an increasing or cumulative effect. Examples of this are 
to be found in metallic preparations, such as those of mercury or lead, 
which are excreted very slowly; or in some of the organic alkaloids, if 
given in sufficiently large and frequent doses. The size of the dose and 
the frequency with which it must be repeated in order to produce a cumu- 
lative effect, will differ according to the rapidity with which the drug is 
excreted; for, if excretion be rapid, a larger dose or more frequent 
repetition will be required. Sometimes the symptoms of the physiologi- 
cal action of a drug instead of increasing gradually may do so suddenly, 
and it is to this kind of action that the term cumulative action is most 
usually applied. This may sometimes be due to a sparingly soluble 
drug accumulating in the intestinal canal, and being suddenly dissolved 
and absorbed on account of some change occurring in the intestinal con- 
tents ; at other times it may be due to arrest of excretion, as in the case 
of the two vegetable active principles, digitalin and strychnine, to which 
an especial cumulative action is ascribed. After moderate doses of these 
drugs have been taken for some time, it is found that instead of the 
effects they produce increasing gradually, as we would expect from a 
gradual accumulation in the blood, the symptoms of poisoning become 
suddenly developed, in somewhat the same way as if the dose had been 
suddenly increased. It is evident that a diminution in the quantity ex- 
creted will produce this effect as readily as an increase in the quantity 
taken, and this is probably the true cause of the phenomenon. When 



1 Eulenburg, Hypodermatische Injection der Arzneimittel, 3d edit., p. 65. 

2 Children absorb more quickly than adults, so opium is more dangerous to them. 
Marx, Lehre von den Giften, vol. ii., p. 117. 



58 PHARMACOLOGY AND THERAPEUTICS. 

digitalin has been taken for some time and accumulated to a certain ex- 
tent in the blood, it causes a diminution in the amount of urine excreted, 
and this diminution is either accompanied or quickly followed by the 
other symptoms of poisoning. 1 The effect, indeed, seems exactly the 
same as Hermann would have obtained in his experiment if he had only 
partially compressed the renal arteries instead of ligaturing them com- 
pletely. For digitalin appears to diminish the secretion of urine by 
causing a powerful contraction of the renal vessels, 2 and in large, doses 
may completely arrest the secretion of urine, 3 and probably also the 
circulation through the kidneys. Strychnine has a similar action on 
the vessels. 4 

Effect of different preparations. — When a drug is given in a 
soluble form, and in small bulk, it is more quickly absorbed and will 
have greater effect than when given in a less soluble form or much 
diluted. Thus drugs given in solution as tinctures will act, as a rule, 
more quickly than when given in the form of pill or powder. 

Effect of Fasting-. — When a drug is given upon an empty 
stomach, it is usually absorbed much more rapidly. Thus the same 
quantity of alcohol which would have no effect on a man if taken 
during or after dinner, might intoxicate him if taken on an empty 
stomach, and especially if he were thirsty, so that absorption occurred 
rapidly. Curare, although it is usually inert when placed in the 
stomach, is sometimes absorbed so rapidly from an empty stomach as to 
produce a certain amount of paralyzing effect. 

Besides the effect of absorption, we have to consider also the local 
effects on the stomach itself, and the reflex effects which may be pro- 
duced through its nerves on other organs. Thus where we give a drug 
for its local action on the stomach itself, it is administered with the 
greatest effect during fasting, as it will come in contact with all parts of 
the gastric mucous membrane. An example of this is the use of a 
small dose of arsenic for gastric neuralgia or lientery. 

But when we wish to prevent local action on the stomach, as, for 
example, when we give arsenic for its general effect on the system, in 
cases of skin disease, we administer it after meals, so that it may be di- 
luted by the food, and not irritate the stomach too much. 

Effecl of* Habit. — The tissues seem to have a certain power of 
adapting themselves to changes in their surroundings. Thus salt-water 
amoebae will die when placed at once in fresh water, but if the fresh water 
be added very gradually, they may by and by become accustomed to live 
in it. Fresh-water amoebae also have the power of becoming gradually 
accustomed to increasing quantities of salt gradually added to the water 
in which they live, and which would at once kill them if added suddenly. 
A similar power seems to be possessed by the tissues of the higher ani- 
mal-, in regard to some drugs at least, Thus the arsenic eaters of Styria 



1 Brunton, On Digitalis^ p. 39. 

Brunton and Power. Proceedings of Royal Soc. 1874, No. 153, and Centralblatl d. 
Med. Wit ,1874, p. 197. 

( Ihrisl i-Mu. r.din. Med. Journ., \ii., 11!>. 
1 Grutzner, Pjtiiger 1 * An-hir. L876, I'.d. si., p. 601. Giirt ner, Separat Abdruck a. d. 
box. Bd. d. k. Akad. d Wiu. 1 1 1. Ai.t. Dec. Heft. Jahrg. 1879. 



ACTION OF DKUGS ON THE ORGANISM. 59 

are able to consume — not only without injury, but with apparent bene- 
fit to themselves — a quantity of arsenic which would prove fatal to one 
unaccustomed to it. The same is the case with opium and morphia. 
With these latter drugs there seems to be hardly any limit to the quan- 
tity which can be taken after the habit has been once established, and 
after a certain dose has been exceeded. 

It is possible, however, that in addition to a process of accommoda- 
tion going on in the tissues, there is a slower absorption, and perhaps 
more rapid excretion, going on at the same time ; for it is observed in 
the case of opium that sometimes the effect is not only diminished, but 
the time which elapses before it occurs is lengthened when persons have 
become accustomed to the drug. 

In regard to the possibility of very slow absorption we must remem- 
ber the power of the liver to arrest and excrete, or to destroy poisons, 
especially as it is chiefly in the case of vegetable poisons that their power 
is lessened by habit, which has much less effect on inorganic substances. 
The tolerance of some inorganic drugs, and especially of tartar emetic 
in disease or after repeated doses, may be due to fever or the drug itself 
lessening the acidity of the stomach, and consequently the action of the 
drug which acts most strongly in presence of an acid. 

The Effect of Temperature. — The effect of temperature on the 
action of drugs is very great. At different temperatures the administra- 
tion of the same drug may be followed by different results, and it is 
probable that a great number of the contradictory observations 
which we find in pharmacological works are due to this most important 
factor having been neglected in making the experiments. It is of the 
greatest importance to the physician also, as many of the cases of dis- 
ease which he has to treat are accompanied by a rise in temperature 
which may have a very important effect upon the action of the drugs 
which he administers. 

The alteration produced in the effect of drugs by warmth was first 
noticed by Alexander von Humboldt, who observed that warmth not only 
acted as a stimulant to the heart in increasing the power and rapidity of 
its contractions, but noticed that warmth increased the rapidity with 
which alcohol destroyed the irritability of a nerve, and potassium sulphide 
that of a muscle. Bernard observes generally that poisons act slightly 
on frogs when cooled down, and become more active the higher the tem- 
perature. The effect of warmth in stimulating the movements of proto- 
plasmic structures, such as amoebae and cilia was investigated by Kiihne ; 
and, in an important research, Luchsinger has experimented on the 
influence of warmth on the action of poisons on many organs, and found 
that the ciliary motion in the pharynx of the frog becomes paralyzed by 
chloral, potassium carbonate, and tartrate of copper and soda more and 
more quickly in proportion to the rise in temperature. On cooling down, 
the ciliary movement again returned. 

Dr. Cash and I have found that the action of veratrine or barium 
on muscle is very much altered by heat and cold. At ordinary tempera- 
tures contraction is greatly prolonged, but under the influence of 
either great heat or great cold the contraction again becomes nearly or 
quite normal. 



60 PHARMACOLOGY AND THERAPEUTICS. 

Many, if not all, muscular poisons act more quickly with increased 
temperature; and frogs poisoned with chloral, copper, manganese, 
potash, and zinc, are paralyzed more quickly when the temperature 
is high, than when it is low, whether the alterations be produced 
artificially, or be due to differences in the season at which the experiments 
are made. 

Rabbits poisoned with copper or potash also die more quickly 
when placed in a warm chamber, than when left at the ordinary tem- 
perature. 

The terminations of motor nerves in the muscles are also greatly 
affected by temperature. 

Guanidine produces in the frog fibrillary twitchings of the muscles, 
which persist even in excised muscles, but are removed by curare, and 
are therefore in all probability dependent on an affection of the terminal 
ends of the motor nerves in the muscle. Luchsinger has found that 
when four frogs are poisoned in this way, and one is placed in ice-water, 
another in water at 18°, a third at 25°, and a fourth at 32°, the 
fibrillary tAvitchings soon disappear from the muscles of the frog at 0°, 
and only return when its temperature is raised to about 18°. In the 
one at 18° convulsions occur, which are still greater in the one at 25°. 
In the frog at 32°, on the other hand, no abnormal appearance is to be 
remarked, and five times the dose may be given without doing it any 
harm. 

This poison then resembles veratrine in acting only at ordinary 
temperatures, and in its action being abolished by excess of heat or cold. 

The effect of temperature on secreting nerves is well marked. When 
the sciatic is stimulated in an animal, the corresponding foot usually 
begins to sweat, but the sweating is very much less if the foot is 
cooled down than if it is warm. A similar action is exerted by tempera- 
ture upon the sweating produced by pilocarpin — a drug which appears 
to act by stimulating the ends of the secreting nerves. When the 
animal is cooled, this drug is much less powerful than when it is warm. 

< Overheating appears to have an opposite action, and when the foot is 
heated up to a certain temperature it does not secrete nearly so readily, 
even though the glands themselves are not injured, and secretion may 
commence after the lapse of a little time. 

The influence of poisons on the heart of the frog is also modified by 
temperature. Kroneeker found that its beats were arrested by ether 
easily and quickly when the temperature was high, but with great diffi- 
culty when it was low. Ringer found that a small dose of veratrine 

atly a fleet- I lie ventricle at a moderate or high temperature, but at a 
low temperature produces no effect, 1 

Luchsinger noticed that when the frog's heart had been arrested 
by passing dilute solutions of chloral, copper, or potassium carbonate 
through ;it 25° C, the pulsations again began when the temperature was 
reduced to \~> I '. When, on the contrary, the heart had been arrested 
m a similar manner, at a temperature of 5° C, pulsations could then 
be induced by warming it to 15°. 



1 Singer, Archives of Medicine, vol. vii., Feb., 1882, p. 5. 



ACTION OF DKUGS ON THE ORGANISM. 61 

Some extraordinary observations on the effect of temperature upon 
the action of drugs on the spinal cord have been made by Kunde and 
Foster, who have found that, in a number of frogs poisoned with strychnia 
and exposed to different temperatures, raising the temperature diminishes 
the convulsions, while cold increases them if small doses are employed. 
Raising the temperature, indeed, may not only diminish but entirely 
abolish the convulsions, while putting a frog in ice may bring them on, 
when they would not otherwise appear, and cause them to last for no 
less than twenty-four hours. When large doses are employed the 
opposite effect is produced; raising the temperature then increases 
the convulsions, while cooling the frog down to 0° abolishes them. 

An observation similar in some respects, though differing in others, 
has been made on the effect of temperature on the action of picrotoxin 
by Luchsinger. 1 When this poison is given to three frogs, and they are 
then placed in water at 0°, 15°, and 32°, in a few minutes the convul- 
sions occur in the one at 32°, shortly afterwards in that at 15°, while 
the one at 0° remains for a long time completely unaffected, and only 
exhibits signs of convulsion when the dose has been very great indeed, 
or when it is taken out of the cold bath. 

The effect of warmth in accelerating death from muscular poisons 
has already been mentioned. 

The power of warmth to preserve life in narcotic poisoning was ob- 
served by Hermann in relation to alcohol, which rabbits bear better when 
they are somewhat warmed. 2 Its extraordinary effect in preventing 
death in animals poisoned with chloral was noticed by Strieker, and more 
thoroughly worked out by myself at his suggestion. 3 Death by chloral 
appeared from my experiments to be in a great measure due to continued 
loss of heat from the animal. This seems to be the case also in metallic 
poisoning by copper, manganese, mercury, platinum, potassium, thal- 
lium, tungsten and zinc. Its cause appears to be twofold : (1) The poi- 
sons lessen combustion in the body, and the amount of heat produced, as 
is shown by their diminishing the amount of carbonic acid excreted. 
(2) Besides disturbing the production, they also disturb the regulation of 
heat, so that animals poisoned by them have less power of resisting the 
influence of external temperature, and therefore the temperature rises 
more quickly when they are put in a warm chamber, as well as sinks 
more quickly when they are exposed to cold. 

All these things show that the definition of the action of a drug", 
already given, p. 34, must be still further modified, and we must define it 
as the reaction between the drug and the various parts of the body at a 
certain temperature. 

Thomas 4 found that digitalis has sometimes no action on the pulse in 
pneumonia. As the slowing of the pulse produced by this drug is to 
some extent effected through the vagi, it occurred to me that its want of 
action in this disease might be due to the paralysis of these nerves by 



1 Luchsinger, Physiologische Studien, Leipzig, 1882. 

2 Hermann, Arch. f. Anat. u. Physiol., 1867, p. 64. 

3 Lander Brunton, Journal of Anatomy and Physiology, vol. viii. 

4 Arch.f. Heilk., vol. iv., 329, 1865. 



62 PHARMACOLOGY AND THERAPEUTICS. 

heat. On testing the action of heat, however, on the vagus, I found 
that it was not paralyzed in rabbits deeply chloralized, at a temperature 
just sufficient to kill the animal. 1 

The reason why digitalis does not reduce the pulse in some cases of 
pneumonia has, therefore, still to be determined. 

The abnormal effect which opium has in some cases of fever — causing 
excitement instead of sleep — is occasionally most distressing to the phy- 
sician. It is possible that this may be partly due to the temperature, 
and that the combination of tartar emetic with the opium may owe 
some of its utility to its effect in lowering temperature, although not im- 
probably both it and another useful combination with chloral also act 
more perfectly on account of the depressing action on the circulation. 
These are points, however, on which further observations are greatly 
needed. 

Climate. — It is said that the action of narcotic drugs is greater in 
warm climates than in cold, and that smaller doses are therefore required 
to produce a similar effect. If this statement be true, it is in all proba- 
bility due to the higher temperature, for Crombie has shown that in 
India the average temperature of the body is about half a degree higher 
than in England. 

Time of Day. — In healthy persons fluctuations occur. The lowest 
temperatures occur at night between 10 p. M. and 1 A. M., and in the early 
morning between 6 and 8 a.m. The highest temperature occurs between 
four and five in the afternoon. 

The action of drugs may be partially altered by the slight variations 
in temperature which occur within the body, and perhaps still more by 
the variations in tissue change, of which these fluctuations of tempera- 
ture are the indication. Thus the necessity for great attention to the 
administration of stimulants in the early hours of the morning in cases 
of threatening collapse has long been recognized. 

Effect of Season. — The action of drugs is altered by the changes 
in temperature due to the seasons. Galen supposed that the quantity of 
blood in the Body was increased in spring, and in this country, till within 
recent years, it was a common custom for people to be regularly bled 
every spring. Purgatives were not unfrequently also administered at 
the same time. There are, no doubt, changes corresponding with the 
seasons in the human organization, although these are better marked in 
the lower animals, e.g., deer; where the antlers bud regularly in spring 
and reach perfection just at the breeding season. It is possible that the 
abolition of the practice of bleeding in spring and the changes in other 
plans of treatment formerly adopted, may not be altogether due, as some 
suppose, to increased knowledge on our part, but rather to the occurrence 
of a change <>(' type not only in diseases but also in slight ailments, 
and to the need for such treatment having disappeared. Formerly, be- 
fore the introduction of coaches, and still more of railways, locomotion 
was difficult and transportation was expensive; in consequence of this 
the food consumed by the generality of people was different in character, 
loaf bread being rery little used, and salt meat often used for weeks and 
months together during the winter, with comparatively few vegetables. 

1 St. Bartholomew's "Hospital Reports, 1871, p. 210. 



ACTION OF DRUGS ON THE ORGANISM. 63 

Such a diet might naturally lead to a condition of body which would be 
benefited by bleeding and purgatives. 

Effect of Disease. — The direct and indirect, the local and remote 
actions of drugs upon the complicated mechanism of a mammalian body 
is so perplexing, that the attempt to ascertain the precise mode of action 
of a drug by its simple administration either to a healthy man, or to 
healthy animals, and observation of its effects upon them is hopeless. 

Moreover the object that we really wish to attain is the power to re- 
lieve the human suffering, and to avert the premature death due to dis- 
ease. But in disease we have new factors, changes are produced by it 
in the functions of the body, and the reaction of the diseased organism 
to the drugs which we administer is oftentimes different from that of a 
healthy one. To a man suffering from cholera, for example, enormous 
doses of drugs have been given without the least effect ; and, in the wake- 
fulness of fever, the opium which ought to produce sleep may simply 
cause excitement and delirium. 

Use of Experiments. 

As we have seen, the problems put before us are too complicated to 
be solved directly, and we must therefore simplify them. 
This is done in four ways : — 

1st, by observation of the effects of drugs on animals with a 
simpler organism than our own, such as amoeba or 
frogs ; 

2ndly, by applying- the drug to some part of an animal body 
more or less completely separated from the rest, such as, 
for example, the muscle and nerve, or the heart of a frog 
separated from the body ; and, 

3dly, by preventing* it from reaching- one part of the body 
while it acts on the others, as by ligaturing an artery as in 
Bernard's or Kolliker's experiments on curare. 

4thly, by producing artificial changes in the relations of the 
various parts of the body of higher animals, either before or 
after administration of a drug, as, for example, by dividing 
the vagi, in order to ascertain how far the change produced 
in the beats of the heart by a drug is due to its action upon 
it by these nerves. 

Comparative Pharmacology. — It may seem almost absurd to 
those unacquainted with the subject, that so much attention should be 
devoted to experiments on the effect of drugs on the lower animals, 
when our object is, as we have just stated, to ascertain their action 
upon human beings, and their mode of employment in the diseases of 
man. 

But in the study of Pharmacology, just as in Histology, very much 
is to be learned by comparative studies. In his lectures, Ranvier ad- 
mirably defines General Anatomy as Comparative Histology, limited to 
a single organism. He illustrates this by showing that the different 
modes of movement which occur in some of the lower classes of the 



64 PHARMACOLOGY AND THERAPEUTICS. 

animal kingdom are to be found united in the highest. Thus leucocytes 
of the blood move about like amoeba. The epithelium of the respiratory 
passages is provided, like infusoria, with cilia ; and while some muscles 
have the power of rapid contraction, others contract slowly, like those of 
some invertebrata. 1 

We have thus in certain parts of the bodies of the higher animals 
and of man, anatomical elements whose functions are performed in a way 
resembling that of organisms low in the scale of existence, and, by 
examining the effect of drugs upon these low organisms, we acquire 
knowledge which aids us in determining the action of drugs upon simi- 
lar anatomical elements in the human body. 

In his admirable lecture on Elementary Pathology, Sir James Paget 
draws attention to the distinction between the conditions of life and the 
essential properties of living things ; and to the fact that, while the va- 
rious parts of a complicated organism like the human body are closely 
connected together, and made to work in harmony for the common good 
of the organism in health, yet each part retains its own mode of life, and 
may sometimes develop to an excessive extent at the expense of the rest, 
and may destroy the organism, and itself as well. We see the power 
which each part possesses of carrying on individual life apart from the 
rest best in lower organisms, or in inorganic substances, where the parts 
are less dependent on the welfare of the whole. 

Thus, in crystals, a chip which has been broken off is replaced, and 
the form of the crystal restored by putting it in a solution which will 
yield it the proper kind of material required. When a hydra is cut in 
two, each part grows into a perfect individual : a tail growing to the 
head part, and a head growing to the tail part. When a claw has been 
broken off a crab or lobster, a new one will by and by grow ; but if the 
animal be divided in two, unlike the hydra, it will die. 

As we ascend in the scale of existence, the power of repair becomes 
less perfect. But even in the human being we see that the different parts 
retain their individual life, and if put into proper conditions may live, 
although the original body from which they were obtained were to die. 
Teeth, for example, which have been extracted from one person have been 
transplanted and grown in the jaws of another ; and the transplantation 
of hair, skin, or of periosteum, is perfectly practicable. 

Idiosyncrasy. — In their onward development from the lowest forms 
of life, man and the higher animals have not only permanently retained 
in their bodies certain parts which resemble organisms low in the scale of 
existence, but every now and again a tendency to reversion appears in 
certain individuals, and we thus get anatomical abnormalities and mal- 
formations. 

These were formerly inexplicable, but the doctrine of evolution has 
thrown much light on their probable causation. 

Now and again we also meet with peculiarities in the reaction be- 
tween drugs and parts of the human body in certain individuals. 



w/ id'anatomu gSnSraleaur le syetdme musculctire, par L. Ranvier. Paris, 
1880, ].. 48. 



ACTION" OF DRUGS ON THE ORGANISM. 65 

Some persons, for example, are like pigeons — only slightly affected 
by opium — and can take enormous doses of it without any apparent 
effect. Others, again, are peculiarly sensitive to the action of certain 
medicines, and a dose of a mercurial preparation which would have but 
a slight purgative action on one, will produce intense salivation in 
another. 

These personal peculiarities in regard to the action of drugs, or 
idiosyncrasies, as they are termed, have been, and are still, very per- 
plexing to the medical practitioner. It is probable, however, that a more 
complete study of comparative pharmacology will enable us, to some ex- 
tent at least, to recognize these, and thus to avoid the inconvenience 
which they occasion. 

Objections to Experiment. — Some people object entirely to 
experiments upon animals. They do this chiefly on two grounds. 
The first is that such experiments are useless, and the second, that 
even if they were useful, we have no right to inflict pain upon 
animals. 

The first objection is due to ignorance. Almost all of our exact 
knowledge of the action of drugs on the various organs of the body, as 
well as the physiological functions of these organisms themselves, has 
been obtained by experiments on animals. 

The second objection is one which, if pushed to its utmost limits 
and steadily carried out, would soon drive man off the face of the 
earth. 

The struggle for existence is constantly going on, not only between 
man and man, but between man, the lower animals and plants, and man's 
very being depends upon his success. 

We kill animals for food. We destroy them when they are danger- 
ous like the tiger or cobra, or destructive like the rat or mouse. We 
oblige them to work for us, for no reward but their food; and we urge 
them on by whip and spur when they are unwilling or flag. No one 
would think of blaming the messenger who should apply whip and spur 
to bring a reprieve, and thus save the life of a human being about to 
die on the scaffold, even although his horse should die under him at the 
end of the journey. Humane people will give an extra shilling to a 
cab-man in order that they may catch the train which will take them to 
soothe the dying moments of a friend without regarding the consequences 
to the cab-horse. Yet if one-tenth of the suffering which the horse has 
to endure in either of the cases just mentioned were to be inflicted by a 
physiologist in order to obtain the knowledge which would help to relieve 
the suffering and lengthen the life, not of one human being only, but of 
thousands, many persons would exclaim against him. Such objections 
as these are due either to want of knowledge or want of thought on the 
part of people who make them. They either do not know the benefits 
which medicine derives from experiment, or they thoughtlessly (some- 
times, perhaps, wilfully) ignore the evidence regarding the utility of 
experiment. 

One of the most important objections that has been raised to this 
mode of experiment is that the action of drugs on the lower animals is 
quite different from their action on man. This objection has a certain 
5 



66 PHARMACOLOGY AND THERAPEUTICS. 

amount of truth, but is in the main groundless. The action of drugs 
on man differs from that on the lower animals, chiefly in respect to the 
brain, which is so much more greatly developed in man. 

Where the structure of an organ or tissue is nearly the same in man 
and in the lower animals, the action of drugs upon it is similar. Thus 
we find that carbonic oxide and nitrites produce similar changes in the 
blood of frogs, dogs and man, that curare paralyzes the motor nerves 
alike in them all, and veratria exerts upon the muscles of each its 
peculiar stimulant and paralyzing action. 

Where differences exist in the structure of the various organs, we 
find, as we would naturally expect, differences in their reaction to drugs. 
Thus the heart of the frog is simpler than that of dogs or men, and less 
affected by the central nervous system. 

We consequently find that while such a drug as digitalis has a some- 
what similar action upon the hearts of frogs, dogs and men, there are cer- 
tain differences between its effect upon the heart of a frog and on that 
of mammals. In all it seems to affect the muscular substance and cause 
increased contraction. But while the frog almost invariably dies with 
the heart in a state of tetanic contraction, this is not the case with dogs 
or men, where the heart sometimes is found in diastole after death. 

Ipecacuanha or tartar emetic will cause vomiting in man, but does 
not do so in rabbits. The reason of this is that the position of the 
stomach in the rabbit is different from that in man, and is such that the 
animal cannot vomit. In dogs, however, the position of the stomach 
agrees with that of man, and tartar emetic or ipecacuanha causes vomit- 
ing in both. Belladonna offers another example of apparent difference 
in action — a considerable dose of belladonna will produce almost no 
apparent effect upon a rabbit, while a smaller dose in a dog or a man, 
would cause the rapidity of the pulse to be nearly doubled. Yet in all 
three — rabbits, dogs and men — belladonna paralyzes the power of the 
vagus over the heart. The difference is, that in rabbits the vagus nor- 
mally exerts but little action on the heart, and the effect of its paralysis 
is consequently slight or hardly appreciable, the pulse being normally 
almost as quick as it is after the vagus is paralyzed. In dogs and men, 
on the contrary, the vagus is constantly exerting considerable restrain- 
in g power over the heart, and the effects of its paralysis at once direct 
attention. 

An example of the apparent difference in the effect of a drug on 
different animals is afforded by nitrite of amyl. If we measure the 
pressure of the blood in the arteries of a rabbit and of a dog, and then 
cause them to inhale nitrite of amyl, we find that the small vessels have 
become widened and allow the blood to pass easily out of the arterial 
in into the veins, so that the pressure sinks considerably in the 
rabbit, whereas it sinks only slightly in the dog. The action seems at 
first sight different; but when we examine it more closely, we find that 
the heart of the dog is no longer beating slowly, but very quickly, 
SO :"- to keep up the pressure, notwithstanding the rapid flow of blood 
through the widened vessels, while the heart of the rabbit was going so 
fast before thai it could not L r o much more quickly. If we cut the vagi 
iu the (Jog, BO that the heart goes as quickly as in the rabbit before it 



ACTION OF DRUGS ON THE ORGANISM. 67 

begins to inhale, the blood-pressure sinks during the inhalation, just as it 
does in the rabbit. 1 

By means of experiments upon animals, then, we are able to ascertain 
the action of drugs upon those organs of the body which are alike in man 
and animals ; and the very differences which exist between various sorts 
of animals, help us to understand the action of drugs more thoroughly. 

Erroneous Deductions from Experiments. — A great fault- — 
and one which is only too common in the works of experimental pharma- 
cologists — is that of drawing general conclusions from limited 
data. 

One experimenter tries the effects of a drug, let us say tartar emetic, 
upon rabbits. He finds that they do not vomit, and instead of drawing 
the only warrantable conclusion, viz., that tartar emetic does not cause 
vomiting in rabbits, he draws the general one — tartar emetic does not 
cause vomiting in animals. Another tries it upon dogs, and he finds 
they all vomit. Instead of the limited conclusion that tartar emetic 
makes dogs vomit, he draws the general conclusion that it makes animals 
in general vomit. The two observers are equally positive in regard to 
their facts — each is assured that he himself is right, and that the other 
is totally wrong. The reason of the discrepancy is simply that the con- 
ditions'under which the experiments have been performed were different^ 
but the observers have not taken these differences into account when 
drawing their conclusions. A third observer then comes, perhaps, and 
by further experiments reconciles the apparently contradictory state- 
ments. Thus one experimenter tries the effect of caffein upon frogs : he 
finds that it produces rigor mortis in the muscles. Another tries the 
same drug and finds no such result. These two observations are com- 
pletely contradictory, until a third tries the effect of the drug upon two 
species of frog, and finds that while the muscles of the rana esculenta 
are but slightly affected, those of the rana temporaria are rendered 
rigid. 2 

These apparent contradictions in the results of different observers are 
exceedingly puzzling to the student, but nothing is more instructive to 
those who are actually working at the subject. 

The utility of apparent exceptions was fully recognized by 
Claude Bernard, who says: "In physiological studies we must always 
carefully note any fact which does not accord with received ideas. It is 
always from the examination and the discussion of this exceptional fact 
that a discovery will be made, if there is one to make." 3 



1 Lauder Brunton, "Action of Nitrite of Arnyl on the Circulation," Journal of 
Anatomy and Physiology, vol. v., p. 95. 

2 Schmiedeberg, Arch. f. Exper. Path. u. Pharmak. Bd. ii., p. 62. 

3 Bernard, Liquides de Vorganisme, torn, i., p. 258. 



68 PHARMACOLOGY AND THERAPEUTICS. 

CHAPTER III. 

ACTION OF DRUGS ON PROTOPLASM, BLOOD, AND LOW ORGANISMS. 
Action of Drugs on Albumen. 

In all living bodies we find that the protoplasm is of a more or less 
albuminous nature. 

Albuminous substances possess a very complex intra-molecular group- 
ing, and very high atomic weights. Many different forms are found in 
animals, and along with albumens we must associate bodies like mucin, 
which probably have a very important relation to it, inasmuch as a body 
nearly, if not quite, identical with mucin, forms the nucleus of the red 
blood corpuscles in fowls, and a substance of an allied nature also occurs 
in the circulating fluid which represents the blood in the echinoder- 
mata. The albumen of serum may be taken as a representative of such 
substances; it is soluble in water, but, when boiled, is coagulated and 
precipitated. It is coagulated also by alcohol, but if the coagulum is 
quickly placed in water it redissolves ; if allowed to remain for some 
time exposed to the action of the alcohol, it becomes permanent and 
insoluble. An insoluble precipitate also falls on the addition of tannic 
acid, lead acetate, mercuric chloride. These just mentioned precipitate 
almost all the albumens, even from somewhat dilute solutions ; in strong 
solutions precipitates are also formed by silver nitrate, copper sulphate, 
and zinc chloride. When these are added to albumen containing only a 
small quantity of water, as for example, the white of an egg, they form 
with it a solid mass of albuminate. A small quantity of strong potash 
added to the white of egg produces a solid transparent jelly of albu- 
minate of potash, and a similar but opaque jelly is formed by the use of 
caustic lime or baryta in the place of potash: these albuminates are, 
however, soluble in water. 

Albumen dissolves in alkalies and may be partly precipitated by 
neutralizing. The alkaline solution is not coagulated by heat, and, 
in fact, the substance present in the solution is no longer serum 
albumen, but a compound of the albumen with the alkali or alkali-albu- 
rn in ate. 

Albumen is precipitated by a small quantity and dissolved by excess 
of most mineral acids, forming with them acid albuminates; thus a 
watery solution of albumen is precipitated by concentrated nitric, sul- 
phuric, or hydrochloric acid. It is also precipitated by acetic acid along 
with a considerable quantity of a neutral salt of an alkali or alkaline 
earth, or of gum-arabic or dextrin. This precipitation is perhaps best 
marked with nit lie acid, but it only occurs with moderate quantities of 
nitric acid. When a minute quantity only of the acid is added, no pre- 
cipitation takes place, and the solution remains clear; but a nitric-acid- 
albuminate containing a small quantity of acid is formed, and if the 
solution is dow boiled, do coagulum will form. On the addition of more 
acid, however, a second Qitric-acid-albuminate, insoluble in water, is pro- 
duced, and a precipitate falls. On the addition of more acid still, the 
precipitate is redissolved, and a third nitric-acid-albuminate is formed, 
soluble in water, and not precipitated on boiling. 



ETC. 69 

The temperature at which albumen coagulates is altered by acids 
and alkalies. Alkalies generally tend to raise the temperature of coagu- 
lation, and when added in large quantities prevent it altogether. 

Very dilute acetic and phosphoric acid, on the other hand, tend 
to lower the coagulating point, although large quantities may interfere 
with coagulation. 

Neutral salts, such as sodium chloride or sulphate, also lower the 
coagulating point. 

The organic alkaloids which have such a powerful action on the 
animal body appear to resemble acids rather than alkalies in their effect 
upon albumen, because, according to Rossbach, they lower considerably 
instead of raising the point of coagulation. 

Albumen undergoes an extraordinary change in consequence of the 
action of ozone, and becomes, after exposure to it, uncoagulable by boil- 
ing, and by acids, excepting in large quantities, and by metallic salts, 
with the exception of basic acetate of lead, and of alcohol. 

The action of alkaloids upon this ozonized albumen is even more 
remarkable than upon ordinary albumen, for when mixed with it in small 
quantity, they restore its coagulability to the albumen and cause it to 
coagulate far under the boiling point. When added to the albumen 
before exposure to a stream of ozone, they prevent the albumen being 
altered by it, in the way which it would otherwise be, and it remains 
coagulable by heat, in the same way as if it had not been exposed to the 
action of ozone at all. It is therefore evident that the alkaloids not only 
increase the coagulability of ordinary albumen at a high temperature, 
but that they act upon it at ordinary temperatures (30°-40° C.) and 
destroy its affinity for ozone. This action will naturally interfere with 
the processes of oxidation, but the methods of examining this action will 
be described later on (page 79). 

When a solution of pure albumen is added to a mixture of guaiac 
and vegetable protoplasm, it greatly lessens the blue color, which would 
otherwise be produced. The cause of this appears to be that albumens 
or albuminous substances have such an affinity for ozone that they take 
it up instead of allowing it to act on the guaiac. This affinity for ozone 
is diminished by the action of alkaloids. 

This is shown by taking several tubes containing an albuminous solution of 
a certain strength. Reserving one as a standard, the alkaloids are added to the 
others, and after a certain time has elapsed, so as to allow the alkaloid to affect 
the albumen, a small quantity of lettuce water is mixed with each, and then a 
little guaiac. In the standard one the color will be least, because the albumen 
not having been acted upon by the alkaloids will interfere with the reaction of 
the lettuce water and the guaiac upon each other. In the others a blue color 
will appear with greater or less intensity, according as the albumen has been 
more or less affected by the alkaloid. This experiment, however, is not free 
from fallacy, because there is to be considered not merely the action of the 
alkaloid upon the albumen, but its action on the protoplasm as well, and it is 
therefore advisable to use it in a quantity which is small as compared with the 
amount of albumen employed. 1 



1 Rossbach, Verhandl. d.phys. med. ges zu Wiirzburg, N. F., 3 Band., p. 346. 



<0 PHARMACOLOGY AXD THERAPEUTICS. 

Action of Drugs on Protoplasmic MoAenients. 

The amoeba consists of a small mass of structureless protojDlasrn, 
without any distinct cell-wall. 

It contains numerous granules and nucleus, with nucleolus, as well 
as one or more vacuoles, which appear to be small spaces filled with 
fluid. 

Some amoeba live in salt water, others in fresh water ; and, although 
it may be impossible with the microscope to detect any marked differ- 
ence between them, they exhibit a great difference in their reactions to 
drugs — the salt-water amoeba being only slightly affected by them, 
while fresh-water amoebae are readily susceptible to their action. 

It is nourished by simply adhering to any particle of food, closing 
over it and digesting it, again opening out and ejecting the residue. 

This protoplasmic mass is almost constantly altering in shape, push- 
ing out projections at one point and drawing them in at another. By 
this means, also, it moves about from place to place. 

3Iethocl of Experimentation on Amoebae and Leucocj tes. — In 

experimenting on amoebae, take a drop of the slimy sediment, such as found in 
the tanks of hothouses, and place it on the covering-glass of a microscope ; this 
may then either be put on an object-glass, the excess of water removed by filter- 
paper, or still better, it may be inverted over the opening of a Strieker's warm 
stage. 

When it is simply laid on the object-glass, a solution of any drug is added 
by putting a drop across the edge of the covering-glass, and allowing it to be 
drawn gradually underneath by capillary attraction. 

Gases are best applied by means of a Strieker's stage, and it is also conve- 
nient for experiments on solutions. 

In experimenting on leucocytes with its aid, a covering-glass is applied to 
the cut surface of a newt's tail, or to the surface of a drop of blood, so that a 
very minute quantity of blood adheres to it. 

The drug to be tested is kept dissolved in a -6o--*J5 per cent, solution of 
common salt (Na CI). The salt solution of this strength is often called simply 
normal Ball .-olution, and is used instead of water, because water itself has a 
very destructive action on those forms of protoplasm, which are usually nur- 
ished by saline solutions, like blood or serum. 

A drop of the salt solution containing the drug is placed over the blood on 
the covering-glasSj ami inverted over the warm stage as already described. If 
the experiment is to continue long, a rim of oil should be drawn around the 
edge of tli.' covering-glass with a camel-hair pencil, so as to prevent evaporation. 

The advantage of using such a small quantity of blood is, first, that it mixes 
rapidly and perfectly with the solution ; and secondly, that it does not dilute the 
solution <>f tin- drug, and we thus know the strength of the drug used. 

If we used a large drop of blood, we should have to employ a solution of the 
din- twice the strength we desire, so that when a drop of equal size was added 
t<> the blood the mixture would contain the proper proportion. 

The effect of \u-.\i and cold upon the movements is very marked, 

cold rendering then slow, or arresting them altogether. Heat at first 

lv quickens their movements, but, when raised to 35° C. it causes 

them to fall into a state of tetanic contraction and assume a spherical 

form. 



ETC. 71 

This state is one of heat tetanus, and if the temperature is now re- 
duced the movements will again reappear. 

At a temperature of 40° C. they also become spherical and motion- 
less. But their movements do not return when the temperature is 
reduced ; they are in a state of heat rigor, the high temperature having 
coagulated the protoplasm. 

Slight electrical shocks from a coil increase the rapidity of the 
protoplasmic movements ; stronger ones cause tetanic contraction ; and 
numerous or powerful ones produce coagulation. 

Common salt in very small quantity (a drop of 1 per cent, solution 
slowly added) first quickens the protoplasmic movements and then causes 
sudden tetanic contraction, and the expulsion of any food they may con- 
tain at the moment, and sometimes even expulsion of the nucleus. 

When water is added so as again to dilute the mixture the amoebae 
resume their movements. 

Both acids and alkalies, when very dilute, increase the protoplas- 
mic movements and afterwards arrest them. 

Hydrochloric acid has a more powerful action than a solution of 
potash of a similar strength. It causes the amoebae to contract and 
form a ball with a sharp double contour. In it, twitching movements 
first occur, which expel any food present. It then becomes pale and 
lumpy, and breaks up. 

Potash causes them to swell up and assume the form of large pale 
vesicles, which quickly burst. 

A constant current of electricity causes contraction and im- 
perfect tetanus ; and, if powerful and long kept up, the positive pole 
produces in the amoebae near it the same changes as dilute hydrochloric 
acid, and the negative pole the same changes as are produced by an alkali 
such as potash. 

Oxygen appears to be necessary for their life ; its removal by means 
of hydrogen deprives the amoebae of their power of motion, and finally 
causes contraction and coagulation. 

Carbonic Acid alone has a similar action to removal of oxygen, 
and produces this effect both in the presence and absence of oxygen, but 
takes a longer time to do so when oxygen is present. 1 

Leucocytes. — In their appearance and movements leucocytes 
strongly resemble amoebae : they are affected in a similar manner by 
heat, electricity, and drugs. Their resistance to the action of drugs 
varies somewhat in different animals. Those obtained from the blood of 
the newt for example are more resistant than those of the guinea-pig ; 
and those of the female newt more resistant than those of the male to 
the action of quinine. 2 Heat and cold affect the movement of leu- 
cocytes in very much the same way as those of amoebae. 

The movements of leucocytes, like those of amoebae, are of two 
kinds, viz., movements of the protoplasmic pseudopods, while the leu- 
cocyte remains in situ. The pseudopods in this instance are generally 
of a waxy look and knoblike form. 



1 Kiihne, Protoplasma und Contractilitat, pp. 28-53. 

2 Geltowsky, Practitioner, vol. viii., pp. 325-330. 



72 PHARMACOLOGY AND THERAPEUTICS. 

Secondly, movements of migration from place to place ; these move- 
ments are accompanied, or accomplished, through the projection of 
numerous fine filaments. 

Effect of Drugs. — Cinchona alkaloids — quinine, quinidine, cin- 
chonine and cinchonidine have a remarkable power of arresting these 
movements in the proportion of 1 in 1,500. They quickly stop the mi- 
gratory movements of leucocytes from the newt, and in a much larger 
proportion will arrest the movements of the knoblike pseudopods. 

No very marked difference is observed in the strength of the cinchona 
alkaloids, though quinine seems to be somewhat the most powerful. 

Sulphate of bebirine is almost as powerful as the cinchona alkaloids. 

Strychnine is very much less powerful than any of the alkaloids 
mentioned. 

Potassic picrate and sesculin have but little action. 1 

Movements of Leucocytes iu the Blood-vessels. — In the 
processes of inflammation leucocytes pass in great numbers through 
the walls of the capillaries. 

The effect of quinine in arresting their movements, when mixed with 
them directly, naturally leads one to expect that it may arrest their mi- 
gration from the capillaries, when injected into the blood, and this 
anticipation has been realized in the experiments of Professor Binz. 

To observe this phenomenon, the brain of a frog is to be destroyed, and a 
little curare injected under the skin, in order to abolish any spinal reflex move- 
ments. It is then laid on a piece of cork, such as that shown in Fig. 5, with a 
hole at one side, over which a piece of glass is fastened about half an inch higher, 




FlO. 1— Apparatus for examining the mesentery of the frog under the microscope. 

by means of two other pieces of cork and some sealing-wax. On this a piece of 
sheet cork of the form shown in the figure, and a round piece of glass are ce- 
mented bo as to form a channel, in which the intestine lies. The body of the 
frog is fixed to the cork, the abdomen opened, the intestines drawn out, and the 
mesentery fastened with very fine pins over the aperture. In half an hour, or 
two hours, the leucocytes pass rapidly through the walls of the capillaries, and 
afterwards wander through the tissues. 

The drug may then be injected into the lymph sac, or locally applied to the 
mesentery. 

When quinine is applied locally to the mesentery in this condition it 

3ts the movements of the leucocytes, which have already emerged, but 

Dot prevent those which are still within the vessels from going out — 

they therefore form a dense accumulation around the vessel (Fig. 6, b). 



Ba< hanan Baxter, Practitioner, vol. xi., p. 321. 



ACTION OF DRUGS ON PROTOPLASM, ETC. 73 

When injected into the circulation, on the contrary, the leucocytes 
which are in the vessels are prevented from passing from the capillaries, 




Fig. 6. — Diagram to illustrate the action of quinine on leucocytes, modified from Binz (Das Wesen der 
Chininwirkung, Berlin, 1868). The thick lines represent the walls of the blood-vessel, and nu- 
merous leucocytes are shown both inside it and outside distributed through the adjoining tissues. 
a represents the vessel before, and b after the local application of quinine. The leucocytes outside 
the vessel have their movements arrested, and cannot wander on through the tissues, while those 
inside are not affected and continue to emigrate, c represents the effect of quinine injected into 
the circulation or lymph sac. The leucocytes inside the vessel are here aflected first, and their 
emigration stopped, while those outside still continue to travel onwards. 

while those which have already passed out continue to wander onwards, 
and thus a clear space is left outside the vessel (Fig. 6, c). 

The quantity of quinine necessary to produce this effect is 25 jj 0Q th to 
2Q jj 00 th of the animal's weight. 

If quinine were given to stop the exit of leucocytes from the vessels in 
peritonitis, three or four grammes would be required to be given within 
a short time, to a man weighing 150 lbs. 

In guinea-pigs a dose of quinine sufficient to kill the animal does not 
stop the movements of the leucocytes in its blood, which are seen to go on, 
when a drop of it is examined after death. 

Red Blood Corpuscles. — The size of the red corpuscles is dimin- 
ished by warmth, either applied locally on the hot stage of a microscope, 
or acting on them in the vessels of an animal suffering from fever, by 
carbonic acid and by morphia. 

It is increased by cold, oxygen, hydrocyanic acid, and quinine ; and 
an increase occurs also in cases of anaemia. 1 

The red corpuscles pass out of the capillaries like the white, but they 
do so very slowly indeed, and in small numbers, under ordinary circum- 
stances. Excess of sodium chloride in the blood causes them to pass out 
much more quickly ; 2 and rattle-snake poison, when locally applied, pro- 
duces such sudden extravasation that it is impossible to follow the 
process : the whole field of the microscope becoming suddenly covered 
with blood. 3 

Action of Drugs on Infusoria. 

Among the infusoria, like the amoebae, each individual consists of a single 
mass of protoplasm, and not of a number of distinct cells ; but the protoplasm 



1 Manassein, Ueber die Dimensionen der Blutkurperchen unter verscJuedenen Einfliissen. 
Ttibingen, 1872. 

2 Prussak. Wiener. AJcad. Sitzungsber., lvi., 1867 (Abth. 2), p. 13. 

3 Brunton and Fayrer, Proc. Roy. Soc., February, 1875, p. 271. 



74 PHARMACOLOGY AND THERAPEUTICS. 

is differentiated. Round the greater part of the animal it seems to be some- 
what harder, so as to form a sort of skin, excepting at one place which is softer 
than the rest, serving for the ingress of food and the egress of egesta. 

Instead of throwing out pseudopods, the body is either covered entirely with 
cilia or they are arranged round the mouth. Once it has entered by the mouth, 
the food finds its way all through the protoplasm of the body. 

A contractile vesicle exists, which pulsates rhythmically. 

3Iode of Experimentation. — For the purpose of examining the action of 
drugs upon infusoria an infusion of hay is prepared some days previously. Two 
small pipettes are then made, which will deliver drops of equal size. 



f 



Fig. 7. — Diagram to show the way of making small pipettes. 

This is done by heating a piece of glass tubing in the middle, drawing it out 
and cutting it across by a scratch with a triangular file (Fig. 7). With one of 
these a drop of hay-infusion is placed on the covering glass, which is inverted on 
a Strieker's stage and examined. In order to ascertain the lethal strength of a 
drug, a drop of a solution of the poison of a definite strength is then mixed with 
it, and the infusoria are examined again after a certain time. 

If they continue moving, another experiment is made with a stronger solu- 
tion ; but if they have completely stopped, it is repeated with a weaker one until 
the solution is of such a strength that the movements become very slight, and 
cease almost immediately after mixing, and cannot be restored by the addition of 
water. As the two drops of fluid were of equal size, the lethal strength of the 
solution is just one-half of that which was last added. By repeating the experi- 
ments in exactly the same way with different drugs, their relative poisonous 
properties are ascertained. 

Heat increases the rapidity both of the rhythmical contractions of 
the vesicle and of the ciliary motion and consequently of the movements 
from place to place of the infusoria. It seems as if the cilia were not 
equally affected by heat, those which produce a longitudinal movement 
appearing to be acted upon more quickly than those which cause a move- 
ment of rotation. Both kinds are first stimulated and then paralyzed. 

At temperatures between 25° and 30° the contractions of the vesicle 
are greatly quickened, and the animal moves with great rapidity in a 
longitudinal direction. 

Between 30° and 35° its movements are still very rapid, but it seems to have 
lost the power of direction ; all the cilia seem in full action, and the movements 
of* the individual arc determined simply by their anatomical arrangement. 

Above H)° the cilia, which act longitudinally, appear to have stopped and 
the animal rotates, at first very rapidly, then slower and slower until all move- 
ment .ml the protoplasm appears to become fluid; but when the heat is 

still farther raised it coagulates. 1 



ibach, ' J)i<- rii> thmisciicn Bewegunggerecheinungen der einfachsten Organ- 
ismen," Ferh, d. Wiirzburger phyrik-med. Gcsellsch, N.F., Bd. ii., Separatabdruck, S. 23. 
This work contains a number of exceedingly interesting and valuable observations 
on the subject. 



ACTIOX OF DRUGS OX PROTOPLASM, ETC. <0 

Cold lessens the quickness of the rhythmical contractions of the 
vesicle, of the ciliary motion and of the movements from place to place. 
Weak electrical currents first quicken the ciliary motion and cause 
movements of rotation, then swelling of the protoplasm, slower move- 
ments, and finally apparent solution of the protoplasm. 

Moderate currents produce a tetanic contraction of the protoplasm 
and of the cilia, while the contractile vesicle is unaffected. 

Strong currents cause liquefaction of the protoplasm. 

Saline solutions appear rather, if we may say so, to alter the con- 
ditions under which the infusoria live than to affect the protoplasm itself. 
Strong solutions cause them to shrivel and then to swell up and become 
motionless. This effect appears to be due to the solution altering the 
quantity of. water which the protoplasm contains. 

"Weaker saline solutions, on the contrary, quicken their movements, 
and instead of causing them to shrivel, make them swell up at once. 
Chloride of sodium, chloride, bromide, and chlorate of potassium, as well 
as alum, all have this effect. 

Acids in minute quantities cause contraction both of the body and 
of the vesicle. The ciliary motion is at first quickened and then 
retarded ; the rate of contraction of the vesicle is at once diminished. 

Moderate quantities cause coagulation of the protoplasm with swell- 
ing and liquefaction after death. 

Strong acids at once destroy the protoplasm. 

Alkalies in minute quantities cause swelling of the protoplasm, 
dilatation and slowness of the contractile vesicle. 

Moderate quantities at once arrest the movements, cause liquefaction 
of the protoplasm, and destroy its differentiation, the contractile 
vesicles and vacuoles disappearing. They then cause swelling, and finally 
solution. 

In large quantities they produce immediate liquefaction of the whole 
body. 

Other drugs appear to affect the protoplasm itself, and arrest its 
movements without producing any apparent change in it. 

The most active are chlorine, bromine, corrosive sublimate, iodine 
and permanganate of potash, and creasote. 

Quinine is much less powerful than these, though it is much more so 
than most other organic alkaloids. 

Strychnia has only one-fourth the power of quinine. 

Cobra poison at first greatly quickens the movements of infusoria 
and then arrests them, causing just before death a contraction of the 
protoplasm, which then expands to its ordinary size. 

Relations of Motion and Oxidation. 

All animals, from the lowest to the highest, evidence their life by 
motion at one time or another ; and the energy required for this motion 
is maintained by processes of combustion. 

The materials for this combustion, viz., oxygen, and fuel of some 
sort, or food, are derived from the external medium in which the animal 
lives ; and in order to enable these substances to be available for each 



i 1 1 PHARMACOLOGY AND THEEAPEUTICS. 

part of the animal body, we must have some kind of respiration and cir- 
culation going on in it. 

In unicellular organisms, consisting of a single mass of protoplasm, 
the oxygen is derived from the water in which they swim, and both it 
and the nutritive material derived from the digestion of inclosed masses 
are circulated through the protoplasm by contractile vacuoles. 

In sponges, where the organism no longer consists of one but of 
several cells united into a community, some of these are furnished with 
cilia, in order to send a current containing oxygen and food to the other 
cells having a less favored position. 

In higher animals, where many cells are built up to form one or- 
ganism, we find a circulatory and respiratory apparatus fully developed. 

The medium in which unicellular organisms live is the water in which 
they swim. The medium in which the cells composing the main parts of 
the bodies of higher animals, such as man, live, is not the air which sur- 
rounds the body, but the intercellular fluid in which the cells themselves 
are bathed. 

Aa Claude Bernard points out with his usual clearness, the cells of 
the human body and the lowest unicellular organisms alike live in a liquid 
medium. From the layer of fluid surrounding it, the cell takes up the 

gen and food which this layer can yield. The supply being exhausted, 
an unicellular organism can move on elsewhere, but the cells in higher 
animals, being fixed and unable to move, require fresh portions of oxygen 
and of nutritive fluid to be brought to them. 

This is effected by the slow circulation of the lymph in which the cells 
themselves are bathed and by the supply to the lymph of oxygen and 
nutritive material from the blood. 

The circulation of the lymph is aided in many lower organisms by 
the motion of cilia, and this is found persisting in some parts of the 
higher animals, e. </., the central canal of the spinal cord. 

li«t ween the blood and the lymph an interchange goes on, oxygen 
passing from the blood to the lymph or unicellular fluid, and carbonic 
acid from the lymph to the blood. 

This interchange of gases between the blood, the intercellular fluid, 
and the Cells is termed internal respiration. 

In oi«l,T to maintain this, a constant current of blood must take 
place; and when its circulation Is locally arrested it becomes deprived of 

gen and loaded with carbonic acid, so that the cells in the district in 
which the stagnation occurs Buffer from local asphyxia, while the other 
parte "1* the body maybe perfectly healthy. 

When the general circulation is arrested by stoppage of the heart, by 
obstruction of the pulmonary arteries, or by the rupture of an aneurism 
draining the blood away, the whole body suffers in a similar manner from 
general asphyxia bythe cessation of internal respiration. 

[f oxygen were simply dissolved in the blood, the quantity which 
would b< ed to the tissues would be too small for their wants, and 

therefore have ac an oxygen-carrier a Bubstance capable of taking up 
a large quantity of oxygen, of readily forming a loose compound with it, 
and of again giving off readily to oxidizable substances. 



ACTION OF DEUGS ON PROTOPLASM, ETC. 77 

In man and mammals and many of the lower animals this substance 
is haemoglobin. In some annelids it is a green substance, chlorocruorin; 
and in the octopus it is a blue body, hsemocyanin. 1 

In order to remove carbonic acid taken up from the tissues and obtain 
a fresh supply of oxygen, an interchange takes place between the blood 
and the external air in the lungs; this is external respiration. 
Without any direct influence being exerted upon the cells of the animal 
bo^iy themselves, they may be affected and their nutrition greatly 
modified by : 

1st. Alterations in the circulation of the intercellular fluid or lymph 
in which they are bathed. 

2nd. In the greater or less rapidity of circulation of blood locally. 

3rd. In the circulation generally from changes in the heart and 
blood-vessels generally. 

4th. Changes in the oxygen-carrying power of the blood, either from 
alterations in its power to take up or give off oxygen. 

5th. Changes in the external respiration. 

All these conditions may be altered by drugs, or at least by thera- 
peutic measures. Thus the circulation of lymph in a part may be in- 
creased by shampooing, and its accumulation in a case of dropsy may be 
removed by incision, by puncture, or by drainage. 

The circulation of blood may be arrested locally and gangrene in- 
duced by the continuous use of ergot. It may be increased by the use 
of local stimulants or irritants. 

The circulation generally may be affected by the large class of vas- 
cular stimulants and depressants, to be afterwards discussed, and some- 
times by stoppage of the pulmonary circulation through minute embola. 

Alterations in the oxygen-carrying power of the blood will be dis- 
cussed presently, and those in the external respiration later on. 

Oxidation of Protoplasm. — The movements of protoplasm are 
intimately connected with processes of oxidation going on in it. 

By these processes chemical energy is converted into the mechanical 
energy exhibited in the movements, and this is sometimes very consid- 
erable. 

The oxygen which takes part in these processes is not always de- 
rived from the surrounding medium at the exact moment when the 
movements take place ; it may have been obtained some time before, 
and the movements may continue for a little while after all oxygen has 
been removed. 

It therefore appears that protoplasm has the power of absorbing and 
storing up within itself, in some manner or other, oxygen, which it can 
afterwards utilize for the purpose of liberating mechanical energy. 

This storage of oxygen takes place not only in the protoplasm of 
unicellular organism, but also in the tissues of the higher animals, e.g., 
the muscles. 

The exact way in which storage occurs is not known, but it has 
been well compared by Professor Ludwig to the storage of oxygen in 



1 For further details vide Physiological Chemistry, by A- Gamgee, vol. i., 1880, p. 
130. 



, 8 PHARMACOLOGY AXD THERAPEUTICS. 

gunpowder. The oxygen is there contained in the nitrate of potash, a 
compound which is readily decomposable by the application of heat, and 
then gives rise to the evolution of mechanical energy ; and this it does 
perfectly well in an inclosed space, like a gun-barrel, where no air is 
present. 

The power of storing up oxygen is very limited, and although pro- 
toplasmic movements continue for a little while after all external oxygen 
has been removed, yet they will not continue long. * 

A convenient way of ascertaining this fact has been devised by Kiihne, who 
adds a small quantity of blood or of haemoglobin solution to a drop of water 
containing protoplasmic organisms or cells placed on a covering-glass. This is 
then observed under the microscope with a micro-spectroscope. The haemoglo- 
bin solution exhibits the two bands characteristic of oxyhaemoglobin. When 
all the oxygen is removed by means of a stream of hydrogen, kept up for some 
time, the spectrum of oxyhamioglobin passes into that of reduced haemoglobin. 

The occurrence of this change indicates the moment when all the oxygen 
ha- disappeared from the liquid. By reckoning from this moment onwards, we 
are able to estimate the length of time during which the movements continue in 
the absence of oxygen. 

Oxygen-carrying Power of Protoplasm. — Not only does pro- 
toplasm possess the power of taking up oxygen readily and assimilating 
it to itself, but it has also the power of taking up and giving off oxygen 
to other substances when these substances would be unable to take it 
themselves. 

We may understand this action better by comparing it in a very 
rough way with that of a man whose greater strength enables him to 

• fruit or break off pieces of sweetmeat and give them to his child, 
which thus enjoys what it could not have obtained for itself, however 
desirous of them it might be. 

method of Experimenting. — Guaiac resin, when finely divided and 
oxidized, becomes of a blue color. It has, however, only a slight power of 
attracting oxygen to itself from the air, or from water in which the oxygen is 
dissolved, ami thus the blue color is developed slowly. 

On tin- addition of protoplasm to the water containing the guaiac, the blue 

color i- developed rapidly. The reason of this possibly is, that the protoplasm 

has taken up oxygen from the water and given it over to the guaiac. This 

process reminds us of the action of spongy platinum in causing oxidation of 

ii formic acid. 

Ozonizing Power of Protoplasm. — It has been supposed that 
in addition to its power of oxidizing such substances as guaiac by giving 
to them oxygen which it has already taken up, protoplasm has the power 
of actually breaking up the molecules of oxygen and forming ozone. 
The rapid oxidation which protoplasm causes has been attributed to 
power. A similar action to this is observed during the slow oxida- 
nt" phosphorus. Phosphorus appears to break up the molecule of 
gen, taking to itself one atom and freeing another, which unites with 
two more in order to form ozone. 






ACTION OF DRUGS OX PROTOPLASM, ETC. 79 

Action of Drugs on Oxidation. — A convenient way of testing the 
effect of drugs upon oxidation is to use the protoplasm of potato, of lettuce, or of 
dandelion. The most active part of the potato lies just under the skin, as is seen 
by pouring some freshly-prepared tincture of guaiac over its cut surface. A 
ring of blue first forms close to the skin, and is always darkest there, although 
it may extend over the whole of the cut surface. The ammoniated tincture of 
the British Pharmacopoeia will not answer. The tincture must be made with 
spirit only. When potato is used, the whole of the potato may be pounded with 
water, or, still better, the peel alone may be cut off and rubbed up with water in 
a mortar and then filtered through linen. When lettuce or dandelion is used, 




Fig. 8. — Test-glasses for examining the action of drugs on oxidation. 

the fresh leaves are triturated in a mortar with five or ten times their bulk of 
water, and the solution is then filtered A row of test-tubes or test-glasses 
having been prepared, a measured quantity of water is put into the first. In 
this glass the protoplasm is not mixed with any foreign substance, and it there- 
fore serves as the standard with which to compare the others ; and into the 
others is put a similar quantity of solutions of the drugs to be tested. Each 
test-glass is distinguished by a label bearing either a number or the name of the 
drug which it contains attached to it. To each glass a measured quantity of 
the lettuce-water is added and the contents mixed by shaking. All are allowed 
to stand for a period varying from a few minutes to some hours. Then a small 
drop of freshly-prepared tincture of guaiac is added to each, mixed by shaking, 
and allowed to stand for one or two minutes ; the glasses are then arranged in 
the order of depth of color. 

In this way it is found that many drugs greatly lessen or almost completely 
abolish the oxidizing power of protoplasm, so that while the lettuce-water in 
the standard-glass assumes a dark-blue color, that in the others exhibits varying 
shades of blue, or may even retain the creamy- white color caused by the guaiac 
without showing any blue whatever. 

The color is deeper and the reaction is more readily obtained when the tinc- 
ture of guaiac is mixed with some substance capable of giving off oxygen readily, 
such as a solution of peroxide of hydrogen in ether, usually called ozonic 
ether. 

A number of experiments made with potato-water by Cash and myself 
showed that oxidation in potato solution was diminished most powerfully by 
strychnine, then by quinine and coniine ; next by morphine, codeine, cinchonine, 
and atropine, each of which had almost exactly the same action ; next by nicotia, 
and then by veratrine. Aconitine seemed neither to retard nor accelerate oxida- 
tion, and presented exactly the same degree of coloration as the standard solution. 
Caffeine, picrotoxin, and digitalin, appeared somewhat to hasten oxidation (St. 
Bartholomew's Hospital Reports, 1882). 

Action of Drugs on Blood. 

The hemoglobin of blood has also the power of taking up oxygen 
readily and giving it freely off again. Haemoglobin free from oxygen. 



PHARMACOLOGY AND THERAPEUTICS. 

or. as it is sometimes called, reduced haemoglobin, is recognized by 
the simple baud which it gives between D and E, when examined spec- 
troscopically. 

Hemoglobin combined with oxygen, or oxyhemoglobin, gives two 
bands, situated in nearly the same portion of the field of the spectroscope. 
These are separated from one another by a clear space, and are more 
sharply defined and darker than the spectrum of haemoglobin. 

The oxygen of oxyhemoglobin may be replaced by other gases. 
Thus : — Carbonic oxide drives out the oxygen from oxyhemoglobin 
and forms carbonic oxide hemoglobin (CO-hemoglobin). This is a com- 
paratively stable compound. It presents spectroscopic bands nearly the 
same as those of oxyhemoglobin, but which are slightly nearer to the 
violet end of the spectrum. This compound, being stable, circulates in 
the blood without performing the functions of respiration. It neither 
takes up oxygen in the lungs nor gives off oxygen to the tissues. 

Animals poisoned by CO therefore die of asphyxia, the internal re-, 
spiration being arrested, and their blood remains for a long time of a 
florid color. 

Hydrocyanic acid appears also to form a compound with hemo- 
globin, which is much less stable than that of carbonic oxide. There has 
been a good deal of discussion about this compound, and its existence, 
indeed has been denied. The spectrum of this compound consists of a 
single band resembling reduced hemoglobin but nearer the violet end of 
the >pectrum. 

Solutions of hemoglobin when boiled are completely decomposed into 
haematin and a proteid body or bodies. 

I Ill-matin gives a single band, which differs according as the solution 
is alkaline or acid, and according as the solvent is water or ether. 

Acids split up hemoglobin into hematin and a proteid. It is some- 
times possible to get these to recombine and to again form hemoglobin, 
but this is far from being always the case. 

Methaemoglobin appears either to be a product of the incomplete 
decomposition of hemoglobin or of its excessive oxidation. Some think 
that it contains more oxygen than hemoglobin, but less than oxyhemo- 
globin. Others think that it is a per-oxyhemoglobin containing more 

_ r -ii than oxyhaemoglobin. At all events the oxygen is more firmly 
combined in methaemoglobin than it is in oxyhemoglobin. 

This body is distinguished by a spectroscopic band nearly in the 
Same place as that of acid haematin. 

W hen the solution is made alkaline by ammonia this band disappears 
and is replaced by another fine one near D. 

Methaemoglobin appeal- to be converted again into hemoglobin by the 
action of reducing agents and subsequent oxidation. When its solution 
is treated with reducing agents, it -hows the spectrum of reduced hemo- 
globin; and on shaking this with air oxyhaemoglobin is formed, as 
Bhown by the appearance of it- characteristic bands. 

When blood ia allowed to stand for a length of time, it assumes a 
brownish color and gires the bands of methaemoglobin. When nitrites 
are mixed with freshly-drawn blood, they impart to it a chocolate color, 
and it then exhibits the hands of methaemoglobin. 



ACTION OF DRUGS ON" PROTOPLASM, ETC. 



81 



As the oxygen in methiemoglobin is more firmly combined with it 
than in oxyhemoglobin, substances such as the nitrites interfere with in- 
ternal respiration, and thus in large doses will cause symptoms of asphyxia; 
but their action differs from that of carbonic oxide in one very important 
particular, viz., that it is altered by asphyxia, whilst that of carbonic oxide 
is not. Reducing substances are constantly present in the blood and 
tissues, and these accumulate to a greater extent during the process of 
asphyxia. Carbonic-oxide haemoglobin, being a stable compound, re- 
mains unaffected by these, and the blood continues to circulate unchanged. 







111 










HI 








II 






If 




1 l \:<: 




f ■ 






h.llH 




1 1 ] 


- 


ill 






1 s 


1 






,11. .. ! M 


I ill 




f,f It 


:||,:; !;: 


»f\j 38 












fill 


S 




" 






i .,-■ ■■■,!- - -Til 1- 










Oxyhemoglobin 

Hsenioglobin 

Carbonic-oxide hsemoglobin 
Sulpha? inoglobin 

Ditto, oxygenated 

Metheeinoglobin 

Blood treated witb nitrite ) 
of amyl and alcohol J 

Acid haematin (alcoholic) 
solution) j 

Alkaline hpematin (alco-1 
holic solution) J 

Blood treated with cyan- 
ide of potassium or hy 
drocyanic acid 

Ditto, oxidized 



C D E b F 

Fig. 9. — Chart showing the spectroscopic absorption-bands of haemoglobin and its derivatives. 

(After McMunn). 

But methsemoglobin, which is produced by the action of the nitrites, 
becomes reduced by these substances and forms the normal reduced hae- 
moglobin ordinarily present in venous blood. When this reaches the lungs 
it again takes up oxygen, forming normal arterial blood, by which the 
internal respiration is again restored. Thus, unless new supplies of ni- 
trites are constantly added to the blood, the asphyxia they occasion quickly 
passes away. That caused by carbonic oxide, on the contrary, is much 
more permanent. It is not removed by artificial respiration, and in order 
to save the life of the animal or person poisoned by it, a quantity of the 
poisoned blood must be withdrawn from the veins and healthy blood in- 
troduced by transfusion. 

A method of ascertaining the effect of drugs on oxidation in the 
Mood consists in estimating the rate at which acid is developed in it 
after its removal from the body. 

In this way Binz and his scholars, Zuntz, Scharrenbroich and Schulte, 
have found that both quinine and sodium nitropicrate stop the formation 
of acid ; cinchonine lessens it. 1 

The alterations effected in the interchange between blood and the 
air have also been observed by simply allowing the blood mixed with the 

1 A very complete list of the literature of this subject is given by Binz in his 
work, Das Chinin, Berlin, 1875. 



82 PHARMACOLOGY AXD THERAPEUTICS. 

drug to stand for a certain time in a closed receiver, partially filled with 
air. and afterwards analyzing the gases which the receiver contains at the 
end of the experiment. 

By this mode of experimentation, Harley 1 found that hydrocyanic 
acid diminished or arrested the processes of oxidation in the blood. 
Alcohol, chloroform, quinine, morphia, nicotin, strychnia, and brucia, all 
had a similar action, though varying in extent, all of them diminishing 
both the amount of oxygen absorbed and of carbonic acid given out. 

Uric acid and snake poison had a contrary eifect, increasing the ab- 
sorption of oxygen and the evolution of carbonic acid. Curare appeared 
to lessen the absorption of oxygen, but increased the evolution of car- 
bonic acid. Mercuric chloride lessened the carbonic acid, but increased 
the absorption of oxygen. Arsenious acid and tartar emetic diminished 
the absorption of oxygen, but arsenious acid appeared also to lessen the 
evolution of carbonic acid, while tartar emetic appeared to increase it. 

Catalysis. — Fermentation.— Inorganic Ferments. 

There are many examples of chemical reactions which only occur be- 
tween two bodies when a third is present, which may nevertheless be 
found unchanged at the end of the process. Notwithstanding the fact 
that the third body is found unchanged at the end of the process, it may 
have undergone changes during the continuance of the process. Thus 
alcohol is not converted into ether and water by boiling alone, but it does 
undergo this conversion by boiling with sulphuric acid. The acid is 
found unchanged at the end of the process, but is changed during it 
into ethyl sulphuric acid, which, combining with alcohol, again yields 
sulphuric acid along with ether. 

In other eases, however, we cannot show that the substance has un- 
dergone change. Thus starch is converted into dextrin and sugar and 
cane-sugar into grape-sugar by boiling with acids, but we do not at 
present know that the acid has undergone any change during the process 
as it does in the preparation of ether. Peroxide of hydrogen is rapidly 
decomposed by finely-divided platinum or silver, and finely-divided 
platinum will, on the other hand, cause oxygen and hydrogen to unite 
rapidly. Such actions, where the third substance seems to act by its 
mere contact with the other substances, and without undergoing change 
itself^ are called catalytic. They are probably due to an attraction 
of some kind bordering both on chemical and physical between the 
molecules. 

Thus Borne organic substances would resist the oxidizing action of the 
:nr for ;i considerable time, but they are readily oxidized by charcoal. 
It is usually -aid thai the charcoal has the power of attracting oxygen 
and condensing this gas upon its surface. It does not unite with the 

Zen chemically so as to form C0 2 , but merely attracts it, holds it for 

a •rpile, and then gives it off readily to any oxidizable substance. 

Platinum, palladium, rhodium, and iron absorb hydrogen, palladium doing 

• .in enormous extent, especially when it is" in a, spongy form. The 



Harley, Phil. Trans., 1 -Go, ,,. u78. 



ACTION OF DRUGS ON PROTOPLASM, ETC. 83 

hydrogen is supposed by some to be simply condensed within the metal, 
while others think that the hydrogen and metal unite to form a hydride. 
The hydrogen is given off from the metal in a nascent form, and has 
very strong affinities. Thus palladium-hydrogen readily reduces ferric 
to ferrous salts, the hydrogen taking oxygen from the ferric salt and 
forming water. But when the hydrogen is liberated from palladium or 
rhodium in presence of oxygen, it appears to convert the oxygen into 
ozone, and greatly increases its oxidizing power. Thus palladium- 
hydrogen with oxygen colors a mixture of potassium iodide and starch 
paste blue, and oxidizes haemoglobin to metheemoglobin and ammonia to 
nitric acid. Spongy rhodium, or iridium saturated with hydrogen, cause 
formic acid to be oxidized to carbonate, calcium formate being changed 
into calcium carbonate. Exactly the same action is possessed by an 
organic ferment, and in the conversion of the formic into carbonic acid 
the ferment and the spongy rhodium or iridium are alike unchanged. 
Spongy platinum, palladium, rhodium, and iridium may thus be regarded 
as inorganic ferments. 1 

Ferments Organic and Organized. 

The mechanical energy displayed in the movements of protoplasm is 
supplied by processes of chemical change, and chiefly of oxidation. 

By these processes some of the substances contained in the proto- 
plasm are destroyed, and their place must be supplied by fresh material. 
This material is obtained from the food, but, in order to render it avail- 
able for the protoplasm, its atoms must be more or less disintegrated in 
order that they may again be assimilated. As Hermann very well puts 
it, the bricks of which the old house is built must be pulled asunder 
before they can be built up again into the new. In the present case, the 
bricks are the atoms of protoplasm in some other organism, living or 
dead, which is being used as food by some larger mass of protoplasm, as, 
for example, a bacillus which has been absorbed by an amoeba (Fig. 10). 



^A 




Fig. 10. — An amoeba figured at two different periods during movement. 
n, nucleus : i, ingested bacillus. 

In order to render the protoplasm in the bacillus available for the 
nutrition of the amoeba, the atoms of which it is composed must be, to 
some extent, decomposed. This process appears to be effected by 
enzymes, or, as they are sometimes called, organic ferments. 



1 Hoppe-Seyler, Ber. d. Deutsch. Chem. Gesellsch., 1883, Feb. 12, p. 117. 



8 i PHARMACOLOGY AND THERAPEUTICS. 

Ferments are bodies which split up carbon compounds at moderate 
temperatures and lead to the formation of other carbon compounds, most 
of which are of a simpler constitution than the first. 

In this definition we require to introduce the term "moderate tem- 
perature," because excessive heat alone will cause the atoms of a complex 
carbon compound to fly asunder and form simpler compounds, as in the 
process of dry distillation. A less heat than this, but aided by the 
aetion of powerful chemicals, will also produce the same effect. For 
example, fibrine heated with diluted hydrochloric acid under pressure 
yields peptones; but the same change is effected at the temperature of 
the mammalian body by the aid of pepsin. Trypsin from the pancreas 
effects a similar change when mixed with water alone without the aid of 
an acid, though its action is certainly aided by alkalies. Neither pepsin 
nor trypsin are alive, but they contain carbon, and are therefore called 
organic ferments. But this term easily leads to confusion with 
ordinary living or organized ferments, and so the term enzymes has 
been lately introduced to signify ferments such as diastase, ptyalin and 
pepsin, which, though they contain carbon and are therefore called 
organic, are not alive and have no definite structure, or, in other words, 
are not organized. The term unformed ferments has also been 
applied to them. 

By organized ferments we mean minute living organisms, which 
in the course of their life-processes cause decomposition of the substances 
in which they live. They have also been called formed ferments. Ex- 
amples of these are yeast and bacteria. 

The processes of fermentation have been divided by Hoppe-Seyler 
into two kinds : — 

( 1 ) Those in which water is taken up ; and (2) those in which oxygen 
is transferred from the hydrogen to the carbon atom. 

The hydration in the first case is produced by the ferment acting 
cither (a) like a dilute mineral acid at a high temperature, as in diastatic 
and investive ferment- and in the decomposition of glucosides : or (7>) 
like caustic alkalies at a high temperature, as in the splitting up of fats 
or the decomposition of amide compounds. These processes of fermen- 
tation by hydration are chiefly carried on by enzymes. 

'I In- second class of fermentative changes by the transference of 

gen from the hydrogen to the carbon, as in lactic and alcoholic fer- 

itation and In putrefactive processes, are chiefly produced through 

the agency of organized ferments. The action of the latter may be to a 

1,1 extent imitated by spongy platinum, which absorbs oxygen. 

lily, and readily gives it off again to oxidizable substances. Thus 
c fermentation usually produced by an organized ferment may be 
rough! ah. nit by spongy platinum." 

The products formed by the action of organized ferments on the 
media in which they live are poisonous to them; and when these pro- 
ducts accumulate above a certain proportion they kill flic ferments. Just 
fire will be smothered in its own ashes, or an animal in a confined 
space will be poisoned by the carbonic acid which it has itself produced, 
plant, when living in a solution of sugar, is killed by the 
alcohol, whieli it produces, as won as this amounts to 20 per cent., and 
other organized ferments have their lives limited in a similar way. 



ACTION OF DKTJGS ON PKOTOPLASM, ETC. 85 

Action of Drug's on Enzymes. — Although, with the exception 
of a kind of pepsin in the naked protoplasm of jEthalium septicum, a 
species of myxomycetes, 1 enzymes have not been shown to be present in 
the protoplasm of the lowest organisms, it is probable that the processes 
of life in all living beings, from the lowest to the highest, are carried on 
by their means. A ferment, which is evidently of the greatest impor- 
tance in the animal economy, has been recently discovered in the blood 
by Schmiedeberg. He has given to it the name of Histozyme, and he 
believes that its function is to split up nitrogenous substances prepara- 
tory to their oxidation. 2 The chief enzymes in the animal body are the 
following : — 

f Diastase from malt. 
Which convert starch | Ptyalin from saliva. 
and amyloids into -j Amylopsin from pancreas, 
maltose | Other ferments having a similar action 

[ from other parts of the body. 



DlASTATTC OE 

Amylolytic 



Inveesive 
Feements 



Which convert maltose) -r, ,, . , ,. 

into glucose ,} From small intestine. 

Which convert cane f Invertin from the intestinal juice, 
sugar into dextrose < " " mucin of the mouth. 

and levulose { " " tissue of the testis. 

i 

Which decompose glu- f Emulsin from bitter almonds. 
[ cosides \ Myrosin from mustard. 

Decomposing sugar Rennet. 

Decomposing fats j £ rom stomach - _ 

F & I From pancreas (Stearopsm). 

[ Pepsin from stomach. 
Peoteolytic f Which decompose pro- J Trypsin from pancreas. 
Feements \ teids and form peptones J Others from saliva. 

[ Histozyme. 

The action of drugs on enzymes is ascertained by taking two portions of a 
solution containing the enzyme and the substance to be acted upon. To one of 
these a quantity of the drug to be tested is added ; the other acts as a standard 
with which to compare it. If the drug is in solution, a corresponding quantity 
of water must be added to the standard solution in order that both may be alike. 
They are then placed in a warm chamber and the rapidity of digestion is noted. 

The action of some of the more important drugs on the action of en- 
zymes will be readily seen from the following table from Wernitz, quoted 
by Meyer. 3 In it the proportion is shown of the drugs which arrest in 
watery solution the action of the enzymes ; thus, one part of chlorine in 
8,540 parts of a watery solution will arrest the action of ptyalin upon 
starch paste, while creasote has no action on it even in saturated solu- 
tion, and corrosive sublimate is so enormously destructive as to arrest 
its action, even in one part in 52,000. 



1 Krukenberg, Untersuch. a. d. physiol. Inst. d. Univ. Heidelberg, Bd. II. , 1878, p. 273. 

2 Schmiedeberg, Arch. f. exper. Path. u. Pharm. Bd. xiv. s. 379. 

3 Hermann Meyer, " Ueber das Milchsaureferment u. sein Verhalten gegen Anti- 
septica," Inaug. Diss., Dorpat, 1880. 



86 



PHARMACOLOGY AXD THERAPEUTICS. 



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ACTION OF DRUGS ON PROTOPLASM, ETC. 



87 



This different action which the same drug exerts upon formed and 
unformed ferments is of great importance, because upon it depends our 
power to use the drug in medicine. Thus creasote, which appears from 
the preceding table not to destroy the digestive power of ptyalin and to 
have but a weak action upon that of pepsin, has been found by Werneke 
to destroy yeast in a dilution of one part to 500 of water ; and by Buch- 
oltz to kill bacteria in a dilution of one part to 1,000 of water. This 
difference enables us to arrest fermentation in the stomach depending on 
the presence of low organisms, while the digestive action of the pepsin is 
not interfered with, or only very slightly. The following diagram shows 
the action of drugs on enzymes and on the lactic ferment, which is a 
bacillus : — 




Fig. 11.— Diagram to show the different action of drugs on different enzymes. The nature of the line 
showing the action of each drug is shown under its name. 

Zymogens. 

As several enzymes act readily in neutral or slightly alkaline fluids, 
it is evident that if they existed free in every part of the animal body, 



PHARMACOLOGY AXD THERAPEUTICS. 

thev would soon lead to its speedy destruction. Accordingly, we find 
that they do not normally exist free, except at the times and places they 
are required. 

This fact was first discovered by Kiihne in relation both to the stomach and 
pancreas, and was announced by him in the course of lectures which he deliv- 
ered at Amsterdam in 1868-69, which I attended. In my note-books of those 
lectures I find that he stated that there seems to exist " a pepsin-giving sub- 
stance, " because if a " slice of stomach is thrown directly into dilute HC1 of 
4 parts to 1,000 of water at 40° C. no digestion takes place," 1 a fact which 
shows that pepsin is not always present in it. In regard to the pancreas, lie 
nut only recognized the existence of a ferment-yielding body, but described a 
mode of obtaining ferment from it in the following words: — " Grlands which 
have no action on fibrine can be made active by digesting in very dilute acid and 
then neutralizing or alkalizing, there seeming to exist a ferment-forming sub- 
stance in the pancreas."' 

Kuhne's discovery of the existence of ferment-yielding bodies does not seem 

to have become widely known, and it was again made independently by Liver- 

1 in regard to the amylolytic ferment of the pancreas, and by Heidenhain 

in regard to trypsin. These observers found that when glands which did not 

contain ferment were exposed to the air ferments were formed. 

Heidenhain 3 -jlso investigated more fully these ferment-forming sub- 
stances, and gave to them the name of zymogens. 

The methods by which we obtain ferments from zymogens are, 
therefore, exposure to air and treatment with acids. 

Organized Ferments. 

The chief organized ferments are the yeast plant, which produces 
alcohol and carbonic acid from grape sugar, and various kinds of bac- 
teria, one of which produces butyric, another lactic, and another acetic 
fermentation. Both yeast and bacteria belong to the lowest class of plants, 
the protophytes. To this class also belong moulds, the action of drugs 
upon which is sometimes important, inasmuch as moulds give rise to some 
skin diseas 

3te, moulds, and bacteria have been variously classified by differ- 
ent authors, and the classification is apt to undergo changes as ourknowl- 
t the life-history of these different organisms increases. 

At present it is not certainly known whether the various kinds of 
bacteria, for example, are genericallj or specifically different, or whether 
they can, by altered cultivation, be transformed into one another or 
not. 

ii, who has cultivated them by the dry process on gelatine instead 
of in liquid, and has thus been able to avoid admixture of different kinds 
of bacteria, has come to the conclusion that each kind possesses distinctive 
cha but Klein has shown that even when cultivated in this way 



tor this there is unfortunately a blank in my notes, but Professor 
has kindly Bupplied the deficiency, and informs me that he was then speak- 
taken from the external ratface of the stomach, and therefore contain- 
• i ends only of the gastric glands. 

v.* . Journ. of Anal and Physiol, Nov. 1873, p. 23. 
i., p. 667. 






ACTION OF DRUGS ON PROTOPLASM, ETC. 89 

bacteria may vary much in form. Thus the bacillus anthracis may form 
torula-like cells, from which ordinary bacilli are again produced. The 
numerous names used in treatises on the subject of organized ferments 
are apt to lead to confusion, hence some of the names are given here 
simply for the purpose of reference. Thus Brefeld's classification is : — 

(1) Phycomycetes = algoid fungi ; (2) Mycomycetes = true higher 
fungi ; (3) Myxomycetes = gelatinous fungi ; (4) Blastomycetes = 
yeast fungi ; (5) Schizomycetes = bacteria. 

Although the classification on the following page may not be botani- 
cally correct, it is convenient for our present purpose. 

Yeasts. — The yeast plant, to which various names have been given, 
as torula cerevisise, saccharomyces, consists of ovoid cells, which multi- 
ply by budding. The buds may remain attached, forming torula-chains, 
but when they attain the size of the parent cell, they fall off and begin 
to multiply anew. When placed in saccharine solutions, the plant de- 
composes the sugar during the process of growth and forms alcohol 
and carbonic acid. 

In this process oxygen is usually absorbed from the air in considera- 
ble quantities, but fermentation can occur in saccharine solutions even 
when oxygen is excluded, though under such conditions the torula grows 
slowly. When plenty of oxygen is present, and the layer of fluid shal- 
low, the torula grows luxuriously, but there is very little fermentative 
change ; while, on the other hand, when free oxygen is excluded, the 
torula grows slowly, but there is marked fermentation. 

Another plant nearly allied to yeast is the mycoderma vini, the fer- 
ment which changes alcohol into acetic acid. The mycoderma is not re- 
garded by Naegeli as a species distinct from torula, and it is considered 
by Grawitz to be the same as the fungus found in the aphthous patches 
which occur about the mouth and throat of children suffering from thrush, 
although this fungus is usually said to be an oidium. 

To test the action of drugs on alcoholic fermentation, equal quantities of a 
solution of grape sugar with yeast are introduced into two test-tubes, and to one 
of them a little of the substance to be tried is added. These are then inverted 
over mercury and kept in a warm place for several days. The amount of gas 
developed is then measured, and the power of the drug to prevent fermentation 
is estimated by the diminution in the amount of carbonic acid produced as com- 
pared with the standard. 

3Iould Fungi, or Hypliomycetes. — These form long filaments or 
hypha?, which become agglomerated into a mycelium or mass of compact 
tufts. They multiply not only by gemmation, but by the formation of 
spores. 




Fig. 12. 

Blastomycetes, or 1 {or S^eh^omyces (Kg. 12), 

ieabTs J (or Mycoderma. 



90 



PHARMACOLOGY AND THERAPEUTICS. 




Hyphoniycetes, or 
Moulds 



Fig. IS 



Mucor. 

Penicilliuni. 

O'idiuni. 

Achorion. 

Trichophyton. 

Microsporon. 









&q 9 s a - 






!pO *- V 



1 12 



Fig. 14. 



^< tii/oniycetes, 
ria 



Spbaerobacteria \ Micrococcus (1 (a & b) & 2, Fig. 14). 

(globular cells) / Sarcina (3). 

Microbacteria. or Bac-1 rT1 . . ,,\ 

B. subtilis (6). 
i B. anthracis (7). 
>or S: I Bacillus (straight) \ g. ££«&' 



lobacteria (larger rod 
like or thread-like cells) J 



Spirobacteria 
(twisted or spiral-cells) 



B. malariae (8). 

B. tuberculosis (12). 

B. leprae. 

C Vibrio (wavy) ] Vibrio serpens (9). 

Spirochaeta (long, flexi- I 
ble, close-wound spi- J Spirocbreta b e r - 
rals) J meyeri (10). 

[ Sl Sfe (sb0rt ' Stiffl ° pen \ S. volutans 



spirals). 



J 



(11). 



These moulds vary considerably according to the soil in which they 

. and the amount of oxygen present. Thus, if the spores of the 

COmmoD white mould, mucor inucedo, are sown in a liquid containing 

U :md expose I to the air, they grow on the surface, forming branched 
hyphae without septa, and the liquid absorbs oxygen. But if the myce- 
lium be immersed, or the oxygen withdrawn, septa develop in the hyphne, 
and they break up into segments which multiply by budding, forming a 
• w itli large e«-lk and, like the true yeast, decomposing sugar 
unto alcohol and carbonic acid. 

They may be trained to thrive on substances on which they do not 
usually grow by gradually altering the composition of the soil. Thus, 



ACTION" OF DRUGS ON PROTOPLASM, ETC. 91 

the commonest of all moulds, penicillium glaucum, although it does not 
usually grow on blood, may be trained to do so by transplanting it from 
bread to peptone, and then to blood. 

Heat destroys them, but a much higher temperature is required to 
kill the spores than the perfect plant, and in order to destroy the spores 
a temperature of 110°— 115° C, kept up for an hour, is requisite. 

The mould fungi cause some local diseases in the body, and especi- 
ally skin diseases such as favus, tinea tonsurans, tinea versicolor, tinea 
sycosis, and onychomycosis, and the madura foot or fungus foot of India. 
They also occur in the fur of the tongue. 

Bacteria, or Schizomycetes. — Bacteria are every day becoming 
more and more important on account of the relation in which they are 
found to stand to various diseases. Anthrax, diphtheria, phthisis and 
typhoid fever, are probably all due to various species of bacteria intro- 
duced into the body, and affecting various organs in it. It is, therefore, 
of the greatest possible importance that their life history should be 
learned, and that we should know what the conditions are under which 
they thrive best, and what the conditions are which will destroy their 
life and prevent their development. 

They appear to increase in two ways : First, by simple multiplication 
of their parts, and secondly, by forming spores. 

Bacteria require water, organic matter and salts, for their life. Some 
of them also require the presence of free oxygen, others do not, hence 
they have been divided by Pasteur into two classes : aerobious and 
anaerobious. To the anaerobious bacteria oxygen is not merely 
unnecessary but hurtful, and even the aerobious bacteria, although they 
require oxygen in a certain quantity, are injured or destroyed by it when 
it is in excess. 

The soil which is most favorable to different classes of bacteria varies 
with each class. .A struggle for existence goes on between bacteria 
and other organized ferments, and between different kinds of bacteria 
themselves, just as it does amongst higher plants. Just as an abundant 
crop of one kind of higher plants will occupy a whole field and choke 
other plants, so that kind of bacterium which grows most readily in a 
particular soil will choke others and prevent them growing at the same 
time with itself. During their growth they alter the soil or substance in 
which they grow, either by exhausting the nutriment it affords, or by 
forming in it new substances which are injurious to themselves, and thus 
they gradually die out. 

But the soil which is no longer suitable for one kind of bacterium 
then becomes suitable for another, and the spores, which may have lain 
without germinating during the time the first kind was growing, now be- 
gin to grow actively. 

Thus, if a number of germs of different classes of fungi be added at 
the same time to a saccharine solution, the bacteria only will grow and 
set up lactic fermentation. If a small quantity of tartaric acid be now 
added (J per cent.) the yeast alone will grow and alcoholic fermentation 
begins. If more lactic acid is added (4-5 per cent.) the alcoholic fer- 
mentation stops, and mould begins to grow. In this process neither the 
bacteria nor the yeast are killed by the addition of tartaric acid, which, 



92 PHARMACOLOGY AND THERAPEUTICS. 

in different proportions, merely renders the liquid more favorable for the 
growth of the yeast and mould respectively, and enables them to flourish 
best, although the others are still present. 

In fresh grape juice many germs are present, but the composition of 
the liquid being more favorable to the growth of the yeast plant than to 
other fungi, it alone grows. When it has converted the sugar into alco- 
hol its growth stops, and bacteria may then multiply and convert the 
alcohol into acetic acid. This in turn checks the growth of the bacteria, 
and mould fungi then find the soil favorable. In their growth they con- 
sume the lactic acid, and the liquid once more affords a favorable soil for 
bacteria, which may then grow and cause putrefaction. 

The same struggle for existence occurs between the different species 
of bacteria themselves. Thus micrococci may be prevented from growing 
by micro-bacteria, and bacilli may be killed by bacterium termo when the 
supply of oxygen is insufficient for both. 1 

It is to be noted, however, that in the struggle for existence the for- 
mation of poisonous products by bacteria may be, and probably is, bene- 
ficial to them. No doubt these poisonous products check their own 
growth and finally destroy them ; but in the struggle for existence be- 
tween bacteria and living tissues these poisons may be beneficial to the 
bacteria by killing the tissues, and thus giving the bacteria a more ample 
supply of nutriment. 

In investigating any problem, it is always best to take the simplest 
ca.se, and if we look at the struggle for existence between bacilli and an 
amoeba, or white blood-corpuscle, we shall see that the formation of poi- 
sonous products by the bacteria may enable them to destroy the amoeba 
or leucocyte instead of their being destroyed by it (Fig. 10, p. 83). 

These poisonous products in fact may prepare the soil for bac- 
teria, and this supposition is confirmed by the observations of Rossbach 
and Rosenberger. Rossbach found that when papain was injected into 
the vessels, micrococci developed in the blood with extraordinary rapidity, 
the ferment seeming to have altered the blood to such an extent that it 

me an exceptionally favorable soil for the micrococci. A similar re- 
sult was observed by Rosenberger from the injection of sterilized septic 
blood. In this blood the bacteria themselves were destroyed, but the 
poisonous Bubstances which they had formed were present, and these 
ed to have a similar action to the papain. 

The septic poisoning which occurs from wounds is not due merely 
to bacteria entering the blood from them, but is due chiefly to the absorp- 
tion of the poisons which the bacteria have formed in the wound. The 
dead or enfeebled tissues which occur in the wound afford a soil favorable 
to the growth of the bacteria, and for the formation of their deadly pro- 
ducts. W hen these are absorbed they not only poison the tissues gener- 
ally, but, by doing BO, convert the whole body into a soil suitable for the 
_ .tli and development of bacteria, as is Bhown by the fact that the tis- 
sues of animals killed by the injection of sepsin decompose very quickly, 
and Bwarm with bacteria shortly after dean. 



Pathological Anatomy* translated and edited by MacAlister, p. 272. 
w, "l< «ra1 ry lucid and complete account of disease-germs. 



ACTION OF DRUGS OX PROTOPLASM, ETC. 93 

Action of Drugs on the Movements of Bacteria. 

Mode of Experimenting-.— In order to test the effect of a drug on the 
movements of bacteria already developed, a drop of the solution containing 
bacteria may be mixed under the microscope with a drop of the solution of a 
drug in the way already described at page 74, and the strength of solution neces- 
sary to destroy their movements estimated in the same manner. 

In order to combine experiments on the movements, and on the reproduc- 
tion, so as to ascertain whether the bacteria which have been rendered motion- 
less by heat or drugs, are really dead, or are only torpid, the covering-glass in 
the experiment just described is taken up with a pair of sterilized forceps, and 
dropped into some sterilized Cohn's solution (vide p. 94). It is then put 
along with the standard solution into a warm chamber, and left for a day or 
two. If the bacteria have been destroyed, it will remain clear like the standard 
solution, but if they have only become torpid, it will be more or less opalescent 
or milky. 

In performing this experiment, great care must be taken that the solution of 
the drug has been sterilized by boiling ; and that the covering-glass, glass slide, 
all the instruments, and indeed everything used in the experiments, have been 
also thoroughly sterilized by heating. 

The bacteria grown in different fluids are not all equally sensitive to 
drugs. 

A temperature of 66° to 70° C. usually arrests the movements of 
bacteria, and if continued for an hour, destroys adult organisms though 
not spores. A temperature of 100° C. usually destroys the spores as 
well, but this is not always the case. 

If the bacteria are moist, this temperature generally kills them, but 
not if they happen to be dry, and a much higher temperature is then 
required. They may become dry, before being killed, by a little solution 
containing them having flowed or spurted into the higher part of the 
tube or flask, where the water evaporates and leaves them dry before the 
temperature has been sufficiently raised to destroy them. 

The most destructive substances to bacteria are corrosive sublimate, 
chlorine, bromine, and iodine. Quinine and the other cinchona alkaloids 
also destroy bacteria, their power diminishing in the following order : — 
quinia, quinidia, and lastly cinchonia. 

Bebeerin is nearly as powerful, and potassic picrate is even superior 
to quinine when used with Cohn's solution. When bacteria are culti- 
vated in beef-tea instead of Cohn's solution, potassic picrate is less 
powerful. 

Sulphocarbolates and strychnia have considerable power, though a 
good deal less than quinia : bebeerin and lesculin have hardly any power 
to destroy bacteria at all. Sodic hyposulphite has very little action : 
sodic sulphate has a destructive action, but it is about ten times less 
strong than quinine. 

Action of Drugs on the Reproduction of Bacteria in General. 

The spores of bacteria have very enormous resisting power to agents 
destructive of vitality, very much greater than that of the fully-developed 
bacteria ; and thus it happens that a quantity of an antiseptic, which is 



94 PHARMACOLOGY AND THERAPEUTICS. 

quite sufficient not only to prevent the spores of bacteria from develop- 
ing so long as they remain in it, but to destroy fully-formed bacteria, 
wiTl not destroy the vitality of the spores or hinder them from germina- 
ting as soon as they are removed from the influence of the antiseptic and 
transferred to a proper soil. 

Yet the power to destroy the vitality of the spores completely is what 
is required in an antiseptic, for we wish to destroy the infectious mate- 
rial, and prevent it from causing disease, rather than to administer sub- 
stances to an animal which will hinder the germs from developing in the 
blood after their introduction into it; although this maybe desirable 
when infection has already taken place. 

It is therefore necessary to test the effect of drugs in destroying the 
germs completely. 

3Iethod of Experimenting. — This is done by adding to a fluid, contain- 
in g bacteria and their spores, varying quantities of an antiseptic, and allowing 
the mixture to stand for a longer or shorter time. A drop of this fluid is then 
introduced by a sterilized platinum wire or glass pipette into some sterilized 
Conn's fluid or beef-tea. This is watched to see whether bacteria will develop 
in it or not. If they do develop, it is clear that the spores have not been killed 
by the admixture with the disinfectant in the original fluid ; if they do not de- 
velop, then the disinfectant has been sufficiently powerful to destroy them. 

The plan usually employed is to take a number of test-tubes, plug their ori- 
fices with cotton-wool, and destroy any germs that may be attached to them by 
thoroughly heating them to about 300° F. in a hot chamber, or in the flame of 
a Bunsen'a lamp. They are then allowed to cool, and a small quantity of a 
liquid (about 5 cc.) in which bacteria readily grow is placed in each. This also 
must Ik- previously thoroughly boiled, in order to destroy any germs which may 
be present in it. The liquid recommended by Colin consists of ammonium 
tartrate one gramme, potassic phosphate and magnesic sulphate of each five 
grammes, cak-ic phosphate '05 grammes, distilled water 100 cc. This is filtered 
and boiled before ose. To the tubes the different agents to be tested are added, 
the -"liiti<.n- <>{' each having been carefully sterilized by boiling, and the pipette 
u-. -d being super-heated in each case before it is employed. If the drugs are 
added in solution, a similar quantity of boiled water must be added to the first 
tube, whi.h is to serve as a standard. To each of them is then added a single 
drop of a liquid containing bacteria. 

The mouths of the tubes are then stopped with the cotton-wool and placed 
for a few days in a warm chamber at about 40° C. The standard liquid will 
then be found to be opalescent or milky. The degree of the opalescence in the 
other tubes will be less according to the effect of the drug which has been 
added, in preventing the development of bacteria, 

W here it has completely hindered the development, the solution will remain 
quite clear, and as it- strength diminishes, the opalescence will become greater, 
until it i- equal to that of the standard. 

In performing this experiment it is best t<> use one definite form of bacte- 
rium, instead of a mixture of several unknown kinds. This is referred to again 
in speaking of tin- experiments of Dr. Koch, who generally employs the micro- 
ns prodigiosus as an example of an organism easily acted upon, and the 
• bacillus anthracis, or of a bacillus found in earth, as examples of 

It i-; found by tlii- mode of experiment that a smaller quantity of 
poison will prevent tin- development of bacteria than will destroy them 
after they are developed. 



ACTION OP DRUGS ON PROTOPLASM, ETC. 95 

By experiments on the comparative action of different drugs on bac- 
teria the results contained in the following table have been obtained by 
N. de la Croix, and these have been to a considerable extent confirmed 
by Koch. 

It will be seen by looking at the table that the exact limit of the 
power of each drug to destroy bacteria is not determined, but that two 
concentrations of each antiseptic are given, one of which is sufficient to 
do it, and the other is insufficient. The disinfecting limit therefore lies 
between the two experiments. But the limit of disinfection is not an 
invariable one for each drug, as its power to destroy bacteria is modified 
not only by the concentration of the solution employed, but by the 
length of time during which it acts, and by the temperature. 



96 



PHARMACOLOGY AND THERAPEUTICS. 



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ACTION OF DKUGS OJN T PROTOPLASM, ETC. 97 

Action of Drugs on Particular Species of Bacilli. 

In these experiments of De la Croix, however, the nature of the 
bacteria experimented on was not determined, and there might be a mix- 
ture of several sorts. Koch has therefore sought to ascertain the action 
of disinfectants upon definite forms of microzyrnes by cultivating them 
in pure crops before applying the disinfectant. Those which he has 
chiefly experimented on are the red micrococcus prodigiosus, the bacteria 
of blue pus, and the bacillus anthracis. 

The first two do not form spores, and are easily destroyed by disin- 
fectants. The bacillus anthracis forms spores, and was therefore 
employed to test the action of disinfectants upon them. 

Mode of Experimenting' on the Action of Drugs on Reproduc- 
tion of Bacilli. — In order to avoid admixture with other species, Koch 
cultivated the first two on slices of potato, instead of in a solution. Upon one 
piece of potato the unaltered microzyrnes were sown, and upon the others similar 
microzyrnes which had been exposed to the action of disinfectants. If the mi- 
crozyrnes had been destroyed by the disinfectants, no result occurred, but if not, 
then a crop was obtained, which in comparison with the control specimen was 
more or less abundant, according as the action of the disinfectant had been less 
or more complete. 

For the cultivation of the anthrax bacilli, Koch used as a soil gelatine mixed 
with some other nutritive substance, usually meat infusion and peptone sterilized 
and spread upon a slip of purified glass, and exposed to such a heat as just to 
solidify it. Koch did not use his solidified blood-serum in these experiments. 
This could be placed under the microscope, and the growth of bacilli observed 
from day to day. Middle-sized test-tubes were then partially filled with the 
disinfecting solutions, and silk threads, steeped in a fluid containing bacilli and 
then dried, were placed in them ; from time to time a thread was removed from 
the tubes by means of a previously heated platinum wire and placed on the slide, 
which was then subjected to microscopical observation. In this way it was easy 
to determine what strength of solution, and what time of exposure to its action, 
was required to destroy the spores. 

The results of experiments made in this way with carbolic acid were 
very surprising. It was to be expected that carbolic acid would readily 
destroy the spores, but this was not the case. A 1 per cent, watery solu- 
tion had almost no action upon them, even after they had been exposed 
to it for 15 days ; 2 per cent, slightly retarded their growth, but it did 
nothing more ; 3 per cent, killed the spores in 7 days ; 4 per cent, in 3 
days ; and 5 per cent, in 1 day. 

This comparatively slight action of carbolic acid on spores and the 
long time that it requires to destroy them, shows that it cannot be relied 
upon as a universal disinfectant. But it has nevertheless great power in 
destroying microzyrnes wdiich have not formed spores. 

The fresh blood of an animal which has died from anthrax contains 
only bacilli and no spores. When it is mixed with its own bulk of a 1 
per cent, solution of carbolic acid, it can very soon afterwards be injected 
into an animal without producing almost any symptoms. A J per cent, 
solution will not do this, so that the limit lies between *5 and -25 per cent, 
for the mixture. 
7 



98 



PHARMACOLOGY AND THERAPEUTICS. 



The action of carbolic acid on other fully-developed microzymes, or 
on the spores, is almost the same as on the anthrax bacilli. 

The following table gives the result of Koch's experiments with other 
substances ; the figures indicating the number of days during which the 
spores had been submitted to the action of the antiseptic previous to 
cultivation. The black-faced figures indicate that the spores were de- 
stroyed, and their germination prevented by exposure to the disinfectant 
for that number of days ; a * indicates that their vitality was dimin- 
ished, and that the crop from them was scanty; a f indicates that their 
growth was retarded ; *f that it was both scanty and retarded. The 
'liMiifectants are divided into three groups. The first contains the group 
of fluids ; the second of solutions in water ; and the third of solutions in 
alcohol, ether, or oil. 

Group I.— FLUIDS. 



Distilled water 


7 


15 


20 


35 


90 








Alcohol (absolute) ... 


1 


3 


5 


10 


12 


20 


30 


40 


Alcohol 1 1 to 1 of water) 


1 


3 


20 


30 


40 


50 


65 


110 


Alcohol (1 to 2 of water) 


1 


3 


20 


30 


40 


50 


65 


110 


Ether 


1 


5 


8* 


30 










Acetone 


2 


5* 














Glycerine 


1 


3 


10 


20 


30 


40 


50 


65 


Butyric acid 


1 


5 














French salad oil 


5 


30 


90 












Bisulphide of carbon 


1 


5 


10 


20 










Chloroform 


1 


3 


10 


20 


100 








Benzol... 


1 


5 


10 


20 










Petroleum ether 


1 


5 














Turpentine oil 


1* 


5 


10 













50 65 110 



110 



Grouf II.— SOLUTIONS IN WATER. 



( hlorine water (freshly made) 

Bromine (2 p. C. in water) 

Iodine water I 1 in 7,000) 

Hydrochloric acid (2 p. c. in water) ... 
Ammonia ... 

Ammonium chloride (5 p. c. in water) 
Common sail saturated solution) 
Calcium chloride [saturated solution) 
Barium chloride 5 ]>. <•. in water) 
Ferric chloride ; 5 i>. c. in water i 
Potassium bromide (5 p. c. in water)... 

Potassium iodide .") ]). c. in water) ... 

Corrosive sublimate 1 1 p, c in water)... 
Arsenic l p. c in water) 

Lime water 

Chloride of lime 5 p. <•. m water) 
Sulphuric acid l p. c in watei I 
Zinc sulphate 5 p. c. in water) 
Coppei sulphate [5 p. c. In water) 

i- Sulphate 5 p. c in water) 
Sulphate of aluminium (5 p, c. in water) 

Mum I p. c in water, ... 

a chromate 5 p. c. in water)... 
lium bichromate 5 p. <■ in wa1 

< lnoine alum 6 p. e. in w;it< i ... 

Chromic acid 1 p. c, in \\ ater ... 

■mi pei manganate 5 p. <•. m water; 
i '"• do. l p. c. in water) 



5 

2f 

5 

5 

1 
1 
5 

t 



5 
5 

5 

5 

5 

5 

5 
10 
6 
10 
10 
2 

6 
10 
2*f 
3 

5* 
5* 
6 
5 
5 
2 
2 
o 



10 

10 
10 
10 
20 
45 

25 
25 

lO 

15*f 
5 

10* 

10* 
10* 

12 
12 



25 
20 
40 

100 



80 



20*f 
20* 



ACTION OF DRUGS ON PROTOPLASM, ETC. 99 

Potassium chlorate (5 p. c. in water) 

Osmic acid (1 p. c. in water) 

Boracic acid (5 p. c. in water) not quite dissolved ... 

Borax (5 p. c in water) 

Sulphuretted hydrogen water 

Ammonium sulphide 

Oil of mustard with water 

Formic acid (sp. gr. 1*120) 

Acetic acid (5 p. c. in water) 

Potassium acetate (saturated solution) 

Lead acetate (5 p. c. in water) 

Soft (potash) soap (2 p. c. in water) 

Lactic acid (5 p. c. in water) 

Tannin (5 p. c. in water) 

Trimethylamine (5 p. c. in water) 

Chloropicrin (5 p. c. in water) 

Benzoic acid (saturated solution in water) 

Benzoate of sodium (5 p. c. in water) 

Cinnamic acid (2 p. c. in water 60 and alcohol 40 

parts) 

Indol (in excess in water) 

Skatol (in excess in water) 

Leucin (| p. c. in water) ... 

Quinine (2 p. c. in water and 40 alcohol 60 parts) ... 
Quinine (1 p. c. in water with HC1) 



Iodine (1 p. c. in alcohol) 

Valerianic acid (5 p. c. in ether) 

Palmitic acid (5 p. c. in ether) 

Stearic acid (5 p. c. in ether) 

Oleic acid (5 p. c. in ether) 

Xylol (5 p. c. in alcohol) 

Thymol (5 p. c. in alcohol) 

Salicylic acid (5 p. c. in alcohol) 

Salicylic acid (2 p. c. in oil) 

Oleum animale (Dippel's oil, 5 p. c. in alcohol) 
01. menth. pip. (5 p. c. in alcohol) 

From this table it appears that the ordinary method of separating 
between formed and unformed ferments by precipitation with alcohol and 
solution in glycerine cannot be relied upon as a trustworthy means of 
separating them, since neither alcohol nor glycerine destroy the activity 
of formed ferments. 

It is remarkable that ether and turpentine oil, which are both ozone 
carriers, should have such a marked action in comparison with other 
fluids. This is in harmony with some recent observations of Paul Bert 
and Regnard, that oxygenated water in sufficient quantity destroys the 
bacteria of anthrax. 

The spores of anthrax bacilli resist in an extraordinary way the ac- 
tion of certain substances which usually are fatal to life, as hydrochloric 
acid (2 per cent.), salicylic acid (1 per cent.), concentrated solutions of 
chloride of sodium, chloride of calcium, metallic solutions, borax, boracic 
acid, chloride of potassium, benzoic acid, benzoate of sodium, cinnamic 
acid, and quinine. 

Action of Drugs on the Development and Growth of Bacilli. — 

In order to test the action of disinfectants on the development and growth of 
bacteria, Koch put into a number of small watch-glasses, or rather crystallization 



2 


6 








1 










1 


2 


6f 


10f 




5 


10 


15 






1 


5* 








1 


2 


5 






1 


5 


10* 






1 


2 


4 


IO 




1 


5 








1 


4 


10 






1 


5 


12 






1 


5 


12 






1 


2 


5 






1 


5 


10 






1 


5 


12 






1 


2 


6 


12 




1 


5 


10 


45 


90 


1 


2 


5 


10 




1 


3 


5 


10 




1 


5 


10 


25 


80 


1 


5 


10 


25 


80 


1 


5 


10 






l*f 


■ 5*f 






1 


5 


io 






ETHER 


, OE OIK 




1* 


2* 








1 


5 








1 


5 








1 


5 








1 


5 








1 


5 


30 


50 


90 


1 


6 


10 


15 




1 


6 


10 


15 




5 


10 


20 


80 




1 


5 


12 






1 


5 


12 







PHARMACOLOGY AND THERAPEUTICS. 

see with flat bottoms, a few drops of blood-serum, or a solution of extract of 
meat and peptone, mixed with varying quantities of the disinfectant. Into each 
of these a silk thread, which had been dipped in the fluid containing bacteria 
and dried, was placed. In one glass serum alone, without any disinfectant, was 
placed, in order to ascertain, by comparison with the growth which takes place 
in it. how the disinfectant in the other classes had interfered with the growth of 
the bacilli. 

In experiments of this sort a difference was found between anthrax 
bacilli and other microzymes. A dilution of carbolic acid 1 in 1,250 
and 1 in 850 sufficed to prevent the growth of anthrax bacilli, while a 
strength of 1 in 500 was required to prevent the growth of others. 

Other species are therefore more resistant than anthrax bacilli to the 
action of carbolic acid. The following table shows the strength of vari- 
ous disinfectants required to hinder or entirely prevent the development 
of anthrax bacilli: — 

Prevents. 



1 to 300,000 
1 to 33,000 





Hinders. 


Iodine 


1 to 5,000 


Bromine 


1 to 1,500 


Chlorine 


1 to 1,500 


Osmic acid 


1 to 1,500 


Permanganate of potash 


1 to 3.000 


Corrosive sublimate 


1 to 1.000.000 


Ally] alcohol 


1 to 167,000 


Oil of mustard 


1 to 330,000 


Thymol 


1 to 80,000 


Peppermint oil ... 


1 to 33,000 


Oil of turpentine 


1 to 75,000 


Oil of cloves 


1 to 5,000 


Arsenite of potash 


1 to 100,000 


Chromic acid 


1 to 10,000 


Picric acid 


1 to 10,000 


Hydrocyanic acid 


1 to 40,000 


he following are about the same strength as 


Fluid. 


Hinders. 


Boracic acid 


1 to 1,250 


Borax 


1 to 2,000 


Hydrochloric acid 


1 to 2,500 


Salicylic acid 


1 to 3,300 


Benzoic acid 


1 to 2,000 


Camphor .... 


1 to 2,500 


Encalyptol 


1 to 2,500 


Sofl soap .... 


1 to 500 


Quinine 


1 to 830 


Hydrate of chloral 


1 to 1,000 


Chlorate of potash 


1 to 250 


Acetic acid 


1 to 250 


»ate of Boda 


1 to 200 


Alcohol 


1 to 100 





1 to 60 No action. 


( Ihloride of sodium 


1 to 64 



1 to 10,000 
1 to 5,000 

1 to 8,000 



Prevents. 
1 to 800 
1 to 700 
1 to 1,700 
1 to 1,500 



1 to 5,000 
1 to 625 



1 to 125 



Influence of the Solvent. — Although a 5 per cent, solution of 
carbolic acid in water has a well-marked destructive action on the spores, 
and a strong destructive action on fally-developed anthrax bacilli, a similar 
solution in oil or alcohol has not the Least disinfectant action. A similar 
influence with regard to iodine is observable in the previous tables. 



ACTION OF DRUGS OX PROTOPLASM, ETC. 101 

Effect of tlie Fluid witli which Disinfectants are inixed. — 

This is sometimes very marked, especially in the case of free iodine, 
bromine, or chlorine. These in watery solutions are powerful disinfec- 
tants, but when mixed with fluids which contain alkalies, as e.g., blood- 
serum, they are converted into bromides, iodides, and chlorides, and 
their action is very greatly diminished. The action of corrosive subli- 
mate, however, and of ethereal oils is not altered. 

Influence of Temperature on the Action of Antiseptics. — 
The action of antiseptics is greatly increased by a high temperature. 
Spores of anthrax bacilli exposed to the vapor of carbolic acid at 
lo°-20° C. remain unchanged even after 45 days' exposure. When 
exposed to the vapor of carbolic acid at a temperature of 55° C. the case 
is very different. Half an hour's exposure does not seem to harm them 
at this temperature, but many are destroyed by an exposure of an hour 
and a half, and very few will stand 3 hours' exposure, so that probably 
an exposure of 5 or 6 hours would destroy the whole of them. 

Alterations in Bacteria by Heat and Soil. — By careful cultiva- 
tion of a slip taken from a wild fruit-tree through successive generations, 
the chemical processes of growth may be so modified in it that the fruit 
will lose its acrid character, and become edible and pleasant. What is 
true of higher plants is true also of lower in this respect, and bacilli are 
much modified by the conditions under which they are cultivated; for 
example, Pasteur has found that the bacilli of anthrax develop and 
multiply in beef-tea best at 25°-40° C. Their development is retarded 
at higher or lower temperatures than these, and is completely arrested at 
15° and 45° C. When cultivated at a temperature where development 
occurs with difficulty, such as 42°-43°, the bacilli no longer form rest- 
ing spores, but only grow into long threads. 

Fresh bacilli injected into an animal rapidly cause death from 
anthrax, but the longer they have been previously kept at this high tem- 
perature the more does their virulence decrease, and at the end of four 
or six weeks they die. 

When some of the first crop of bacilli are put into fresh beef-tea, the 
second crop retains the degree of virulence of the first, and a third crop 
taken from the second, and again grown in fresh beef-tea, has exactly 
the same morbific power, and so on. 

When the bacilli are cultivated at 35°, the microzymes not only multi- 
ply quickly, but they form spores of a definite degree of virulence, and 
these spores may be kept unaltered for years in sealed tubes, whereas 
the threads of developed bacilli die when air is excluded. 

When an animal is inoculated with anthrax bacilli whose virulence 
has been diminished by cultivation at a high temperature, they produce 
merely temporary illness instead of death. By the growth of these non- 
virulent bacteria in the body, its constitution appears to undergo some 
alteration, and virulent bacteria subsequently injected have a much less 
powerful action on it. If the first injection be made with bacteria 
having a very slight amount of virulence, the animal may still die if 
infected a second time with virulent bacteria, but if inoculated first with 
a non-virulent bacteria and a second time with bacteria rather more 
powerful, a slight disturbance is produced by each inoculation, and a 
subsequent injection of virulent bacteria no longer causes death. 



PHARMACOLOGY AND THERAPEUTICS. 

The changes which are produced by inoculation with modified 
anthrax or with vaccine matter in the blood and tissues, although prob- 
ably very slight, are sufficient to confer on the organism immunity 
from further infection. This is usually permanent, although the immu- 
nity may diminish with the course of years, unless the advancing age of 
the animal in itself tends to lessen its liability to infection. 

A similar immunity against infection with different bacilli is some- 
times conferred by age. Thus young dogs are easily infected with 
anthrax, but old ones are not. 

A difference of species also confers immunity. Thus rats and field 
mice are not liable to infection with anthrax, while house mice are highly 
so. Algerian sheep also resist infection with anthrax, while French 
sheep do not. 

We do not as yet know whether it is possible by the action of drugs to 
alter the blood and tissues in such a way as to render the animal proof 
against infection by pathogenic bacteria; but this is one of the directions 
in which further research is likely to yield interesting results. 

Possible Identity of Different Forms of Bacteria. 

It has already been mentioned that we are not quite certain whether 
all the species, genera, or even orders of bacteria are natural divisions, 
<>r whether the same organism under various conditions of nutrition and 
development may not present such different appearances as to be in- 
cluded in different orders and under different names. Yet this is a 
matter of very great importance in regard to the causation of disease, 
for if it be true that organisms which are usually innocuous may undergo 
an opposite process to that which occurs in anthrax bacilli by cultiva- 
tion, and may in certain conditions of soil be changed from innocuous 
into pathogenous forms, we can understand how diseases may appear to 
originate de novo. 

It has been stated by Naegeli that bacteria may be so modified by 
cultivation as to form entirely different fermentative products. Thus he 

- that the bacterium which produces lactic acid fermentation in milk 
may bo changed by cultivating it in extract of meat and sugar, so that it 
will do Longer produce a lactic but an ammoniacal decomposition in 
milk. II<- considers also that innocuous may be transformed into viru- 
lent bacteria, and back again into an innocuous form, and Buchner 
thinks that he has succeeded in transforming the ordinary hay-bacillus 
(bacillus Bubtilis) into anthrax bacillus by cultivating it for a number of 
ins in Liebig's meat extract, peptone, and sugar. This obser- 
vation is denied by Klein 1 and others, but observations which partly 
support Buchner and partly Klein have been made by F. Kohler, 2 who 
finds that, while the ordinary hay-bacillus (bacillus subtilis) is not altered 
in its appearance by repeated cultivations, it acquires a progressive viru- 
lence which renders it BO lata] to animals as to resemble the anthrax 

illufl in it- deadly properties. 



Klein, Quarterly Journ, of Microscopic 8cience, .Ian. 1883. 
Inaugural Dissertation (Gottingen), 1881. 



ACTION OF DRUGS ON PROTOPLASM, ETC. 103 

H. C. Wood and Formad 1 have also come to the conclusion that the 
micrococci found in diphtheria resemble those on furred tongues in all 
respects excepting in their greater tendency to grow. When cultivated 
successively, they lose their contagious power and grow less readily. 
These authors, therefore, consider that circumstances outside the body 
are capable of converting the slower growing or common micrococcus 
into the rapidly growing micrococcus of diphtheria, which, when cultivated 
again, reverts to the common type. 

Action of Bacteria and their Products on the Animal 
Body. — When bacteria are injected into the animal body they produce 
different effects, according to the original nature of the bacteria or ba- 
cilli, the conditions under which they have been cultivated, and the 
quantity introduced. There is probably another factor of no less im- 
portance which, however, still requires to be investigated, viz., the con- 
dition of the body into which they are introduced. In considering the 
effect of an injection into the living body of a solution containing 
bacilli, we must be careful to distinguish between the effect of the 
bacilli themselves, after their introduction into the circulation upon the 
tissues and organs of the body, and the effect of the substances which 
they have already formed in the solution before their injection. 

We must distinguish between those two things in the same way as 
we would have to distinguish between the effects of the particles of the 
yeast plant and the effects of the alcohol which it had formed if we were 
to inject a solution in which yeast was growing into the veins of an 
animal. The yeast or the bacteria would have one effect upon the 
animal, the alcohol or the septic products of the bacteria would have 
another. 

Solutions of putrid organic matter containing numerous bacteria cause 
high fever and often death. 

The course of the fever depends on the specific nature of the bac- 
teria, e. g., septic bacteria, anthrax bacilli, &c. 

It is difficult at present to ascertain exactly how far all the following 
diseases are due to the presence of microbes or their products \ but it 
has been found that micrococci cause erysipelas, a'cute necrosis, gonor- 
rhoea, gonorrhoeal ophthalmia, contagious ophthalmia, ophthalmia neano- 
torum, and are present in pyaemia, puerperal fever, ulcerative endocar- 
ditis, infective myositis, and contagious pneumonia. When malignant 
oedema or traumatic gangrene occur, bacilli are usually found. Micro- 
cocci are also supposed by some to be the cause of vaccinia and of diph- 
theritic inflammation. The bacillus anthracis produces anthrax ; bacil- 
lus septicsemise, blood poisoning ; bacillus malaria, ague and malarious 
diseases ; bacillus tuberculosis, phthisis ; bacillus leprae, leprosy ; and 
another bacillus is the cause of glanders. In relapsing fever the spi- 
rochaeta obermeyeri is found in the blood, and is probably the cause of 
the disease. 

Alkaloids formed by Putrefaction. — Ptomaines. From de- 
composing organic matter substances can be separated which have all 



National Board of Health Bulletin, Supplement No. 17, Jan. 21, 1882. 



104 PHARMACOLOGY &KD THEEAPEUTICS. 

the characters of alkaloids. Thus albuminous substances yield during 
putrefaction various poisons which have different physiological actions 
according to the stage of decay at which they are produced. 

Some of these, like the sepsin separated from putrefying yeast by 
Bergmann and Schmiedeberg cause vomiting, diarrhoea, and bloody 

BtOols. 

The extract from putrefied maize has a tetanic and narcotic action 
which appears to be due to two different substances. These are not 
present in the same proportion, so that sometimes the tetanizing action, 
and at other times the narcotic action is most marked. 

Another alkaloid, resembling atropine in its action, has been sepa- 
rated by >onnenschein and Zuelzer from decomposing animal matter; 
and this has also been found in the bodies of persons dying from typhus 
fever. 

Another which resembles curare in its action has been separated by 
(xuareschi and Mosso 1 from putrefying brain. 

Another substance causing tetanic symptoms has also been obtained 
from animal matter. 

These alkaloids produced by decomposition are known by the name 
of ptomaines. 

Effect of Drugs on the Action of Bacteria in the Animal Body. 

So long as bacteria are outside the body, we may use drugs of any 
strength we please to destroy them, but the case is quite different when 
they have once gained entrance, and are no longer outside but inside the 
body, because then the nature of the drug and the amount we can em- 
ploy is limited by its effect on the organism itself, and we cannot admin- 
ister very large doses of antiseptics lest we should injure or kill the pa- 
tient at the same time that we destroy the bacteria which are causing the 
di-ea-e. All that we can hope to do is to turn the scale, if possible, 
in favor of the organism in the struggle for existence between the cells 
which compose it and the bacteria which have invaded it. 

< >ur hope of doing this rests on the fact that drugs which may be 

injurious both to the tissues and to the bacteria, are not equally so to 

each. Thus excess of temperature is injurious to the organism, but it is 

destructive to bacteria ; and. as Fokker 2 has pointed out, the febrile 

reaction whirl! occurs on the introduction of bacteria into the blood may 

be a means of destroying the microbes and preserving the animal. There 

i- often a genu of truth in apparently foolish plans of treatment, and 

the old practice of treating scarlet fever, small-pox, and measles by 

warm drinks, hoi rooms, and abundant clothing, may have been a blind 

effort to aid the natural processes of cure, just as the irritating ointment 

'/!' thr Middli eems to have been an attempt at antiseptic surgery. 

raordinary destructive power of corrosive sublimate, and the fact 

that it continues to ad in blood-serum jusl as it does in distilled water, 

to indicate thai it might be used to destroy bacilli in the body, 



Turin, L8£ 
International Medi< », [881. 



ACTION OF DEUGS ON PROTOPLASM, ETC. 105 

especially as Schlesinger has found that it may be injected subcuta- 
neously into rabbits and dogs daily for several months without doing 
them any harm, even in doses of 1 cc. of a J per cent, solution. 
Koch's experiments on this point, however, have as yet led to a nega- 
tive result, the animals inoculated with anthrax dying of the disease, 
notwithstanding the injection of the sublimate. 

The extraordinary effect of allyl alcohol, and the less powerful but 
still great action of ethereal oils, indicate, however, that we may look 
forward with hope to the discovery of some organic substances which 
may so hinder the development of bacteria in the body after their inocu- 
lation, as to allow of their gradual destruction in the organism, and 
prevent the sickness or death which they would otherwise have occa- 
sioned. 

In relation to this, the observations of the late Dr. W. Farr in his 
Report are very interesting : " Alcohol appears to arrest the action of 
zymotic diseases, as it prevents weak wines from fermenting ; like cam- 
phor, alcohol preserves animal matter — this is not now disputed. But 
may it not do more ? May it not prevent the infection of some kinds 
of zymotic disease ? " 

Experiments have shown that alcohol itself has but a slight power in 
destroying bacilli, but it is possible that even the slight traces of the 
ethers which are present in wine or spirits may have some beneficial 
action in cases of septic poisoning. 

Antiseptics, Antizymotics, Disinfectants, Deodorizers. 

These classes of remedies are often confounded together. It is well, 
however, to distinguish their meanings : — 

Antizymotics are remedies which arrest fermentation. 

It has already been mentioned (p. 83) that fermentative processes 
may depend upon either enzymes, or organized ferments, and that or- 
ganized ferments may be subdivided into several classes, such as those 
consisting of yeast, innocuous bacteria, and pathogenic bacteria. 

The class of antizymotics includes all substances which arrest fer- 
mentative processes due to these bodies. It contains two sub-classes : 
antiseptics and disinfectants. 

Antiseptics are remedies which arrest septic decomposition. They 
do this by preventing the development, or completely destroying the 
bacilli on which septic decomposition depends. 

Disinfectants are remedies which destroy the specific poisons of 
communicable diseases. Many of those poisons, perhaps all of them, 
belong to the class of microbes, and so disinfectants may be regarded as 
a sub-class of antizymotics. 

Deodorizers or deodorants are remedies which destroy disa- 
greeable smells. Such smells often accompany the decomposition of 
various organic substances, which septic organisms cause. These foul- 
smelling products may be injurious to health in themselves by acting as 
poisons ; but they are not to be confounded with the bacteria which 
produce them. Moreover, the disagreeable nature of the smell is not 
always to be relied upon as an index of its poisonous nature. M. Gustav 



106 PHARMACOLOGY AND THERAPEUTICS. 

le Bon made some experiments with hashed meat and water, over which 
he put some small animals. As the meat decomposed, the liquid teemed 
with organisms, was very fatal when injected into an animal, and emitted 
a very foul smell, which, however, did not seem to be very injurious. 
Afterwards the organisms present in the liquid died, and the foul smell 
became much less disagreeable, but the emanations from the liquid ap- 
peared to become much more poisonous, although the liquid itself, when 
injected into an animal, had no longer the same virulent power as at 
first. 

I fees of Antiseptics. — Antiseptics are employed externally in 
order to destroy microbes before their entrance into the body, and are 
administered internally with a like object, or for the purpose of at least 
preventing the free development and multiplication of the microbes. 

They are employed externally in surgical operations, with the 
object of destroying any organisms which might find a nidus in the 
wound, and there give rise to the formation of poisonous substances. 
Both these substances and the bacteria themselves will not only have an 
injurious local action in the wound, but by undergoing absorption may 
prove injurious or fatal to the organism as a whole. The antiseptic 
plan of treatment has been empirically practised in a limited manner for 
a very long period without its principle being recognized : for the well- 
known Friar's balsam has antiseptic properties. It is to Lister that we 
owe the introduction of such a mode of treatment, not based upon mere 
empiricism, but upon scientific knowledge. The reason why it had 
fallen into disuse probably was, that some of the antiseptic substances 
used for dressing wounds in the Middle Ages were irritants, as well as 
antiseptics. Those who employed them did not know the reason why 
they were beneficial, and supposed that their virtue was due to their 
irritating properties. The ointments were accordingly made more and 
more irritating; and thus more harm than good was done, until they 
were discarded by Ambrose Pare. The antiseptic most commonly em- 
ployed is carbolic acid. Not only are all the instruments to be em- 
ployed disinfected, but the operation itself is conducted under a spray of 
the dilute acid, so a- to render innocuous any organisms wdiich may be 
present in the air. The wound is then covered with an antiseptic dress- 
in::. Whenever this requires to be removed, it must always be done 
under the -pray. The reason of these great precautions is obvious: if 
any germs, however few, gain an entrance they will soon multiply and 
prove as deadly as a great number, the only difference being one of time. 
Tie- greal danger which may arise from an exceedingly minute por- 
tion of septic matter renders great caution necessary on the part of those 
who might, by a little indiscretion, convey it from one to another. Thus 
a number of years ago a medical man was nearly driven mad by an epi- 
demic of puerperal feverwhich he had in his practice: one patient dying 
after the other. In order to gel rid of any infection, he burnt all his 
clothes and \wiit away for three months. During his absence, every- 
thing wmt well. On his return, the epidemic again broke out: on 
tnl investigation, he found the only tiling he had forgotten to burn 
his gloves, and these had acted as a reservoir of infection. The 
hands, imperfectly cleaned in the first instance, had conveyed the septic 



ACTION OF DRUGS ON PROTOPLASM, ETC. 107 

matter into the gloves, and there it remained, reinfecting the hands 
every time the gloves were put on. In the same way a thermometer 
case may prove a cause of continual reinfection unless the thermometer 
be carefully washed, and if necessary disinfected, each time it is used 
and before it is put into the case. In a similar manner it has been 
found that gonorrhoeal matter may remain in the vagina and infect sev- 
eral persons without the woman herself ever suffering. One of the best 
antiseptics for disinfection in such cases is permanganate of potash. 
This may be used to wash out abscesses, if there is any fear of danger 
from absorption of carbolic acid ; and also as a lotion for ulcers or wounds 
about the mouth, the urethra or anus, where the carbolic acid might be 
too irritating ; as is evident from Koch's experiment, however (vide page 
98), a solution of the strength ordinarily used — one per cent., i.e., four 
grains to the ounce — is not sufficient to destroy the septic organism, 
although one of five times the strength will do so. 

Another way in which septic poisoning may be produced is by the 
introduction of a catheter into the bladder, where this cannot be com- 
pletely emptied naturally on account either of paralysis, enlarged pros- 
tate, or stricture. So long as the contents of the bladder have not come 
in contact with any foreign matter they may remain in the bladder for 
some time without undergoing decomposition, but if a dirty catheter 
should be passed, and thus a few organisms introduced into the bladder, 
decomposition may set up in the urine and septic poisoning ensue. A 
solution of carbolic acid in oil is sometimes trusted to for the disinfection 
of catheters, but, as Koch's experiments (page 100) show that such a so- 
lution has little or no antiseptic power, the catheters should be disinfected 
by a strong solution of carbolic acid in water and afterwards oiled before 
their introduction. 

The use of antiseptics internally is limited by the resistance of the 
organism itself, as already mentioned (page 104). In the stomach anti- 
septics are used for the purpose of preventing decomposition, and by 
thus lessening the production of irritating products they diminish irrita- 
tion of the stomach and arrest vomiting. Those which are chiefly em- 
ployed for this purpose are creasote, carbolic acid, and sulphurous acid, 
but all bitter tonics seem to have this effect to a greater or less extent. 
In the intestine antiseptics are useful in arresting putrefaction, and thus 
preventing the harm caused locally to the intestine by the products of 
decomposition as well as the injury due to their subsequent re-absorp- 
tion. They therefore tend to check diarrhoea and dysentery. It is 
probably to its antiseptic action that corrosive sublimate owes its curative 
power in cases of infantile dysentery, and it is not improbable that the 
beneficial action of calomel is due to a similar action, for it has been 
found by Wassilieff greatly to retard the decomposition due to low or- 
ganisms. 

The beneficial action of mercurials in such cases may be partly due 
to their antiseptic power not being greatly diminished by admixture with 
fiecal matters as that of other antiseptics. After absorption into the 
blood antiseptics are chiefly employed in febrile conditions, in order, if 
possible, both to lessen the growth of the septic organism and to remove 
the danger to the individual which the fever itself would occasion. The 



108 PHARMACOLOGY AND THERAPEUTICS. 

principal antiseptics used for this purpose are alcohol, eucalyptol, qui- 
nine, salicine, salicylic acid, and salicylates. Carbolic acid and creasote 
can hardly be used, as their action on the organism is too poisonous, but 
hydro-ijuinone, cresotinic acid, kairine, pyrocatechin, and resorcin are 
not markedly poisonous, and are antipyretic. They may thus be useful 
although not largely employed at present (vide also Antipyretics). Eu- 
calyptol has sometimes appeared to me to be more beneficial in cases of 
septic poisoning than quinine ; at any rate, I have seen patients recover 
under its use who had not been benefited by quinine. 

Disinfectants. — These are generally employed in order to destroy 
the germs of disease in the excreta of a patient suffering from an infec- 
tious disease, or those germs which may be adhering to articles of cloth- 
ing or to furniture or to walls of a room in which the patient has been 
lying. Probably the most efficient and generally applicable to articles of 
clothing is heat. The heat employed is usually from 230° to 250° F., but 
as a general rule it should be as hot as the fabrics will bear without injury, 
and should be continued as long as is necessary to raise the central parts 
of the articles to be disinfected to the temperature of the chamber in 
which it is placed. As the presence of moisture aids the destructive 
action of heat upon septic organisms, superheated steam appears to be 
the best disinfectant under ordinary circumstances. The only disinfec- 
tant that seems to be really trustworthy for destroying septic organisms 
when it is simply washed over them, is corrosive sublimate : even in a 
dilution of one to a thousand it appears to destroy microzymes and their 
spores by a single application for a few minutes. 

Deodorizers. — Deodorizers are mainly strong oxidizing and deoxi- 
dizing substances, as chlorine and its oxides, sulphurous acid, nitrous 
acid, ozone, peroxide of hydrogen, permanganate of potash. Charcoal, 
in addition to oxidizing, absorbs and condenses the foul-smelling gas. 
Those which are most commonly used as deodorizers for the air of rooms 
are chlorine or its oxides set free from chlorinated lime. 

For removing smells from the hands, carbolic acid is to be preferred 
to others, and for deodorizing frecal matters, permanganate of potash, 
carbolic acid, or charcoal. A mixture of eight or nine parts calcined 
dolomite (magnesia and lime) with one or two of peat or wood charcoal 

• t only an excellent deodorizer, but increases the value of the fiecal 
matters ;i- manure. 

Antiperiodics. 

These are remedies which lessen the severity or prevent the return 
oi attacks of certain diseases which tend to recur periodically. 

The chief of these are : 

Cinchona bark and it- alkaloids : — 

Quinine. Arsenic. 

Cinchonine. Salicylic Acid. 

Quinidine. Salicylates. 

' achonidine. Salicin. 

••in bark and it- alkaloid : — 

Bebeerine. Eucalyptol. 



ACTION OF DRUGS ON INVERTEBRATA. 109 

Action. — The mode in which antiperiodics act is not at present de- 
finitely ascertained, nor yet is the pathology of the diseases which they 
prevent. Remittent fever, however, has been shown to depend upon the 
presence of a spirillum in the blood, and there is considerable evidence 
for considering that malarious conditions are connected with the presence 
of a bacillus. The periodical return of the attacks in such diseases 
would appear, then, to be associated with the growth of successive crops 
of these protophytes, and the action of antiperiodics might be explained 
by supposing that they interfere with the development of these pathogenic 
organisms. 

Uses. — Quinine and cinchona bark are often regarded as almost 
specific in the various affections due to malarious poisoning, i. £., inter- 
mittent fevers, periodic headaches, neuralgias, etc. In tropical remittent 
fever of malarious origin, quinine is also the best remedy we possess. It 
must be given in very large doses however, and is less certainly curative 
than in intermittent fever. The other cinchona alkaloids have a similar 
action to quinine, but are not quite so powerful ; they, as also quinine, 
may be used as prophylactics in order to prevent the recurrence of ague 
in persons travelling through or living in malarious districts as well as 
for the purpose of curing malarious conditions already present. 

Arsenic is sometimes even more powerful than quinine, but as a rule 
it answers best in malarious conditions which are sometimes known as 
masked or latent malaria, and which manifest themselves in neuralgia and 
nervous or digestive disturbance rather than in well-marked ague fits. 

Adjuncts. — Emetics and purgatives aid the action of antiperiodics 
and sometimes, indeed, can replace them and cure ague without their aid. 
Antiperiodics rarely succeed if the functions of the liver are disturbed 
unless they are aided by emetics or purgatives, and especially cholagogues. 



CHAPTER IV. 

ACTION OF DRUGS ON INVERTEBRATA. 

The study of the action of drugs on invertebrata has not been carried 
out methodically to any great extent, but it offers a very promising field 
for investigation, and probably in the course of a few years may yield 
very valuable results. 

Action of Drugs upon Medusae. 

This subject has been worked at almost exclusively by Romanes 1 and Kru- 
kenberg. 2 At present it has little practical bearing, but it promises to be of 



1 Romanes, Phil. Trans., vol. clxvi., part 1, and vol. clxvii., part 2, 1866 and 1867. 

2 Krukenberg, Vergleichend. Physiologische Studien, Heidelberg, 1880. 



HO PHARMACOLOGY AND THERAPEUTICS. 

-reat service by enabling us to understand better the action of drugs on con- 
tractile structures generally, and on the heart in particular. 

In medusae the swimming organ consists of a bell-shaped mass of contractile 
Bubstance, within which the polyp hangs like the clapper. Around the margin 
of this bell are a number of ganglia connected with one another by nervous 
filaments. 



Bell. 



Lithocyst and ganglion H )|i«|d HPolypite. 
Tentacles ■ 'IUHh 



Fig. 15.— Medusa iSarsia) natural size. 

In the normal state of the animal, the bell alternately contracts and dilates 
rhythmically, so that the animal is propelled through the water. 

When the marginal strip containing the ganglia is removed, the bell becomes 
entirely motionless. The bell thus resembles, as we shall see afterwards, the 
ventricle of the frog's heart, both in the relation of ganglia to it, and in its 
rhythmical movements. Oxygen accelerates, and carbonic acid slows and finally 
stops, the rhythmical movements. 

When the bell, paralyzed by the removal of the ganglia which supply its 
normal stimulus to motion, is momentarily stimulated by a single induction 
-hock, it invariably responds by a single contraction. 

When successive shocks are employed at regular intervals the effect of each 
3es until the maximum is reached. 




- iows the in> n asing contractions of the tissue of medusa when stimulated by repeated -weak 

intensity. Thefirsl two shocks had no apparent effect, and the first 

• .mi in the figure was caused by the third -hoik. (From paper by Romanes in 

But if .-in additional constant stimulus is supplied to it by the addition 

cid to the water in which it Lb floating; by the passage of a constant or of an 
interrupted electrical current through it: or by alcohol or glycerine dropped 
up. ui its Burfaoe, it oommi ncea to beat regularly, rhythmically and continuously. 
When rhythmical action is thus artificially induced in the paralyzed bell, its 

Le increased by raising the temperature and reduced by cooling it. Tem- 
peratures below -<» or above 85 arrest the rhythm. 

When the marginal Btrip containing the ganglia is cut off and left attached 
only at one point, a Btimulua applied to its end travels along the strip and finally 




ACTION OF DRUGS OX IXYEETEBEATA. Ill 

causes the bell to contract. The stimuli which pass along may be of two 
kinds — they may occur separately or together. This first kind is a wave of 
contraction in the contractile tissue of the strip itself. If the stimulus is 
applied to a portion of the strip the contraction will pass along like a wave 
until it reaches the bell, which it excites to contraction. The second is a rudi- 
mentary form of nervous activity. This may occur along with the contraction 
wave, and when this is the case it is seen to pass along in front of the contrac- 
tile wave. But it may also occur when no wave of contraction takes place. Its 
occurrence is rendered visible by the movements of the tentacles which fringe 
the strip, and are much more sensitive than the contractile tissue of the strip 
itself. This wave of stimulation without contraction passing along the strip, will 



Strip of contractile tissue with fringe 
of tentacles 



Fig. 17.— Diagram of a medusa (tiaropsis), about one-third natural size, with a strip of contractile tissue 
cut froru the bell, hut left attached at one end. 

cause the bell to contract on reaching it, provided there is a marginal ganglion 
in the bell, but not if the bell is paralyzed. The wave of stimulation is more 
easily excited than that of contraction, so that it may occur from stimuli too 
weak to excite a wave of contraction. The passage of stimuli along the strip may 
be impeded or prevented altogether by compressing the strip, by making trans- 
verse incisions into it so as to narrow the band of tissue by which the wave is 
transmitted, or by injuring the tissue by straining. Sometimes the contraction 
wave may be blocked by the injury before the stimulus wave, and sometimes the 
stimulus wave may be blocked before the contraction wave. When the block is 
only partial it frequently happens that two or three waves will pass along the 
strip up to the block without being able to cross it, but after a long time their 
effect appears to penetrate so that a wave at last crosses it. 

As Gaskell has shown, a similar occurrence takes place in the frog's heart, 
and stimuli proceeding from the auricle to the ventricle may also be blocked by 
compression. 

The influence of poisons can be studied either upon the bell containing the 
ganglia, or upon this marginal strip. 

In healthy medusas chloroform first arrests the spontaneous movements of 
the bell. When now irritated it answers by a single contraction, instead of by a 
series, to such stimulation. 

After the bell has ceased to respond, nipping its margin causes the polyp to 
contract. 

After stimulation of any part of the bell ceases to produce response in any 
part of the organism, the polyp will respond to stimuli directly applied to it. 
Nitrite of amyl also produces effects which in many respects are similar to those 
of chloroform. There are, however, certain exceptions; the first is that, before 
the spontaneous movements are abolished, the rhythm becomes quickened, and 
the strength of the pulsations is diminished. The movements also die out more 
gradually than under chloroform, and before they entirely cease they become 
localized to the muscular tissue close to the margin. 

When the dose is large, spasmodic contractions are produced which obliterate 
the gradual paralyzing action of the drug. Caffeine first causes an increase in 
the rate of pulsation, and diminishes its strength after a few seconds. This 



112 PHARMACOLOGY AXD THERAPEUTICS. 

condition passes off, and the spontaneous movements become gradually abolished. 
They still remain for a long time sensitive to stimulation, and at first respond by 
st veral feeble contractions to each stimulus; afterwards by a single response ; and 
afterwards they do not respond at all. 

As medusae paralyzed by removal of the ganglia never respond to a single 
stimulus with more than a single contraction, the increased number of contrac- 
tions which at first appear after the application of the stimulus, are probably due 
to increased reflex irritability. 

Caffeine causes the tentacles and polypi to lose their tonus, and become 
relaxed, which is not the case with chloroform. Medusae anesthetized with 
chloroform when put into a solution of caffeine also lose their tonus, but their 
irritability is restored, though their spontaneity is not. 

The effects of strychnine differ in different species of medusa. In Sarsia it 
accelerates the rhythmical contractions which occur in groups separated by inter- 
vals of quiescence. This quiescence finally becomes continuous, and during it, 
it d<»es not respond to irritation of the tentacle, but does so to direct muscular 
stimulation. 

Yeratrine causes first increase both in the number and power of the contrac- 
tion.-: afterwards it diminishes both. 

Digitalin first quickens them, then renders them regular, causes persistent 
spasms, and produces death in strong systole. 

Atropine causes first acceleration, then convulsions, then feeble contractions, 
and finally death in systole. 

Nicotine causes violent and continuous spasm, with numerous minute rapid 
contractions superimposed upon it. These latter soon die away, leaving the bell 
in strong systole. 

After spontaneous movements have disappeared, the bell no longer responds 
to stimulation of the tentacles, but responds to direct stimulation. 

Alcohol first greatly increases the rapidity of the contractions, so much so 
that the bell has no time to expand properly between them, and they are in 
consequence feeble and gradually die out. The reflex stimulation shortly ceases 
to produce any effect, but muscular irritability is longer maintained. 

Cyanide of potassium first quickens and then enfeebles the contractions; 
spontaneous movements rapidly cease, and the bell soon becomes irresponsive 
either to irritation of the tentacles, or to direct irritation. For a long time after 
it has become irresponsive, the nervous connections between the tentacles and 
polyp remain intact, as also do the nervous connections of these organs, with all 
parte of the bell. 

The sensory organs are therefore not paralyzed by this drug. 

The effects of poisons on medusae were localized by Romanes in two ways: 
one way was to divide the medusa almost into two halves, connected only by a 
narrow strip of tissue. These halves were plunged into two beakers filled with 
water, pure in one and poisoned in the other. The connecting strip rested upon 
the edges of the beaker. When curare was employed as a poison in this way, it 
w;l- found to have an action similar to that which it exerts on mammals: appar- 
ently paralyzing the motor nerves, while it left the sensory nerves capable of 
action. Thus, on nipping the half of a medusa which was plungedin the curare 

tion, it remained absolutely motionless, while the other half at once responded 
by a peculiar contraction to the stimulus. Here, also, however, just as in mam- 
mals, the sensory fibres are also paralyzed by a large dose, so that if much poison 
be used, irritation of the poisoned par! will have no effect either upon it or 
up. .11 the unpoisoned part. When experimenting in this way with strych- 
nine, Krukenberg found thai the excitability of the poisoned part was increased 
inched the connecting strip lightly with a needle no effect was 



ACTION OF DRUGS ON INVERTEBRATA. 113 

produced on the unpoisoned half, but the poisoned half responded by several 
energetic contractions. Veratrine had a similar action to that of curare, so that 
irritation of the poisoned half caused no movement in it, but caused movement 
in the unpoisoned half. The irritability of the contractile tissue is also dimin- 
ished so that it no longer reacts so readily in the poisoned half to electrical 
stimuli. Nicotine appears to paralyze the ganglionic structures and not the 
nerves. 

It has already been mentioned that the rhythmical movements of medusse 
depend upon the ganglia : when these are all cut off the movements cease, but 
even if one be left the movements continue. In the medusa divided into two 
halves, as already described, it is evident that if the ganglia are removed from 
one-half, or one-half rendered functionally inactive by poison, that half will still 
continue to contract, so long as it remains connected with the other half, but 
will cease to move when it is completely divided from the half which still con- 
tains ganglia. The effect of nicotine is such as one would expect if the poison 
paralyzes the ganglia, for it is found that when one-half of a medusa is steeped 
in water containing nicotine, both halves still continue to pulsate rhythmically ; 
so soon as the connecting band of tissue is divided, the poisoned half at once 
ceases to move, while the other half continues to pulsate. 

The second way in which Romanes localized the action of poisons on medusse 
was by applying them to a strip of contractile tissue. He found that various 
poisons applied to the strip, or injected into it, caused a blockage of contractile 
waves, preceded by a progressive slowing of the rate of transmission along the 
poisoned part. Chloroform, ether, alcohol, morphine, strychnine, and curare, all 
have this effect. 

General Results. — The most marked results of experiments on 
medusae are, that the contractile tissue contracts rhythmically when 
stimulated by ganglia. It ceases to do so when the ganglia are removed 
and the contractile tissue left under ordinary conditions, but a constant 
stimulus, either chemical or electrical, applied to it after the removal of 
the ganglia, will cause it to beat rhythmically, just as if the ganglia were 
present. This appears to show that the rhythmical contractile power is 
a function of the contractile tissue and not merely of the ganglia. Be- 
sides its power of contracting once on the application of a single stimulus 
or rhythmically from continued stimulation, the contractile tissue also 
possesses the power to conduct stimuli. This is seen in the passage of 
the contraction wave along a strip of medusse which, on reaching the bell, 
causes it to contract. When two contraction waves travelling along the 
contractile strip in opposite directions meet one another they arrest each 
other. This mutual extinction may be regarded either as a process of 
inhibition or interference, or as a consequence of exhaustion of the 
tissue which possibly may be unable to contract twice with such a short 
interval between. 

The power of the contractile tissue to transmit stimuli is diminished 
or destroyed by cutting it more or less completely across, by compression, 
by stretching, by very high or low temperatures, and by poisons, such as 
chloroform, morphine, nitrite of amyl, caffeine, strychnine, curare, and 
indeed almost any foreign substance added to the water in which the strip 
is immersed. 

There are, however, two conducting- channels, along which 
stimuli may be transmitted ; the first, already mentioned, is the contractile 



114 PHARMACOLOGY AND THERAPEUTICS. 

tissue ; the second is the nervous tissue. The passage of stimuli along the 
second is rendered evident by the movements of the tentacles. These 
nervous or tentacular waves and the contractile waves may exist either 
together or separately. These nervous waves are excited by stimuli 
which are too weak to excite contraction waves, and it is to be particu- 
larly remarked that when this is the case they only travel at half the rate 
at which a contraction wave travels, although when the stimulus is strong 
enough to excite a contraction wave also, both the nervous and the contractile 
waves travel at the same rate, the nervous one being a little ahead of the 
other. The passage of nervous stimuli may also be diminished or com- 
pletely blocked by section or compression, just as in the case of contrac- 
tion waves. 

The transmission of stimuli along nerves is also affected by poisons. 
It appears to be destroyed by anaesthetics, though more slowly than that 
of the contractile tissue. The ganglia may be paralyzed, e. g., by nicotine, 
before the transmission of nervous stimuli from them is diminished. 
The contractile tissue alone may be paralyzed. 

Action of Drug's on Mollusca. 

In the lamellibranchiata, instead of a chain of ganglia as in the medusas, 
we have three pairs of ganglia: cerebral at the mouth, pedal in the foot, and 
parietal splanchnic supplying the bronchial apparatus and viscera. The heart 
has distinct chambers, but apparently consists of protoplasmic substance without 
distinct nerves or ganglia. The application to it of an interrupted current will 
arrest the rhythmical pulsation and cause stoppage in diastole. 1 This effect is 
prevented by atropine. Warmth up to 104° quickens the heart, when raised 
higher it destroys reflex movement in the animal, and afterwards arrests the heart 
also. Pure water without salts quickly paralyzes the muscles and causes death 
in salt-water mollusks. Curare in small doses has no effect, large doses quicken, 
but do not abolish movement, and do not affect the heart. Strychnine somewhat 
stimulates movement, and may cause some local contractions, but never 
any general tetanus. Nicotine acts in a similar way, but in large doses appears 
to paralyze the muscles and cause death ; it also appears to cause contraction of 
the vessels, so that the heart becomes more bulky and beats more quickly. 
Veratrine baa a Bimilar action. Digitalis has no action, excepting when applied 
to the heart directly, and then it renders the beats slower and sometimes stops 
them. Antiariiir. like digitalis, has no general action, but stops the heart if ap- 
plied to it directly. Muscarine generally causes muscular contractions in the 
body: first acceleration, quickly followed by retardation of the cardiac beats. 
Sulphocyanide of potassium diminishes reflex action, but has little effect on the 

itabilityof the nerves. A small dose somewhat quickens the cardiac action; 
;i 1;i1 topa the bear! in diastole, and if it is directly applied to the heart 

is permanent. 

Action of Drugs on Ascidians. 

The bearl in ascidians consists of a tube open at both ends, and 
which, by its contraction, drives the visceral fluid alternately towards 
the viscera and away from then). Its action .does not seem to depend 



M. Poster, Pfliiger's Archie, v., 191. 



ACTION OF DRUGS ON INVERTEBRATA. 115 

on the nervous ganglion lying between the oral and anal sac, or indeed 
upon nervous influence at all. 

The application of an induced current causes it to beat for some 
time in one direction instead of alternately, but does not arrest its pulsa- 
tions. 1 According to Krukenberg, it is not affected either by atropine 
or muscarine. It is paralyzed by veratrine, quinine and strychnine : 
these poisons rendering the beats gradually weaker and more irregular. 
No evidences of tetanus are to be seen from the action of strychnine. 
The mode of action of the heart is affected by helleborin and nicotine : 
helleborin increases the number of the advisceral beats, while nicotine 
diminishes them. Camphor and strychnine have possibly an action in 
this respect resembling helleborin. 

Action of Drug's on Annulosa. 

In annulosa the nervous system consists of ganglia in each segment 
united together by nervous bundles. These bundles in general appear- 
ance correspond with the gangliated cord of the sympathetic in higher 
animals, and the spinal cord is absent. We might therefore expect that 
drugs which act specially on the spinal cord in vertebrates would not 
have the same marked action on annelida, and this appears to be the 
case. It was found by Moseley that strychnine had no action on cock- 
roaches ; 2 and leeches, when placed in water containing strychnine, be- 
come elongated but do not exhibit signs of tetanus. Some years ago I 
noticed that ants sprinkled with insect-powder died in violent convul- 
sions, and it occurred to me that possibly substances which excite move- 
ments of the intestine in the higher animals might have a somewhat 
convulsant action on invertebrates. I therefore tried the effect of oil of 
peppermint on leeches, and it produced in them violent excitement. 
This appears to be of a somewhat convulsant' nature : the animal at first 
flying rapidly hither and thither through the water, and afterwards, 
when it becomes quiet and nearly exhausted, there is a constant rhyth- 
mical twitching movement in the body which appears to last nearly until 
death. But if my idea had been correct, all carminatives should excite 
convulsions in annulosa. This is not the case, for the oils of pepper- 
mint, caraway and anise have no apparent effect on black-beetles other 
than that of making them sluggish. Chloroform, ether, and other sub- 
stances belonging to the alcohol group, act as anaesthetics on mammals, 
temporarily abolishing the functional activity of the brain, spinal cord, 
and medulla. On leeches they have a different effect, coagulating the 
muscular substance and rendering it stiff and hard before affecting the 
nerves. This has been shown in an ingenious way by Krukenberg, who 
applied chloroform to the middle part of the leech while he protected the 
two ends of the animal from the action of the vapor. The middle part 
then became stiff and rigid, but the movements of the two ends of the 
animal were perfectly co-ordinated, so that its actions were that of a 
single animal having a stiff girdle surrounding its middle. Ether and 



1 Dew-Smith, Boy. Soc. Proc, March 18, 1875, p. 336. 

2 Moseley, unpublished experiment made in C. Ludwig's laboratory. 



116 PHARMACOLOGY AXD THERAPEUTICS. 

alcohol had a similar result. The co-ordination of the two ends showed 
that although the muscles had been rendered rigid by chloroform, the 
nerves which passed through the middle part of the body were still func- 
tionally active. When the middle part of the body was coagulated by 
the application of hot water, the muscles became rigid but the nerves 
were also destroyed, and the movements of the two ends of the animal 
were no longer co-ordinated, so that they appeared like two distinct 
animals connected by a rigid cylinder. Atropine has a similar action to 
chloroform, ether and alcohol, on the muscles of the leech. Veratrine 
appears to some extent to affect the muscles, so that after contraction 
they relax slowly. It appears also, however, to affect the nerve-centres, 
and according to Krukenberg paralyzes more especially the sensory 
centres. Camphor, strychnine, morphine, caffeine, copper sulphate, and 
mercuric chloride, act chiefly on the nervous system of leeches, although 
they also affect the muscles when applied for a length of time. Caffeine 
renders the muscles in the leech also rigid. 



CHAPTER V. 

ACTION OF DRUGS ON MUSCLE. 
Action of Drugs on Voluntary Muscle. 

In the bodies of animals we find the protoplasmic masses or cells of 
which they are composed variously modified, in order to perform special 
functions. 

In Borne the power of nutrition is chiefly developed: and these we 
find in glands. In others the power of contractility is developed: and 
these we find in muscles, striated and non-striated. 

I n the course of special development towards the fulfilment of a particular 
function, the protoplasm of the muscular cells undergoes marked changes 
But it must always be borne in mind that the protoplasmic elements 
of the body, however different from one another, always tend more or 
to retain all the functions which are seen in an organism consisting 
of B Bingle cell, a reference to which may sometimes throw much light 
upon the mode of life of the more highly organized tissues. In amoeba 
or leucocytes the protoplasm contracts in any direction. In muscle it 
contract* chiefly in one direction, riz., that of its length, though the 
probability of its contraction in a transverse direction also is to be borne 
in mind. 

We distinguish in musole its elasticity, a physical property; and its 
contractility, a vital property. 

word elasticity is applied to the tendency of the body both to 

• change of its form, and to regain it when 'this change has been 



ACTION OF DRUGS ON MUSCLE. 117 

effected : so that ivory may be taken as the type of a very strongly elas- 
tic body. Indiarubber, on the other hand, is regarded as a feebly elastic 
body, because it does not strongly resist changes of form, although it 
tends very strongly to regain its original form after such changes. It 
is, however, popularly regarded as the perfect type of an elastic body. 
In talking of the elasticity of muscle, confusion is apt to occur; it is 
better then to avoid the term elasticity and to use the words suggested 
by Marey — extensibility and retractility. The extensibility of mus- 
cle is of two kinds — immediate and supplementary. When a weight 
is attached to it, it extends considerably : this is its immediate extensi- 
bility: it then goes on slowly and gradually lengthening for a consid- 
erable time, and this is supplementary extensibility. When the weights 
are removed the retractile power of the muscle again becomes evident, 
and there is immediate retractility and supplementary retractility, 
the muscle at once contracting to a considerable extent, and then con- 
tinuing to do so slowly and gradually for some time afterwards. The 
extensibility of a muscle is increased by stimulation, so that if a weight 
be hung on a muscle while it is contracted in consequence of stimulation, 
it will produce a greater extension than it would if applied to the same 
muscle in a state of rest. If a muscle, too, is loaded with a weight too 
great for it to raise, stimulation of it, instead of causing contraction, 
causes elongation. Heat renders the muscle less extensible and more 
retractile; cold has an opposite effect, rendering it more extensible and 
less retractile. Section of the nerve has a similar effect to that of cold. 
Fatigue increases the extensibility. Alkalis (potash or soda), in very 
dilute solutions, diminish extensibility ; dilute acids (lactic acid) increase 
it. By the alternate application of alkalis and acids the muscle may be 
made to yield curves which, when recorded on a very slowly-revolving 
cylinder, are similar in form to the normal contraction curve recorded on 
a rapidly-revolving cylinder. 

Irritability of Muscle. — In order to ascertain the irritability of 
muscle itself or the readiness with which it responds to various stimuli 
independently of the nerves within it, the muscle is first poisoned by 
curare, and then exposed to various conditions or to the action of drugs. 
The muscle thus poisoned by curare, woorara, woorali, or urari (for the 
poison has all these names), is much less sensitive to the action of fara- 
daic currents. The readiest way of testing its excitability is by the 
making and breaking of a constant current, the strength of which can be 
estimated very exactly by using du Bois Reymond's rheochord. The 
excitability of muscles is increased by heat and diminished by cold. 
It is increased by physostigmin and diminished by most poisons which par- 
alyze muscle. 1 

Contraction. — When the ends of the muscle are not kept apart by 
force too great for it to overcome, and it is stimulated by heat, mechani- 
cal injury, chemical irritants, or electricity, it contracts and then relaxes. 

The form of this contraction varies according to the species of ani- 
mal, and the particular muscle tested. 



1 Harnack and Witkowski, Arch.f. exp. Path. u. Pharm., v., 1876, p. 402. 



118 



PHARMACOLOGY AND THERAPEUTICS. 



In cold-blooded animals, as a rule, the contraction is slower than in 
warm-blooded animals. It is not alike in all the muscles of the body of 
mammals. Thus in the rabbit there are two kinds of muscles — red and 
white: the white muscles contract more quickly and relax more quickly 
than the red ones. The muscle usually employed in experiments is the 
ocnemius of the frog, freshly prepared with the nerve and end of 
the femur attached to it. 

The femur is fixed in a clamp, and the lower end of the muscle is 
attached to a writing lever usually loaded with a weight (Fig. 18). 
The end of this lever writes upon a revolving cylinder, (Fig. 19), 




18.— Apparatus for registering muscular contraction. It consists of an upright stand on which. 

two horizontal bar- may be moved by a rack and pinion. The upper bar ends in a clamp, the 

es a delicate lever, the part near the hinge being of metal, and the part hevond of light 

tipped with quill or tinfoil. a, a, wires for exciting muscle; 6, muscle; c, writing lever. In 

jure no arrangement i- shown fur exciting the nerve, and for the sake of simplicity the 

■ i- shown directly under the muscle. In actual experiment, however, the weight should be 

applied dose to the a\le, or on it, so as to lessen oscillation due to the inertia of the lever. 

which is made to rotate with greater or less rapidity. The rate 
of revolution is usually ascertained by marking the time upon it by 
means of an electro-magnet (Fig. 20), communicating with a clock or 
metronome, or, when the revolution is quick, with a large tuning-fork, 
vibrating LOO times or more per second. When the cylinder is not in 
motion each contraction of the lever makes a straight line upon it (Figs. 
21 a and 27); when the cylinder is moving, the lever describes a curve 
more or less elongated, according to the rapidity of the cylinder's rota- 
tion (Figs. 21 and 22). 

Latent Period of the Muscle. — The mechanical energy devel- 
oped by muscle during its contraction is derived from chemical energy 
liberated by changes m the constituents of the muscle itself. These 

<> the nature of oxidation, and during them oxygen is used up, and 
r \ irl I '- liberated. But the oxygen is not necessarily present 

either around the muscle, or in the blood circulating through the muscle; 
it i- Btored up in some loose form of combination within the muscle. 1 



appeal tint this force-yielding Bubstance, or muscle-dynamite, as we 
1,1 lt »« ""' presented least b large quantity,in the muscles in a form in 



ACTION OF DEUGS ON MUSCLE. 



119 



The form in which it is stored up has been compared by Ludwig 
to gunpowder, a small quantity of which is fired off at each contrac- 
tion. 

One of the final products is carbonic acid ; but there are interme- 
diate products, one of them being sarcolactic acid ; and these products 
tend to cause muscular fatigue. 




-Screw. 



Framework. 



Clockwork. 






Fig. 19.— Revolving cylinder for recording movements. The screws at the top are for fixing the cylin- 
der in position. The brass pin is for making or breaking a current at a given time in the revolu- 
tion. It does this by striking against a small key. The curve is described by the lever, Fig. 18. 
The abscissa, or zero line, is drawn by a fixed point, and serves to show the height of the contrac- 
tion. 

When they are washed out of the muscle by a current of blood, or 
of simple saline solution, the fatigue of the muscle is removed ; and 
this removal is effected even more perfectly when the internal oxidation 



which it can be at once fired off. There appears rather to exist a substance yielding- 
it, or dynamogen, which may be looked upon as corresponding to the zymogen of 
the glands, while the muscle-dynamite may be regarded as corresponding to the 
ferments of glands. Irritation of a nerve appears both to liberate muscle-dynamite 
and to explode it, if we may so term it. The passage of a constant current through 
the muscle appears to liberate the muscle-dynamite from the dynamogen, but 
causes no expulsion except at the moment when the current is made or broken, or 
its strength altered. It must be carefully borne in mind that the idea of a muscle- 
dynamogen is at present simply theoretical, and must be looked upon not as a fact, 
but rather as a means of remembering facts. According to A. Schmidt, however, 
the contraction and relaxation of muscle is closely connected with formation and 
destruction of a ferment. 



120 PHARMACOLOGY AND THERAPEUTICS. 

is rendered more complete by adding permanganate of potash to the 
solution, or by the addition of minute quantities of potash. A mere 
trace of veratrine has also a similar effect in restoring the muscle after 
fatigue. 

We find that the muscle does not immediately respond to a stimulus, 
but that a period elapses between the stimulus and the commencement 
of the contraction, which is on the average about the 100th of a second. 
This is termed the latent period. 

During this period a chemical change is probably going on in the 
muscle, and it is evidenced by an electrical change known as the nega- 
tive variation, or diminution in the natural current which passes from 
the longitudinal to the transverse section of the muscle. 

The latent period is altered by fatigue. Loading the muscle short- 
ens the latent period, until the load is just sufficient to extend the 
muscle. An increase of load above this lengthens the latent period. 
Cold lengthens it; heat shortens it. Small doses of strychnine or vera- 
trine shorten the latent period. Large doses of strychnine or veratrine, 
and also curare, lengthen it. 

Summation of Stimuli. — During the latent period, the stimulus 
applied to a muscle excites chemical changes which result in contraction ; 




Electro-magnet. 



flndiarubber thread to draw 
< back the writing-point when 
(released by the magnet. 



Ik.. 2o.— Electro-magnet (after Marey) for recording time on a cylinder. When used to record time, 
the current is made and broken alternately by clockwork or by a tuning-fork. It may by used 
ftlBO to record the time of irritating or dividing a nerve, or of injecting a poison, &c. 

but if the stimulus be very small, the chemical changes may be so slight 

that contraction does not occur. If the stimulus, however, be repeated 

era! times, the changes which it induces in the muscle become suffi- 

r to produce at first a slight contraction, and then one greater and 
greater, until the maximum effect is produced — this is called summation. 
It occurs not only in voluntary muscles, but in other contractile tissues, 
Bucfa as those of the medusae, vide Fig. 16, p. 110. A similar phenome- 
non occurs also in the heart, and has there received the name of "the 
Btaircfl 

ContractioD of Muscle. — In the muscular curve we notice (1) 
the rapidity of its rise, winch Indicates the rapidity of contraction of the 
muscle; (2) its length, indicating the duration of contraction ; (3) its 
height, indicating power of contraction; and (4) slowness of fall, indi- 
cating the condition of extensibility. 

The muscular contraction is modified by numerous conditions. 

One of these is the strength of stimulus. 

The stimulus usually applied is electricity, as its strength can be 
more easih regulated, and h does not destroy the muscle so readily as 
mechanical or chemical irritants. 



ACTION OF DRUGS ON MUSCLE. 121 

With a weak current, making (closing) has no action on the muscle, 
but breaking (opening) causes contraction. 




Fig. 21. — Muscle curves, showing the different appearances they present according to the rate at 
which the recording cylinder revolves, a is a curve with a very slowly revolving cylinder ; 6, c, 
and d are curves with increasing speed of rotation, c is written witb a lever pointing in the 
opposite direction from that with which a and b are recorded, and the curve therefore inclines to 
the other side. 

A moderate current gives contraction both in making and breaking, 
but that of making is comparatively small (Fig. 22). With a strong 
current no difference is observed. 




Fig. 22.— Shows effect of making and breaking shocks. These are normal muscle curves with a still 
quicker rotating cylinder than in Fig. 21. The first is caused by irritating the muscle by making 
(closing) a constant current, and the second by breaking (opening) it. 

The more intense the stimulus, the higher and longer is the curve. 
The increase in height is shown in Fig. 23. 




Fig. 23.— Tracing of the contractions of a muscle with stimuli of varying strength. The numbers 
indicate the distance in centimetres of the secondary from the primary coil in the induction 
apparatus. As and Des indicate the ascending and descending direction of the current. 

Cold renders contraction slower, lower, and more prolonged (Fig. 24 b). 

Heat renders it quicker, higher, and shorter (Fig. 24 a). 

Fatigue. — Fatigue makes the ascent slow, the height less, and the 
descent slow (Fig. 25). 

Exhaustion of the animal has a similar action ; and dilute acids 
applied to the muscle produce the same effect. 



122 



PHARMACOLOGY AjS'D THERAPEUTICS. 



The effect of fatigue is probably due in a considerable measure to the 
accumulation of acid products of muscular waste. When these are 




Fig. 24. 



-Effect of heat and cold. In a the muscle has been artificially warmed, and in b it has 

cooled. 



been 



washed out by passing a weak solution of chloride of sodium through the 
vessels of the muscle, or removed to some extent by kneading, it regains 
to a great extent its normal power of contraction. 




Fig. 25.— Effect of fatigue. 

Oxidizing agents, such as permanganate of potash, added to the salt 
solution increase this power, and restore the muscle even more quickly 
and completely. 1 

Deprivation of blood has a similar action on the muscle to fatigue : 
and free circulation of blood tends to remove the effects of fatigue. 

Contracture. — When the stimulation is exceedingly strong, the re- 
laxation after contraction may become very slow, and the descent of the 
curve may be divided into two parts. At first it descends for a short 
time pretty (prickly, and then falls very slowly indeed. This long con- 
traction of the muscle is known as contracture. It is very strongly 
marked in muscles poisoned by veratrine or barium. It occurs, though to a 
less extent, in muscles poisoned by salts of calcium and strontium, by 
ammonia, and by the chloride, iodide, nitrite, nitrate, and cyanide of am- 
monium.' 

The cause of contracture is not known ; it is considered not to be a 
tetanic contraction, because, unlike an ordinary tetanized muscle, it does 
Dot give rise to secondary tetanus in another frog's muscle when the nerve 
of the latter is placed upon it. It is, however, an active contraction, not 
a mere alteration in the elasticity of the muscle preventing its relaxation ; 
for, as Pick and Boehm have shown, a much greater amount of heat is 
developed during the long-continued contracture than in an ordinary 
contraction. Sometimes, and indeed not unfrequently, the contracture, 
instead of consisting of a single prolonged contraction, appears in the 
l" 1 "'" of a prolonged contraction added on to an ordinary contraction be- 
fore relaxation has had time to occur. This gives rise to a peculiar hump 



1 Kronecker, Ludwig's Arbetten, 1871, p. 183. 
Brunton and Cash, Roy. Soc. rw., \m\\. 



ACTION OF DRUGS ON MUSCLE. 123 

in the curve, as is well seen in the middle curve in Fig. 30. This appears 
to show that the contracture is really a double phenomenon, like the two 




Fig. 26. — Secondary contraction in the muscle of a crayfish. The thick part of the lower line shows 
the time during which the muscle was irritated by a tetanizing current. It will be noticed that 
the secondary contraction occurs after the irritation has ceased, and after the tetanus caused by it 
has relaxed. It is not a simple continuous rise, but exhibits several waves indicative of a kind of 
rhythm. (After Eichet). 

contractions observed after a single stimulation in the muscle of the cray- 
fish by Eichet (Fig. 26). How far the contracture may depend upon 
irritation of the muscle by its own current has yet to be determined. 

Tetanus. — If instead of a single stimulation a number of stimuli 
rapidly succeeding each other are applied either directly to the muscle 
itself or to its motor nerve, we get, in place of a single contraction, a 
continued contraction or tetanus. As this is due to a fresh contraction 
of the muscle occurring before the previous one has had time to relax, 
it is evident that the number of stimuli requisite to produce this will 
vary with the length of each single contraction in a muscle : thus in the 
muscles of the tortoise, which contract and relax very slowly, tetanus may 
be produced by 3 stimuli per second, while in the white muscles of rabbits 
20 may be necessary, and in some muscles of birds 70 stimuli per second are 
insufficient. It has been said that with as rapid stimuli as 250 per second 
the tetanus ceases, and after a single initial contraction a muscle goes to 
rest just as if a constant instead of an interrupted current had been used. 
Kronecker and Stirling have shown that with no less than 22,000 inter- 
ruptions per second, still tetanus is obtained ; but when such extremely 
rapid stimuli are applied, the muscle still contracts about the ordinary 
rate of 20 per second ; and this is also the case when chemical stimuli are 
applied to the nerve, or when the muscle is irritated by the nerve centres, 
either voluntarily or by artificial stimuli applied to them. It seems, 
therefore, probable that the number of contractions of the muscles 
in tetanus are not due to the number of stimuli sent down from the nerve 
centres, but that the rate is determined either by the ends of the nerve 
in the muscle or by the muscle itself. 1 

The form of a tetanus curve may be modified very considerably by 
the action of drugs: thus substances which diminish the contractile power 
of muscle cause the tetanus curve to fall very rapidly notwithstanding 

1 Wedenskii, Archivf. Anat. «. Physiol. Phys., Abthlg., 1883, p. 325. 



124 PHARMACOLOGY AND THERAPEUTICS. 

the continued application of stimuli either to the muscle itself or to its 
nerve (vide Ammonia). 

Sfuscular Poisons. — We may distinguish several groups of muscu- 
lar poisons, but at present the classification is difficult, and the division 
into six groups, based on that of Robert, which I have adopted, although 
it possesses some advantages, is far from satisfactory, and can only be 
regarded as temporary. 
Group I. — Leaves the irritability of the muscle unaffected, but diminishes 

the total amount of work it is able to do. 
Group II. — Diminishes the excitability of the muscle as well as its ca- 
pacity for work. 
Group III. — Diminishes the capacity for work, and produces marked 

irregularity in its excitability. 
Group IV. — Alters the form of the muscular curve. 
Group V. — Increases the excitability. 
Group VI. — Increases the capacity for work. 




Fie. 27.— Tracings showing the gradual loss of contractile power from fatigue in a normal muscle, a, 
and in one poisoned by carbolic acid, b. Each section, 0'— 1', &c, shows the contractions in one 
minute. (After Gies). 

The poisons in Group I. do not alter the muscle curve, so that if the 
action of the poison were tested by a single contraction only, it would be 
-apposed that the muscle was unaffected; they lessen, however, the 
amount of work which the muscle can yield. 

The amount of work is estimated by the weight which a muscle raises 
multiplied into the number of times it is lifted and the height it is raised 
cadi time. These are ascertained by registering the contractions on a 
slowly revolving drum, as in Fig. 27, which shows the rapid exhaustion 
of a muscle poisoned by carbolic acid as compared with a normal one. 
The rapid exhaustion of muscles may also be observed in the form of the 
tetanus curve, which, under the influence of such poisons, falls much more 
rapidly in heighl than that of the normal muscle. 

This group contains a number of drugs having an emetic action. 1 
These are: apomorphine, asclepiadine, cyclamine, delphinine, sanguinar- 
ine, and saponine, copper, zinc, and cadmium. Antimony has a some- 
what similar action, hut only in large doses, and after a great length of 
time. Arsenic, platinum, and probably mercury, act in the same way as 
antimony. 1 Tin, nickel, 8 cobalv manganese, 2 aluminium, and magnesium, 
have little or do action on muscle. Large doses of iron are nearly as 

FTarnack, Archivf, exp. Path, u, Pharm. Bd. ii., p. 299, and iii., p. 44. 
Kobert, Arch./, exp. Path u. Pharm. Bd. \\\, p. 22, and xvi., p. 361. 
AndenoD Stuart, journ. of Anat and Physiol, vol. xvii.,.p. 89. 



ACTION OF DRUGS ON MUSCLE. 125 

powerful as arsenic, but in small doses it rather increases the amount of 
work the muscle can do. 

Carbonic oxide at the atmospheric pressure does not affect muscular 
contractility, but abolishes it at a pressure of five atmospheres. 

Perhaps we may take as a subdivision of this group those poisons 
which lessen the contractile power of the muscle without altering its irri- 
tability. When a muscle poisoned by one of these is stimulated, it may 




Fig. 28.— (After Harnack). Shows the action of lead on muscle, a shows the contraction of a normal 
muscle after eighty stimulations ; 6, the irregular contractions of a muscle poisoned by lead after 
ten to fifty stimulations; c shows the slow relaxation of the muscle after contraction in a muscle 
poisoned by lead after numerous stimulations. 

contract quite as readily as a normal muscle, provided the weight that it 
has to raise is but slight, but it cannot raise such a heavy weight as a 
normal muscle. This is tested by loading it with a given weight, and 
the slightest contraction is ascertained by adjusting the lever of the myo- 
graph in such a way that if raised in the very least it breaks a connection 
in an electrical current and causes a bell to ring. In this way contrac- 
tions quite imperceptible to the eye are readily appreciated. Digitalis 
has an action of this sort, as I found in some experiments carried on 
under the direction of Professor J. Rosenthal in 1868, but not published. 

Group II. contains salts of potassium, lithium, ammonium, quinine, 
cinchonine, oil of mace, alcohol in large doses, chloroform, etc. 

Chloral, chloroform, and ether, also belong to this group, but they 
might also be reckoned as belonging to Group IV., for they slow the 
ascent, lessen the height, and prolong the descent of the curve. Curare 
has a similar action. 

It is usually stated that curare, while it paralyzes motor nerves, leaves 
the excitability of the muscles unaffected, but this appears not to be quite 
correct, for, when very weak currents are employed, the muscle loses its 
excitability by them before the nerve, and the contractions of the muscle 
at the same time become unequal. It is perhaps not yet perfectly certain 
how far these appearances are due to the curare and how far to the gradual 
death of the muscle. 1 

Group III. contains poisons of which lead is a typical example. 
These poisons cause the muscular contractions to become very unequal, 
although the stimuli are equal and regular. Emetine and cocaine have 
a similar action to lead. This action is probably due only to the gradual 
death of the muscle. It is produced also by ptomaines, and it may occur 
in muscles which are simply dying without being poisoned at all. 2 



1 Marey, 'iravaux da Laboratoire, 1878, p. 157. 

2 Mosso, Les Ptomaines. Turin, 1883. 



126 PHAKMACOLOGY AND THERAPEUTICS. 

Group IV. contains poisons which alter the form of the curve to a 
marked extent. 

The action of veratrine is very peculiar : it does not lessen the rapid- 
itv of contraction, and even increases the height of the curve, but it 
prolongs the descent to an enormous extent. 




Fi«.. 21'.— Tracing of the contraction curve of a muscle poisoned by veratrine, showing enormous pro- 
longation of the contraction, the recording cylinder making many complete revolutions before 
the muscle is completely relaxed. 

This action of veratrine is most marked at moderate temperatures. 

It is much diminished, and sometimes entirely removed, by cold ; 
and it disappears also when the temperature of the muscle is consider- 
ably raised. When the muscle which has been cooled or heated is again 
brought back to a moderate temperature, the contracture sometimes re- 
turns, but occasionally does not, the effect of veratrine on the muscle 
appearing to be sometimes, but by no means always, destroyed by the 
heat or cold to which the muscle has been exposed. 1 

The result of this exceedingly prolonged contraction is that a frog 
poisoned with veratrine is able to jump with considerable power, but the 
extensor muscles, by which the movement is executed, remain contracted 
instead of relaxing. The animal therefore lies extended and stiff, and is 
only able very slowly to draw its legs up towards the body. After they 
have been drawn up, the flexors in their turn remain contracted for a 
while, and so the animal is unable to jump until some time further has 
elapsed. 

Another remarkable point about the action of veratrine on muscle is, 
that although a single contraction lasts so long as seriously to interfere 
with the power of co-ordinated movement, yet if the muscle is made to 
contracl a fewtimes in rapid succession, the effect of the veratrine disap- 
pears, and it again acts normally. After a short rest the effect of vera- 
fcrine again reappears. 

\ similar action to that of veratrine is exerted by salts of barium, 
which, when locally applied, cause the muscle to describe a curve resem- 
bling that of reratrine, not only in its form, but in the alterations pro- 
duced I <v temperature and in its temporary disappearance after repeated 
contractions. A similar action is exerted also, though to a less extent, 
by strontium and calcium. Salts of potassium may at first increase the 
height of contraction, but afterwards both moderate and large doses shorten 



Brunton and Cash, Journ. of Physiol, vol. iv.,p. 1, and Centralblatt d. Med. Wise., 



ACTION OF DRUGS ON MUSCLE. 127 

the muscular curve and lessen its height, so as finally to abolish its con- 
tractile power altogether. When applied to a muscle poisoned by vera- 
trine, barium, strontium, or calcium, salts of potash remove the excessive 




Fig. 30. — Tracing of the contraction curves of a muscle poisoned by varatrine, showing the peculiarly- 
elongated curve at a moderate temperature, and its restoration nearly to the normal by cooling 
and heating. 

prolongation of the contraction which these drugs occasion, and restore 
the muscular curve again to its normal. 1 

Although veratrine alters the form of the muscular curve so greatly, 
it does not (excepting in large doses) paralyze the muscle, so that when 
a poisoned muscle is made to contract at regular intervals for a length of 
time, it is able to do as much work as a normal one. 

Nearly allied to this is another group of muscular poisons, some of 
which have already been mentioned as a subdivision of Group I. It con- 
tains : digitalin, digitalein, digitaleresin, digitoxin, toxiresin, scillain, 
helleborein, oleandrin, adonidin, neriodorin, and neriodorein. Tanghinia, 
thevetin, and frynin, or toad poison, probably also belong to this class. 

These drugs do not lessen the irritability of muscle, but appear to 
alter somewhat the form of the muscle curve, somewhat in the same way, 
but to a less extent than substances of the veratrine group. Some of 
them when applied in a concentrated form directly to the muscle cause 
a condition of rigor. This is especially the case with caffeine and digi- 
talin. This rigor is well marked in the rana temporaries, and only to a 
comparatively slight extent in the rana esculenta. Although caffeine in 
concentrated solution produces rigor mortis in the muscle, yet in very 
dilute solutions it is a muscular stimulant, and as such is included in the 
sixth group. 

Group V. contains physostigma, which increases the excitability of 
muscle to slight stimuli, but does not increase the amount of work it can 
do ; on the contrary, in large doses it diminishes it. 



1 Brunton and Cash, Boy. Soc. Proc, 1883. 



128 PHARMACOLOGY AND THERAPEUTICS. 

Group VI. — Poisons belonging to this group in small doses increase 
muscular work, and cause the muscle to recover rapidly after exhaustion. 
Creatine has this power to a great extent ; hypoxanthine has it also, 
though less powerfully. The effect of these substances is very interest- 
in or, because they are products of muscular waste. They also occur in 
beef-tea, and their action appears to show that beef-tea assists muscular 
power, as well as acts as a nervous stimulant. 

Other members of this group are caffeine and glycogen : these have 
great power to increase muscular work. The relation of caffeine to hy- 
poxanthine is very interesting. Xanthine, which is another substance 
derived from muscles, differs from hypoxanthine in containing one atom 
more oxygen. Theobromine, the active principle of cocoa, is dimethylx- 
anthine ; and caffeine, the active principle of tea and coffee, is trimethylx- 
anthine. The restorative effects of beef-tea, coffee, tea, and cocoa have 
long been recognized empirically, although their action could not be ex- 
plained. It now seems not at all improbable that it may be partly due 
to their restorative effect on the muscle. 

Massage. — The effect of kneading a muscle so as to remove the 
waste products from it is very extraordinary. 

When the muscles of an uninjured frog are stimulated to contraction 
by the rhythmic application of maximal induction currents until they are 
exhausted and no longer contract, kneading them, or massage, restores 
their contractility so that their contractions are nearly as powerful as at 
first, while simple rest without massage has very little restorative effect. 
In man also, while a rest of fifteen minutes after exhausting labor had 
very little restorative action, massage during the same period increased 
double the work that could be done. Massage has a similar action to 
very complete and perfect circulation through the muscle, in removing 
the waste products and restoring its power. 1 

Propagation of the Contraction Wave in Muscle. — When a 
muscle is irritated at one point, the contraction wave which occurs at that 
point is conducted along the muscle in both directions. 

This contraction wave, like that which occurs in the contractile tissue 
of the medusa, Is independent of the nervous system. The completeness 
with which it is conducted, and the quickness with which it subsides at 
each point, are closely connected with the repidity of the conduction, and 
they are also injuriously affected by anything which impairs it. It di- 
minishes during the death of the muscle, and it is lessened also by fatigue, 
by cold, by injury, such as excessive stimulation. Certain poisons also 
lessen it. as cyanide of potassium, veratrine, and upas antiar. 2 

Heal increases the rapidity of the conduction. 

Rhythmical Contraction of muscle. — Rhythmical contraction 
i- frequently regarded as a function of involuntary muscular fibre only; 
this, however, is not the case, for it is observed also in voluntary muscles. 
Rhythmical contraction of involuntary muscle is well marked in the heart 
and blood-vessels. It Is wry distinct in the intestines and bladder, and 



Oentral. d. Med. Wisa., 1883, No. 14, p. 241. 
.\«-i.\ . UfUenuchungen uber du Fortpflanzungsgeschvnndigkeit der Reizungen der 
■ I (i>n MvuHcdfam Braunschweig, 1862, p. 62. 



ACTION OF DRUGS ON MUSCLE. 129 

becomes still more marked after the influence of the central nervous sys- 
tem has been destroyed. In the case of the sphincter ani, for example, 
the rhythm is strong and regular, especially after the nerves have been 
divided and the muscle subjected to some mechanical distension by the 
introduction of the finger. 

In voluntary muscle the tendency to large rhythmical pulsations is 
slight, although we see rapid contractions occurring in tetanus. 

It is usually supposed that eighteen or twenty contractions per minute 
of the muscle when tetanized by stimulation of nerve centres is due to 
this number of stimuli being sent to it from the nerve centres. 

From the observations of Wedenskii that irritation of the motor nerve 
of a muscle by exceedingly rapid stimuli still produces the same number 
of contractions in the muscle, it seems probable that this rate of contrac- 
tion is due to the constitution either of the muscle itself, or of the nerve- 
endings within it. Under certain circumstances, however, the voluntary 
muscle may be made to contract with a slow rhythmical movement of 
considerable extent and closely resembling that of involuntary muscular 
fibre. 

Thus voluntary muscle treated by veratrine tends to remain con- 
tracted for a length of time like an involuntary muscle; heat has a 
tendency to cause its relaxation, and sometimes, as is seen in the accom- 
panying figure, these contending influences produce in the voluntary 
muscle a tendency to marked rhythmical contraction (Fig. 31). 

A still more remarkable phenomenon has been noticed by Kiihne, 1 
who finds that when the uninjured sartorius of a frog is placed in a 
solution of 5 grammes NaCl, and 2*5 grammes of common alkaline 
crystallized phosphate of soda in a litre of water, it begins to contract 
at once, and after it has been transversely divided, it beats with the 
regularity of the heart. 

The action of various substances on the rhythmic action of muscle 
treated in this way has been investigated by Biedermann. He finds 




Fig. 31. — Tracing of the contraction curve of a muscle poisoned by veratrine and exposed to a high 
temperature. The poison tends to cause prolonged contraction, and the high temperature to cause 
rapid relaxation of the muscle. The result is a somewhat rhythmical spontaneous contraction. 
The muscle was only irritated at the very beginning of tbe first contraction. 

that the best fluid for the sartorius is 5 grammes NaCl, 2-2*5 grammes 
of Na 2 HP.0 4 , -04- 05 grammes of Na 2 C0 3 , in a litre of water. A low 

1 Untersuchungen aus dem PhysiologiscJien Institute der Universitat Heidelberg. Son- 
derabdruck, 1879, p. 16. 



130 PHARMACOLOGY AND THERAPEUTICS. 

temperature not rising above ten degrees is best. The lower the tem- 
perature the slower is the rhythm and the more extensive the contrac- 
tion. Heat quickens the rhythm and lessens the contraction. At about 
18° to 20° C. the contractions become rapid and indistinct. When 
caustic soda is used instead of carbonate, the effect is similar, but the 
muscle dies much more quickly. Potassium carbonate and other potash 
salts only cause pulsations when greatly diluted. Lactic acid stops the 
pulsations : alkaline NCI solution again restores them. Veratrine and 
digitaline in a solution of NaCl also cause pulsations. 1 

Schonlein finds that, with a certain strength of current interrupted 
about 88<> times in a second, the muscles of the water beetle are not 
tetanized but contract rhythmically from two to six times in a second. 2 

Biedermann has succeeded in making a voluntary muscle, such as 
the sartorius, contract rhythmically by applying a solution of sodium 
bicarbonate ('2 per cent.) to the tibial end, and then passing a constant 
ascending current through the muscle. 3 

Connection between Chemical Constitution and Physiological 
Action on Muscle. 

I have already mentioned (page 49) that one can hardly look for a 
general relation between the atomic weights of metals and their lethal 
activity, so that what we want is really a knowledge of the particular 
relationship of each group of elements to the organs and tissues of the 
body. 

In such an investigation it seems natural to take the muscles first, 
then the motor nerves, afterwards the nerve centres and individual 
organs. A number of experiments have been made by Cash and myself 
in order to do this for the alkalies and alkaline earths, and we have 
found that the contractile power of muscle, as shown by the height of 
the curve, is increased by rubidium, ammonium, potassium, and caesium. 
It is Blightly increased or unaffected by sodium, excepting in large doses, 
and i- almost invariably diminished by lithium. 

The duration of* contraction, as shown by the length of the curve, is 
increased by rubidium in large doses, ammonium, sodium, and caesium. 
It i- shortened by ammonium, lithium, rubidium, in small doses, and 
potassium. 

The contracture, or viscosity, is increased by rubidium in large 
doses, ammonium, lithium, and sodium. It is diminished by rubidium 
in small doses, ammonium, caesium, and potassium. 

Both ammonium and rubidium have two actions on muscle of an 
opposite character, sometimes increasing and sometimes diminishing both 
the duration of the contraction and of the contracture, or viscosity, 
which remains after the ordinary contraction has ceased. In the case of 
rubidium, this appears to depend upon the dose, but we were not satis- 
fied thai it was so entirely in the case of ammonium salts. 



ngsber. d. Wiener .W.W., Ixxxii., AMh. Hi., pp. 257-275. 
ulein, «Im Boie Re\ mond'a Archiv, 1882, s. 357. 

tber. '/. Wien. Ikad. Bd., lxxxvii., Abt, iii., March, 1883. 



ACTION OF DRUGS ON MUSCLE. 



131 



In regard to the action of the alkaline-earths and earths, we found 
that the contractile power of muscle is increased by barium, erbium, and 
lanthanum. It is sometimes increased and sometimes diminished by 
yttrium and calcium. It is diminished by didymium, strontium, and 
beryllium. 

The duration of contraction is increased by barium, calcium, stron- 
tium, yttrium, and erbium. It is unaffected, or slightly diminished, by 
beryllium, didymium, and lanthanum. 

Contracture is increased by barium, calcium, strontium, yttrium, and 
beryllium. 

The contracture produced by barium is enormous, resembling that 
produced by veratrine. It is, like that of veratrine, diminished by heat, 
cold, and potash, and may be abolished by these agents. It is by no 
means so well marked when the drug is injected into the circulation as 
when locally applied to the muscle. 

The action of some of the more important of those drugs can be 
graphically represented by a spiral, the terminal members of which are 
potassium and barium, and these two are to a certain extent connected 
by ammonium as an intermediate link. 



K 

Rb 

Li 

Na 
Sr 
Ca 
Rb 
Ba 
NHo 



Increase or diminish 
after action or contracture. 
Increase, o Diminish. 



Increase or 

diminish altitude. 

Diminish, o Increase. 



Shorten or 

lengthen curve. 

Lengthen. Shorten. 



The effect of one member of one of these groups may be diminished 
or increased by the subsequent application of another. Potassium 
shortens the elongated curves caused by barium, calcium, sodium in 
large doses, and lithium, and reduces the contracture which these sub- 
stances cause. The veratrine-like curve of barium is counteracted by 
almost all the substances which produce a shorter curve than itself. 



Action of Drugs on Muscle is Relative and not Absolute. 

In considering the action of drugs on muscle, the first point which 
comes clearly out is that the action of a drug on the muscle is not abso- 
lute but merely relative. Thus veratrine and salts of barium are not to 
be regarded as absolute muscle poisons — they are only poisons under 
certain conditions of quantity and of temperature. An exceedingly 
small dose of veratrine instead of acting as a poison to muscle, 
acts rather as a food, and restores it when exhausted. Caffeine 
likewise in small doses has a restorative action, while in large doses it 
is a powerful poison. Veratrine and barium in moderate doses and 
at moderate temperatures are powerful muscular poisons, but at low 



132 PHARMACOLOGY AND THERAPEUTICS. 

temperatures and at high temperatures their action is to a great extent, 
or even completely, abolished. Nay more, moderate quantities of barium 
salts at moderate temperatures are poisonous to the normal muscle, but 
they are restorative to the muscle whose composition and functions have 
been already altered by rubidium. Acids and alkalies also produce 
an effect on muscle, but their effect depends upon whether they are 
applied to the normal muscle or to one previously treated with a sub- 
stance having an opposite reaction. 

It is evident then that the whole question of the action of drugs on 
muscle is one involving the relation of the drug to the muscle at the time 
of application, and we must expect that if the temperature is different 
from the normal, or if the composition of the muscle should vary, the 
action of the drug will vary likewise. Now the composition of all the mus- 
cles in the body is not the same, as has been shown by Toldt and Nowak, 1 
and the composition of the ash obtained by the combustion of different 
animals is also different, as has been shown by Lawes and Gilbert. 2 
We may therefore expect that muscular poisons will not act alike at 
the normal temperature and in febrile conditions, nor alike upon 
all the muscles of an animal; nor will they always have the same 
action upon different animals — the relations being different the effects 
will be different. The effect of poisons upon muscles will also vary 
according to their chemical composition at the time. This composi- 
tion may probably to a certain extent be altered by feeding — at least as 
far as regards the proportions of inorganic ingredients. We know 
that the quantity of sodium chloride in the body can be increased, for 
if an animal be fed with a larger quantity of salt than usual, it does 
not at once begin to excrete it, but stores it up for two or three 
days, and then the excretion rises. After the administration of the 
sail has been stopped the excretion still continues large for two or three 
days, and then returns again to the lower standard. It seemed probable 
that similar retention would take place with potash, and if this were so, 
we might expect to counteract to a great extent the effect of barium by 
feeding an animal on potash for some time before administering the 
barium. I )n trying this, Cash and I have found that this is the case to a 

on extent, and although we have not been able completely to coun- 
teracl the effect of a large dose of barium so as to prevent death from a 
lethal dose, we have been able to modify and diminish its action by the 
administration of potash for several days previously, so that the charac- 
teristic symptoms of barium poisoning do not occur until some hours 
after they would otherwise do so, and thus life is prolonged though not 
preserved. 

\< tiou of Drugs on Involuntary Muscular Fibre. 

Contraction. — Involuntary muscles, with the exception of the heart, 
differ from voluntary not only in their anatomical structure but in their 
functional activity: instead of contracting or relaxing rapidly, both their 



oted bj Seegen, ir-,„. !/.„,/. Ber., lxiii., Abt. ii., 11-43. 
•' A'oy. 80C. I'm, ., , x v"., p. 344. 



ACTION OF DRUGS ON MUSCLE. 133 

contraction and relaxation are slow. We have seen that although vol- 
untary muscle occasionally exhibits spontaneous rhythmical contractions, 
yet these occur only under exceptional circumstances, and but rarely. 
Involuntary muscle, on the other hand, has a much greater tendency to 
rhythmical contraction, although it may be regarded as doubtful whether 
some stimulus, however slight, is not required to induce this rhythm 
even in involuntary muscle. It has been already mentioned that the 
contractile tissue of medusa will beat rhythmically so long as it is con- 
nected with motor ganglia. When these ganglia are removed, the con- 
tractions cease, but will again reappear, notwithstanding the absence of 
the ganglia, if a constant stimulus be applied to the contractile tissue 
itself. This shows that the conditions for rhythm are contained in con- 
tractile tissue itself — that the rhythm may be independent of the gan- 
glia with which the contractile tissue is connected (p. 110). The same 
appears to be the case with involuntary muscular fibre generally. 

The ventricle of the frog's heart, containing ganglia, will beat rhyth- 
mically for a length of time after its removal from the body. If the 
ganglia which lie close to the auriculo-ventricular groove are cut off, the 
rhythmical action will cease just as in the medusa when the marginal 
ganglia are removed ; but if a constant stimulus be applied to the apex 
of the heart, as for example by passing a constant current through it, or 
by distending it with serum, its rhythmical movement will again com- 
mence, mechanical distension appearing to have upon it the same excit- 
ing action that a little acid added to the water has upon the nerveless bell 
of the medusa. 

Effect of Stimuli. — Mechanical distension appears to be one of 
the most powerful of all stimuli to excite rhythmical contraction in in- 
voluntary muscular fibre. 

Luchsinger observed distinct pulsation in the veins of a bat's wing 
twenty hours after the death of the animal, if artificial circulation was 
kept up. This appears to show that the power of rhythmical contraction 
resides in the muscular fibres of the veins as it does in the nerveless apex 
of the frog's heart, and the contractile tissue of the medusa ; but here 
also an external stimulus appears to be required to induce contraction. 
When the pressure by which artificial circulation was maintained fell to 
zero, the pulsation stopped, but if it were raised to forty or fifty centi- 
metres of water, so as to distend the vascular wall, rhythmical pulsation 
again commenced. It appears possible, however, that when involuntary 
muscular fibre is perfectly healthy and possessing the highest degree of 
irritability, it may contract rhythmically without any extra stimulus. 
Thus Englemann 1 observed that the ureter, in which he could find no 
nerves at all, contracted rhythmically when freshly exposed, although it 
was not distended or subjected to any mechanical irritation ; but if arti- 
ficial respiration has been long kept up, and the animal is exhausted, so 
that the excitability of the ureter is diminished, then the effect of min- 
imum distension in increasing its rhythm becomes very evident. 

Cold causes the isolated non-striated muscles of animals to relax. 
Heat causes them to contract. 2 



1 Pfliiger's Archiv, 1869, Bd. 11, p. 251. 

2 Luchsinger and Sokoloff, Pfliiger''s Archiv, Bd. 26, p. 465. 



134 PHARMACOLOGY AND THERAPEUTICS. 

The influence of heat and cold, however, does not seem to be con- 
stant, and in the non-striated muscle of frogs they have an opposite con- 
nection to that just described. It is probable that the different results 
may depend to a great extent upon the amount of heat or cold applied, 
and its relation to the condition of the tissues at the time of application ; 
for mechanical stimulation has also an opposite effect, according to its 
amount ; and while gentle stimulation of involuntary muscular fibre, 
such as that of the small blood-vessels, causes dilatation, more powerful 
irritation produces contraction. 1 

The influence of various drugs upon involuntary muscular fibre, as 
seen in the contraction of the blood-vessels, will be described when con- 
sidering the circulation. 

The Relation of the Contractile Tissue to the Nerves is dif- 
ferent in voluntary and involuntary muscular fibre. In the latter there 
are no end plates, but the terminal twigs form a plexus around the fibres. 
The motor nerves of involuntary muscular fibre appear to be affected by 
atropine and its congeners in a similar way to those of voluntary muscle 
by curare. There appears also to be a certain relationship between the 
atropine and curare group. Small doses of atropine paralyze the motor 
nerves of involuntary muscle, while very large doses of curare are re- 
quired. The converse is the case with voluntary muscle. These effects 
arc usually supposed to be due to a definite paralyzing action on the 
nerves themselves. There are difficulties, however, in the way of this 
hypothesis, and a more probable one, perhaps, is that these drugs disturb 
the relations between the nerves and the muscular fibres which they ex- 
cite. On the idea of a specific action it seems hard to explain the results 
obtained by Szpilman and Luchsinger, 2 who found that atropine produces 
paralysis of the motor fibres of the vagi supplying the oesophagus, only 
in those parts of it where involuntary muscular fibre is present. Thus, 
the oesophagus of the frog and the crop of birds consist of involuntary 
muscular fibre, and atropine destroys the motor power of the vagus over 
them. 

The oesophagus of the dog and rabbit contains striated muscular fibre, 
and atropine does not paralyze the motor nerves. The oesophagus of the 
eat contains striated muscular fibres in its upper three-fourths, and non- 
Btriated in its lower fourth : atropine destroys the motor action of the 
vagus upon the upper part, but not upon the lower fourth. 3 

Propagation pf Contraction Waves. — Although involuntary 
muscular fibre consists of short cells and not of long fibres like voluntary 
muscle, yet the contraction wave may be propagated along a strip of in- 
voluntary muscular tissue in both directions from the point of irritation, 
just as in voluntary muscle or in the contractile tissue of medusae. This 
transmitted more slowly in involuntary than in voluntary muscle ; 
and it- rate in the involuntary muscle of the heart, though slower than 
in ordinary Btriated muscle, is quicker than in unstriated muscle, so that 
in this respect the heart is intermediary between the two. 4 



:1111ml Mcv. r. Hermann's Eandb, <l. phyaiol Bd. 5, Theil ii., p. 476. 
Szpilman and Luchsinger, P finger' a Archiv, Bd. :>(;, p. 459. 
Szpilman ;hh1 Luchsinger, Vfliiger 9 * ArcMv,Bd. 2(>, p. 240. 
Hermann* Eandbueh d, Phgsiologie, Bd. 1. p. 56. 



ACTION OF DRUGS ON MUSCLE. 135 

The passage of contraction waves in involuntary muscular fibre is 
affected by the same conditions as voluntary muscle, the conduction of 
the contractile wave being rendered slower by fatigue and cold, while it 
is quickened by heat. 

Cold and fatigue also render the rhythmical pulsations smaller and 
longer, while heat has an opposite effect. The passage of the contraction 
wave may also be diminished or arrested by section or pressure, just as 
in the contractile tissue of medusae, 1 so that instead of each contraction 
wave passing the block produced by the sections or compression, only 
one out of several, or none at all, may pass. The proportion passing the 
block depends upon its completeness. If the tissue forming the bridge be 
dry as well as narrow, the block becomes more complete, and may be 
again diminished by moistening. Variations in the strength of the stim- 
ulus do not affect the passage of the contraction wave over the block, so 
that it would appear that the injury caused by the section, along with 
the narrowing of the conduction path, retards the re-establishment of the 
conductive power. 

In experiments made upon the heart of a tortoise cut into a strip, it 
has been found by Gaskell that stimulation of the vag-us removes the 
block, quickens the recovery of the tissue, and causes every contraction 
wave to pass. The effect upon the muscle therefore seems to be trophic. 

A weak interrupted current applied to the muscle directly has 
the same action as stimulation of the vagus, i.e., it increases the conduct- 
ing power of the muscle. Sometimes, however, both the vagus and a 
weak interrupted current have an opposite effect, and diminish instead of 
increasing the conducting power. 

An artificial rhythm may be induced in a strip of involuntary 
muscular fibre cut from the heart of the tortoise by passing a weak in- 
terrupted current through it and then stimulating it at one end by induc- 
tion shocks, at intervals of about five seconds. After a while, if the 
induction shocks are discontinued, the muscle still continues to contract 
rhythmically at the same time. These contractions, at first weak, after- 
wards become strong, and may last for many hours. Both the conducting 
and the contractile power of the muscle is diminished by muscarine. 
When a strip of it is stimulated by induction-shocks applied to one end, 
the contraction wave passes quickly along, but muscarine appears to 
block its transmission, so that while the part of the muscle between the 
electrodes contracts at every shock, the rest of the muscle contracts only 
at every second one. A weak interrupted current then sent through the 
muscle may lower its conducting power and still further reduce the force 
of the contractions, and not only block the passage of most of the con- 
traction waves from the point of excitation, but may even prevent the 
contraction of the excited part itself. 

Atropine has an opposite action and appears to increase the conduct- 
ing power of involuntary muscle, so that when applied to a strip of the 
heart, the conducting power of which has been diminished by muscarine, 
the contractility is at once increased, and each contraction wave passes 

1 Englemann, Pfliiger's Archiv, 1875, Bd. 11. p. 465; Gaskell, Journal of Physiology, 
vol. iii., p. 367. 



136 PHARMACOLOGY AND THERAPEUTICS. 

over the whole muscular strip each time that a single point is irritated. 
Large doses, however, appear to have a depressant action on the muscle. 

Hypothetical Considerations regarding- the Action of 
Drugs on Muscle. 

The modifications which drugs produce in the functions of the animal body 
and of its parts, are so numerous and varied that we are unable fully to explain 
them on the basis of our present physiological knowledge. The results of pharm- 
acological experiment furnish us indeed with a number of additional facts regard- 
in- the functions of organs and tissues which will ultimately lead us to a more 
correct and thorough knowledge of their physiology. At present, however, we 
can <»nly explain them hypothetic-ally, and indeed, in many cases we can do little 
more than guess at the explanation. 

The advantage to be gained from hypothetical explanations is, that hypotheses 
nut only lead to further experiment, but serve as guides for experiments, by 
which, if false, they may be soon disproved, or if true, may be maintained. 

The disadvantage of hypotheses is, that they are sometimes apt to be taken 
for tacts, and being made use of as bases for further speculation, may lead 
more and more astray from the truth. While bearing in mind the danger of 
speculation, it may be useful to make some guesses at the mode of action of drugs 
upon the muscle as guides to further research. 

The most striking point about muscle is the motor function which it exercises 
l»y contracting, and the nature of its contraction must engage our attention. 
Throughout the universe we find that motion of nearly all sorts resolves itself 
into a series of vibrations, and the question arises whether the motion of muscle 
cannot be explained in the same way. When a muscle is stimulated it contracts 
and relaxes once, describing a wave-like curve upon the revolving cylinder. Fre- 
quently this first wave is followed by a second, and sometimes even by a third, 
which are usually ascribed to the simple elasticity of the muscle. Sometimes we 
• an notice that the single contraction wave appears really to consist of two or 
more partially superimposed on each other, and sometimes we may find two dis- 
tinct waves arise from one stimulation. 

When a muscle is in a state of tetanic contraction it appears to the eye to 
be perfectly quiet, yet we know that during this period of apparent rest the 
muscle is in a state of vibration, alternately tending to contract and elongate. 
These vibrations may succeed one another with a rapidity such that the muscle 
appears to the eye to he motionless, while a tracing taken upon the revolving 
cylinder shows distinct successive waves. If the vibrations are still more rapid, 
the waves may disappear, and we get the muscle describing a straight line. 
Bui even when a muscle is entirely relaxed, its parts may be in a state of vibra- 
tion quite a- continuous as in tetanic contraction. This is seen by examining 
muscular fibre under the microscope. The phenomenon which then presents 
itself was described by Porret and is often known by his name. On passing a 
constant current through a thin muscular slip a contraction is seen when the 
current is closed. During the whole time of the passage of the current, the 
muscle to tin- naked eye appears to he perfectly at rest, but under the micro- 
scope it- part- are seen t<> be in constant motion, presenting an appearance 
almost exactly similar to the waving of a field of corn on a windy day, or to the 
motion of rows of cilia, At the Bame time an actual transference of material 
takes place in the muscle: the end next the positive pole growing smaller, and 
th.- .-ml next th.- negative pole growing larger. When the current is suddenly 
i sudden contraction of the whole muscle takes place, and it then 
returns to apparent rest, but microscopic observation shows the same cilia-like 
motion a- before, hut in an opposite direction. 



ACTION OF DRUGS ON MUSCLE. 137 

This phenomenon reminds one very strongly of the crowding together of 
carriages in a railway train when it is set in motion or stopped by the locomotive 
pushing behind or stopping in front. We know that the apparent steady move- 
ment of the train is due to the backward and forward vibration of the piston in 
the cylinders of the locomotive, and the question occurs whether the contraction 
of the muscle as a whole at the moment of opening and breaking the current, is 
not due to an interference with the rhythmical vibration of its parts. The 
question also arises whether these vibrations are not to a great extent dependent 
upon the molecular weight of its constituents. This seems to a certain extent 
to be indicated by the curious relations between the effects of the alkalies, alka- 
Hne earths, and certain metals upon muscle. Thus Cash and I have found that 
potassium and calcium neutralize each other's action upon muscle, and if the 
hypothesis just expressed be correct we should expect that metals having a 
similar molecular weight to a mixture of calcium and potassium would have no 
action upon muscle. This appears to be the case. In researches made in 
Professor Schmiedeberg's laboratory, Anderson Stewart found that nickel and 
cobalt had no action upon muscle, and White found that tin also had little or 
none. On comparing then the atomic weights of potassium (39) calcium (40) 
nickel (59) cobalt (59) and tin (118) we get the following relationships : 

K 2 (78) + Ca(40) = Ni 2 (118,) or, Co 2 (118,) or, Sn(118). 

Sodium in large doses lengthens the curve and increases the contracture 
when applied to a normal muscle. It adds to the length of the long curves 
caused by calcium and strontium. Rubidium in large doses produces a long 
curve with enormous contracture almost like that of barium. One would 
naturally have expected that the rubidium and barium would have increased 
each other's effect like sodium, calcium, or strontium, but the reverse is the 
case, for the abnormal curve caused by rubidium is reduced to the normal by 
the application of barium. If barium be applied to a greater extent than is 
sufficient to antagonize rubidium, it first abolishes the prolonged rubidium 
curve, reducing it to the normal, and then again elongates it, producing its own 
characteristic curve. Calcium and strontium, which also prolong the curve, 
though to a less extent than barium, do not antagonize one another's effect — 
they rather increase it ; but calcium reduces the barium curve to the normal 
before causing its own peculiar curve. At first sight these results seem to be 
independent of any rule, but a curious relation is to be observed between the 
atomic weights of these substances. Thus we have seen that rubidium in large 
doses has the same effect as barium in causing a veratrine-like curve, but barium 
destroys the effect of rubidium before producing its own effect. On comparing 
the atomic weights of these elements we find that eight atoms of rubidium have 
nearly the same weight as five of barium, and by subtracting one from the other 
we »et almost no remainder. Thus 



r^ 



Ba 137 X 5=685. 
Rb 85-4 X 8=683-2. 

Potassium is, as we know, an important constituent of muscle, and it seems 
possible that the reduction in the barium curve which calcium causes may be 
due to their union having resulted in a substance whose molecular weight is a 
multiple of that of potassium. Thus 

Ba 137 X 2=274 — Ca 40=234. 
K 39 X 6= 234. 

The alterations which occur in voluntary muscle from the action of such 
substances as calcium or barium appear to approximate it to some extent to 



138 PHARMACOLOGY AND THERAPEUTICS. 

involuntary muscle. Voluntary muscle is chiefly characterized by sudden and 
rapid contraction and relaxation. Involuntary muscle usually contracts and 
relaxes slowly. In the slowness of its relaxation, at least, the muscle poisoned 
by barium or calcium approaches involuntary muscle. 

The power of summation which contractile tissues possess is strongly sug- 
gestive of the idea that rhythmical vibrations of gradually increasing intensity 

going on within the tissue even before any movement becomes visible. A 
pendulum very gently struck at proper intervals will gradually begin to oscillate 
through a larger and larger arc. If touched on one side while oscillating, 
the effect of the touch will depend upon the time at which the touch is applied, 
for at one period of oscillation it will tend to impede, and at another to assist 
the oscillation. Possibly some unseen rhythm in the muscle itself may be the 
cause of the curious variations in excitability observed in dying muscles and in 
muscles poisoned by lead. Two pendulums connected together will swing har- 
moniously if their rate of oscillation is the same, but if one be loaded so as to 
alter its rate of oscillation they will interfere with each other. Possibly the 
effect of poisons in paralyzing nerves may be due rather to alteration in the 
relative rhythms of the nerve and muscle than to any specific destructive power 
on the terminations of the nerve itself. 

The opposite effects which Gaskell has noticed the vagus nerve and a weak 
induced current to produce upon the conducting power of the cardiac muscle, 
sometimes increasing and sometimes diminishing it, may be due to the inter- 
ference or co-incidence of rhythm such as are discussed more fully further on 
under the head of Inhibition. 

It is impossible to say at present what the true cause of the curious rhyth- 
mical contractions of voluntary muscle is ; and it must be borne in mind that 
the eonsiderations contained in this section are purely hypothetical, and their 
only use is to indicate the direction in which we may possibly look for an 
explanation of the action of medicines on muscle. 



CHAPTER VI. 

ACTION OF DRUGS ON NERVES. 
Action of Drugs on Motor Nerves. 

In low organisms the contractile protoplasm fulfils the functions of 
both oerve and muscle, but as we ascend in the scale differentiation be- 
ro,n ' and more complete. From their original common origin, 

however, we mighl expect that the poisons which act on the muscles 
would also art on the motor nerves, and viceversd, and we should hardly 
expect any poison to act entirely on the one without affecting the other. 
This i- to a considerable extent the case, for very many substances par- 
*lyze ttam both. lint, as one would also expect from the differentiation 
they have under-one muscle and nerve are not equally affected in 
tin- higher animals. Thus we find that although most of the salts of 



ACTION OF DRUGS ON NERVES. 139 

ammonia, and the iodides, chlorides, and sulphates of the compound 
ammonias into which methyl and ethyl enter, paralyze both muscle and 
nerve, yet they paralyze the nerve before the muscle. In some cases the 
nerve is aifected so much before the muscle that at first sight it might 
appear that the nerve alone was paralyzed and the muscle left unaffected. 
More careful observation, however, shows us that most of the compound 
ammonias, and probably most of the organic alkaloids, affect muscle, 
motor nerves, and nerve centres, and if their action can be continued 
long enough, will paralyze all three. The symptoms they produce may, 
however, be entirely different, because these depend upon the order in 
which the different parts of the nervous system are affected, as has already 
been pointed out at page 48. The symptoms produced for example by 
strychnine and methyl-strychnine are utterly different, the former causing 
tetanic convulsions and the latter gradually increasing torpor, weakness 
and paralysis. Strychnine stimulates the spinal cord, and methyl- 
strychnine paralyzes the motor nerves ; yet if their action continue long 
enough it is found that both of them will ultimately cause paralysis of 
both spinal cord and motor nerves. The final result is thus the same in 
both cases, but the order in which the various parts of the nervous sys- 
tem are affected is different. 

The readiness with which a muscle responds to a stimulus depends 
both on the condition of the muscle itself and on the terminations of 
motor nerves within it. A faradaic current readily stimulates the nerve 
endings, but does not act at all readily on the muscle. The making and 
breaking of a constant current, on the other hand, has comparatively 
slight action on the nerves, but a powerful action on the muscle. One 
of the questions which arises most constantly in connection with the action 
of drugs is : — whether or not they paralyze the ends of the motor nerves 
in muscle. This question was fully worked out by Bernard and also in- 
dependently by Kolliker, in relation to curare. 

The same methods of experiment were adopted by both. They 
were twofold, and consisted, 

First, in preventing the poison from reaching the part on which it 
probably acted : 

Secondly, in applying the poison to that part alone. 

The first of these methods was employed by ligaturing the artery of 
one leg in a frog, so as to prevent the poison from reaching the muscles 
and motor nerves in that leg (Fig. 34); the second was carried out by 
the local application of the drug to the muscles and motor nerves them- 
selves (Figs. 32 and 33). 

Both methods possess advantages of their own : the advantage of the 
first being that it affords information regarding the action of the poison 
upon the other parts of the nervous system, as well as upon the motor 
nerves. It also gives the order in which the poison affects the various 
nervous structures, and shows whether the quantity of poison conveyed 
to the nerves by the circulation is sufficient to paralyze them or not. 
For some substances, directly applied to the ends of the motor nerves, 
may paralyze them, although they do not have this effect when injected 
into the blood. The reason is that the quantity applied to the nerves 
directly, may be much greater than what reaches them through the 
circulation. 



140 PHARMACOLOGY AND THERAPEUTICS. 

The effect of drugs in paralyzing motor nerves is chiefly investigated 
on frogs as the action conies out much more distinctly in them. 

Warm-blooded animals may die from paralysis of the motor nerves 
while the nerves still respond readily to faradaic stimuli applied to them, 
the faradaic stimulus being much greater than what is normally sent along 
the nerves from the nerve-centres. Thus after an animal has been killed 
by paralyzing it with curare, its muscles will still respond readily to irri- 
tation of the motor nerves. 

A fallacy to be guarded against in experiments on the results of prevent- 
ing a poison from reaching one part of the body is that caused by diffusion. 
Even when the circulation is stopped in a frog's leg by ligature of the artery, 
poison introduced into the dorsal lymph sac may pass down the limb by dif- 
fusion and affect the parts below the ligature. This may be to a great extent 
prevented by ligaturing the whole limb en masse, but carefully excluding 
the sciatic nerve from the ligature. Diffusion may also occur although 
circulation has been stopped throughout the whole body by removal of 
the heart and other viscera, and the anterior part of the spinal cord may 
be affected before the posterior when the poison is injected into the dorsal 
lymph sac. 

The advantage of the second method, viz., that of local application, is 
that it allows us to deal with only one organ at a time, and the results 
are therefore less complicated than those of the first method. In some 
respects it is better to begin with the second method and work back from 
the simpler to the more complex organs. 

Paralysis of Motor ^erve Endings. — Curare produces symptoms 
of paralysis. Paralysis may be due to the action of the drug on the 
muscles themselves, on the motor nerves which set them in action, 
or to the nerve centres which originate motor impulses. In order to 
decide this, Bernard applied electricity to the nerves and to the muscles 
of a frog poisoned by curare administered subcutaneously. He thus 




I i'.. ;2.— Shows the method of applying a drug in solution locally to the trunk of a nerve. 

found thai when the nerve was irritated no effect was produced on the 
jcles; but thai when the muscle itself was stimulated, it contracted 




I i... 58. Shows the method of applying a drug in solution locally to a muscle and theendsof 
motox oervea within it. 

lily. In order to decide whether this loss of irritability in the nerve 
was due to B change in the nerve trunk, or in the terminations within 
the muscle, Bernard employed the method of local application. He 



ACTION OF DRUGS ON NERVES. 



141 



placed a solution of curare in two watch-glasses ; in one he immersed the 
trunk of the nerve, Fig. 32, and in the other the muscle, so that the 
solution penetrating between the fibres could reach the nerve endings, Fig. 
33. He then irritated the nerve attached to both muscles, and found 
that irritation caused contraction readily enough in the case where the 
nerve trunk had been steeped in the solution of curare, but had no effect 
when the curare had been allowed to reach the nerve ends by immersion 
of the muscle in the solution. The irritability of the muscle itself to 
mechanical stimuli or to the making and breaking of a constant current 
directly applied to it remained quite unaltered, so that the muscular fibre 
had evidently not been affected by the action of the'poison. 

The other mode of testing the action of drugs upon motor nerves is 
to allow the drug to be carried to the muscles and nerve endings by the 
circulating blood in one leg of a frog, while it is prevented from reaching 
the other either by ligaturing (Fig. 34) the blood-vessels alone, or liga- 
turing the whole leg with the exception of the sciatic nerve. After some 
time has elapsed, the sciatic nerve is stimulated on each side. If the 
muscles of the poisoned limb do not contract at all or do so more feebly 




Fig. 34.— Diagram of the mode of experimenting on motor and sensory nerves in the frog. — The shaded 
part shows where the poison has been carried by the circulation. The unshaded left leg shows 
where the tissues have been protected from the poison by ligature of the artery just above the knee . 
The unbroken lines with arrows pointing to tbe spinal cord indicate the sensory nerves. Tbe 
broken line with arrows pointing outwards indicates the motor nerve to the unpoisoned leg. 

than in the unpoisoned limb, it is evident that the poison has paralyzed 
either them or the motor nerves. In order to decide whether the nerves 
or the muscles are paralyzed the muscle is next stimulated directly ; if it 
then contracts normally it is evident that the paralysis observed when 
the nerve was irritated is due to the action of the drug on the nerve 



142 



PHARMACOLOGY AND THERAPEUTICS. 



endings. If the muscle is completely paralyzed no definite conclusion can 
be drawn regarding the nerve endings, but if the muscle shows only par- 
tial paralysis, and the paralysis is greater when the nerve is stimulated 
than when the muscle is stimulated directly, we conclude that the drug 
has acted upon both the muscular substance itself and the motor nerve- 
endings within it. 

It is not so easy to prove positively that a drug has increased as that 
it has diminished the excitability of motor nerves. The fact that the 
nerves of the poisoned leg are found to be more excitable than those of 
the ligatured one in such experiments as those just described, does not 
prove it, for it must be borne in mind that the arrest of the circulation 
in the ligatured leg lessens the excitability of the muscles and the nerves 
in it. This effect of the ligature strengthens the proof that a drug has 
1 .induced paralysis when we find that in spite of the freer circulation the 
poisoned leg is less irritable than the ligatured one, but it prevents our 
concluding that the drug has increased excitability when we find that the 
poisoned leg responds more readily to stimuli than the ligatured one. 

To try whether a drug increases excitability we treat two muscles with 
saline solution, and after ascertaining that their excitability is alike we 
add the drug to be tested to the saline solution in which one muscle is 
steeped, and after some time test the excitability again. If the muscle 
in the poisoned saline solution becomes more excitable than the other, we 
conclude that the increase is due to the action of the drug. 

In order to test the effect of drugs on nerve centres we use the 
method of ligature. 

The muscles and ends of the motor nerves being thus protected in the 
ligatured leg from the action of the poison while it still remains in connec- 
tion with the nerve centres by means of the sciatic nerve, it serves as an in- 
dex to sh< )\v what is going on in the nerve centres. Thus in a frog poisoned 
by curare it is found that the ligatured leg moves on irritation of the sen- 
sory nerves, while all the poisoned parts remain perfectly still. This shows 
that the afferent nerves are still capable of conveying impressions to the 
spinal cord, and the cord itself of reflex action, although the poisoned limbs 
give no indication of the changes which are occurring in the nerve centres. 
By and by irritation of a sensory nerve or root ceases to produce any 
movement even in the ligatured limb. This effect is shown to be due to 
paralysis of the nerve centres by observing the effect of irritation of the 
nerves in the ligatured limb, for the muscles still respond readily to irri- 
tation of the nerve by a moderate stimulus. We may conclude with 
tolerable certainty that the motions have ceased in the limbs because the 
nerve centres have become paralyzed. 

Many other drugs have an action somewhat similar to that of curare 
upon the motor nerves : — 



Ammonium cyanide. 1 
iodide. 

Ethyl ammonium chloride. 1 

Ainvl ammonium chloride." 
iodide. 1 



Di-methyl ammonium chloride. 1 
" " iodide. 1 

" k ' sulphate. 1 

Di-ethyl k ' chloride. 1 

" * " iodide. 1 



: BraxitOD and Cash, Roy. Soc. Proc. 



ACTION OF DRUGS ON NERVES. 



143 



Amyl ammonium sulphate. 1 


Di-ethyl ammonium sulphate, 


Tri-methyl " iodide. 2 


Curarine. 6 


Tri-ethyl " chloride. 


Curare. 7 


" " " iodide. 


Ditaine. 8 


" " sulphate. 


Methyl-delphinine. 3 


Tetra-m ethyl " iodide. 


Echium. 3 


Tetra-ethyl " " 


Erythrina coralledendron. 9 


Anchusa. 3 


Guachamacha 10 


Methyl aniline. 4 


Lobeline. 


Ethyl " 4 


Methyl morphine. 2 


Amyl " 4 


Methyl nicotine. 2 


Methyl atropine. 2 


Ethyl " 3 


Methyl brucine. 2 


Ptomaines. 11 


Ethyl " 3 


Methyl quinine. 3 


Camphor. 


" quinidine. 3 


Methyl cinchonine. 3 


" piperidine. 


Amyl " 3 


Saponine. 


Chloroxethylene. 


Sparteine. 


Methyl codeine. 2 


Methyl strychnine. 2 12 


Collidine. 


Ethyl strychnine. 2 


Conine. 


Methyl thebaine. 2 


Di-methyl conine. 2 


Methyl veratrine. 3 


Cotarnine. 3 


Amyl " 3 


Cynaglossine. 5 





Although the substances mentioned in the above list have all the 
power of paralyzing motor nerves, they do not possess the same power 
as curara. In the case of the salts of ammonium and the compound 
ammonias, the curara-like action is accompanied by a paralyzing effect 
upon the muscular substance and on the nerve centres. When salts of 
these substances are employed, their effect is somewhat modified by their 
acid radical, although this is not the case to the same extent in the salts 
of the compound ammonias and in the salts of ammonia itself. Thus, 
the iodide of ammonium has a much stronger paralyzing action on the 
nerves than bromide, chloride, sulphate, or phosphate, and this is observed 
also, though to a less extent, in the salts of the compound ammonias. 

Irritation of Motor Nerve- endings by Drugs. — The peri- 
pheral terminations of motor nerves in muscle appear to be irritated by 



1 Brunton and Cash, Boy. Son. Proc. 

9 Crum-Brown and Fraser, Trans, of Boy. Soc. of Edinburgh. 

3 Buchheim and Loos, Eekhard's Beitrdge, Bd. v. 

4 Jolyet and Cahours, Compt. Bend., lxvi., p. 1181. 

5 Diedulin, Med. Centralbt., 1868, p. 211. 

6 Preyer, Gottingen Ztschr. f. Chemie, 1, p. 381. 

7 Bernard and Kolliker. 

8 Harnack, Arch. f. Exp. Path. u. Pharm., vii., p. 126. 

9 Harnack, Buchheim's Pharmacologic, 3d edition, p. 615. 

10 Sachs, Archiv, f. Physiol, 1877, p. 91 ; Schiffer, Deutsch. Med. Wochenschr., 1882, 
No. 28. 

11 Several authors quoted by Guareschi and Mosso, Les Ptomaines, 1883. 

12 Schroff, Wochenblait d. Ztschr d. Aerzte zu Wien., No. 14, 1866. 



144 PHARMACOLOGY AND THERAPEUTICS. 

certain poisons, so that the excised muscle exhibits fibrillary twitchings. 
This micht be due to irritation of the muscular structure itself, but as 
they are gradually abolished by curare they are supposed to depend 
upon irritation of the terminations of motor nerves. The poisons which 
produce this effect are : aconitine, camphor, guanadine, nicotine, pilo- 
carpine, pyridine. Physostigmine produces it most markedly in warm- 
blooded animals, but does not seem to cause it in frogs. 

Action of Drugs on tlie Trunks of Motor Serves. — Nerve 
trunks are as a rule very much less affected by poison than the end 
plates ; but they may, nevertheless, be also acted upon by strong solu- 
tions of poison. It appears necessary to apply the poison locally to 
them, and they are probably little if at all affected by poisons introduced 
into the system generally. The action of poisons is tested by placing a 
small piece of gutta-percha tissue under the nerve trunk, usually the 
sciatic of the frog, and applying the poison directly to it, or dipping the 
nerve into a weak solution of common salt, or of sodium phosphate, to 
which the poison has been added, and comparing the poisoned nerve 
with one dipped into a similar saline solution without the poison. 

There are two methods of comparison. The first consists in using 
the contraction of the corresponding muscle as an index of the func- 
tional power of the nerve. The second, in ascertaining the effect of 
the poison on the normal electrical current in the nerve. 

The motor fibres of a nerve appear to have their excitability abol- 
ished more readily than that of sensory nerves by changes in the body 
generally, and sometimes also by the local application of drugs to them. 
Thus in wounded nerves the motor function may be destroyed, while the 
sensory function is little altered, and where both sensibility and motion 
have been destroyed by a bruise of the nerve trunk, the sensibility may 
reappear, while the motor power does not. In rheumatic neuralgia there 
is do1 unfrcipiently motor paralysis with exaggerated sensibility. When 

lution of physostigma is applied locally to the nerve trunk for a 
while, and the nerve is then irritated beyond the point of application, it 
is found that it will produce reflex movements of the body after it has 
ceased to do so in the limb supplied by the nerve, which shows that the 
sensory fibres can still conduct impressions, though the motor fibres can- 
not. Longer application of the poison will destroy the sensory fibres 
also. When a paste of theine is applied to the sciatic nerve, or the 
nerve is -lipped in a solution of opium, similar results are observed. 

By dipping nerves in a solution of poison Mommsen finds that 
atropine diminishes the irritability of the nerves, affecting first the intra- 
muscnlar endings, and afterwards the trunks. Alcohol, ether, and 
chloroform, first increase and then diminish the irritability. 

Action of Drugs on Sensory Nerves. 

The general action of a drug on sensory nerves is much more 
difficult to ascertain with precision than its effect upon motor nerves, 
because the evidences of sensation we have in the lower animals are 
cries, and movements either of the limbs or involuntary muscles, such 
u the iris, arteries or bladder, which ensue on irritation of sensory 
ner . 



ACTION OF DRUGS ON NERVES. 145 

In the production of these movements or cries, many structures are 
concerned, viz., sensory nerves, nerve centres, spinal or cerebral motor 
nerves, and muscles. It is comparatively easy to ascertain the local 
action of the drug upon sensory nerves, for in this case these other 
structures are not affected. By applying the substance to one part of 
the body, either by painting it upon, or injecting it under, the skin, and 
then comparing the effect of stimulation produced by pinching or by the 
application of heat or electricity upon that and other parts of the surface, 
we can see whether or not the sensibility of the sensory nerves has been 
affected by the drug. 

But when the drug is absorbed into the circulation, it may affect all 
the other structures already mentioned, as well as the sensory nerves, 
and thus it may be impossible to decide with certainty whether these 
nerves are affected or not. But even here definite results are sometimes 
obtainable, as in the case of curare. The method of experimenting is to 
ligature the sciatic artery of a frog and arrest the circulation in one leg. 
The animal is then poisoned with curare, or any drug the action of which 
is to be ascertained. The poison is carried by the circulation to all other 
parts of the body excepting the ligatured leg. 

In the case of curare the motor nerves are paralyzed by the drug, 
and it would be impossible to ascertain whether irritation of the sensory 
nerve produced any effect at all, were it not that the ligatured limb, 
retaining its irritability, serves as an index to the condition of the nerve 
centres. At first it is found that pinching the poisoned foot will cause 
movements in the non-poisoned leg. This shows that the sensory nerves 
retain their irritability and transmit the stimulation up to the spinal 
cord, whence it is reflected down the motor nerves to the non-poisoned 
foot. 

As the poisoning becomes deeper, however, pinching the poisoned 
leg produces much less effect. 

This might be due to paralysis of the spinal cord, but it is shown 
that this is not the case by pinching the ligatured leg just above and 
below the ligature. 

It is found that a pinch just below the ligature causes marked reac- 
tion, while a pinch just above has little or no effect. 

In this experiment all the structures concerned in the movement 
have been alike subjected to the action of curare with the exception 
of the ends of the sensory nerves below the ligature. It is thus evi- 
dent that the diminished reaction from pinching above the ligature is 
due to paralysis of the ends of the sensory nerve, in the part of the 
body to which the poison has had access, and which is shaded dark 
in the engraving (Fig. 34). 

In the experiment just mentioned, the first of the two methods already 
described in the reference to motor nerves is employed, and the action of 
the drug on the ends of the sensory nerves is ascertained by preventing 
the poison from reaching them ; but the second method may also be em- 
ployed and the action ascertained by applying the poison to the ends of 
the sensory nerves, while the nerve-trunks and nerve-centres are protect- 
ed from its action. Thus, in the experiments of Liegeois and Hottot 
upon the action of aconitine on the sensory nerves, they ligatured the 
10 



146 PHARMACOLOGY AXD THERAPEUTICS. 

vein and injected the poison into the artery of a frog's leg; the poison 
was thus carried to the ends of the sensory nerves in the skin, while it 
was prevented from reaching the nerve centres. In this way they found 
that irritation of the poisoned skin ceased to produce any reflex action, 
while stimulation of the trunk of the nerve distributed to that leg still 
caused well-marked reflex action. Normally the terminations of a sensory 
nerve in the skin are much more sensitive than the trunk of the nerve; 
and this experiment therefore proves that aconitine paralyzes the ends of 
the sensory nerves. 

The local action of drugs on the sensory nerves in man is ascer- 
tained by producing, when applied locally, either diminution in pain 
which may be present at the time, or insensibility, which is usually ascer- 
tained by the ivsthesiometer. This is simply a pair of compasses with 
blunt points and a scale by which the distance of the points from one 
another can be read off. 

When the sensation is acute, the points are distinctly felt as two, even 
when they are but slightly separated from one another ; but when the 
sensation is blunt, they are felt as one, when they are at a considerable 
distance apart. 

In frogs it is ascertained by dipping one leg for some time in the so- 
lution to be tested, and then comparing the effect of irritating correspond- 
ing points in the two feet or legs by pinching, or the application of acids, 
or a faradaic current. Where the drug is very powerful, and a sufficient 
quantity, its action on the nerve centres might complicate the result; if 
a sufficient quantity should be absorbed into the blood, the circulation 
may be entirely arrested by excision or ligature of the heart. In this 
way it has been ascertained that hydrocyanic acid has a powerful local 
action in paralyzing sensory nerves. 

Local Sedatives and Local Anaesthetics. — Local sedatives are 
substances which diminish, and local anaesthetics are substances which 
destroy, the sensibility of the skin for the time being. 

Local Sedatives. Local Anaesthetics. 

Aconite. Extreme cold. 

Atropine. Ice. 

Belladonna. Ether spray. 

Carbolic acid. Erythroxylon. 

Chloroform. Cocaine. 

Chloral. Carbolic acid. 
Morphine. 
< tpinm. 
Veratrine. 

Action. — Their effect in some degree is due to a paralyzing action 
upon th<- terminal branches of the cutaneous nerves. It is probably, to 
Borne extent, also due to an effed upon the vessels and tissues analogous 
to that which is produced by rubbing or scratching, which, as every one 
Jhk>! temporary relief to itching. Sweating also relieves the itch- 

ing, which ia sometimes felt just before it begins. 

[ Be8( — i, 1M . ;i ] aedativea arc employed to relieve itching and to lessen 
pain, whether it be due to neuralgia or inflammation. Local anesthetics 



ACTION OF DRUGS ON THE SPINAL CORD. 147 

are employed temporarily to abolish the sensibility of the skin, and allow 
slight incisions or operations to be made painlessly. 

Stimulating- Action of Drugs on the Peripheral Ends of 
Sensory Serves. — The peripheral terminations of sensory nerves ap- 
pear to become more sensitive when the supply of blood to the part is 
increased. This is markedly seen, not only in inflammation, where the 
part becomes exceedingly tender, but in cases where turgescence of the 
vessels occurs under physiological conditions. Besides the class of irri- 
tants which act on the peripheral terminations of sensory nerves so as to 
cause pain when locally applied, there are several drugs which appear to 
have a special irritant action on the ends of sensory nerves when intro- 
duced into the circulation : these are aconite and aconitine, which give 
rise to a peculiar tingling and numbness in the tongue, lips, cheeks, 
and indeed in all parts supplied by the fifth nerve. Yeratrine also 
causes peculiar sensations in the sensory nerves when taken internally, 
but these are felt more in the fingers and toes, and in the joints, than 
in the tongue. 1 



CHAPTER VII. 
ACTION OF DRUGS ON THE SPINAL CORD. 

In the spinal cord we have to distinguish three functions: that of 
conduction, that of reflex action, and that of origination of nerve 
force, as in the sweat centres, &c, contained in it. 

The spinal cord transmits sensory or afferent impulses upwards 
to the medulla and brain; and motor impulses downwards to the 
muscles as well as other efferent impulses to the glands. It transmits 
reflex impulses across, either from behind forwards, or laterally from 
one-half of the cord to the other. Transmission from behind forwards 
occurs when the impulse passes from the sensory to the motor columns on 
the same side, as in the case of reaction of a sensory stimulus on the same 
side of the body. It occurs laterally when the sensory stimulus produces 
motion, not on the same side, but on the opposite side of the body. 

Action on the Conducting Power of the Cord. — Its con- 
ducting power for motor impulses is assumed to be impaired when it 
is noticed that any drug causes partial paralysis of the hinder extremi- 
ties of an animal before the anterior extremities. 

It is usually tested by irritating the spinal cord at its upper end, either 
mechanically with the point of a needle, or by a galvanic or faradaic current 
passed through electrodes inserted into it close together, and observing whether 
irritation of the cord itself in this way causes contraction in the muscles of the 
legs. 

1 Von Schroff, Pharmacologic, 4th Ed., p. 584. 



148 PHARMACOLOGY AXD THERAPEUTICS. 

When no contraction is produced by irritation of the cord itself, while 
direct irritation of the motor nerves can still produce vigorous contrac- 
tion, it is evident that the cause of the paralysis must be that the spinal 
cord has lost its power to conduct motor impulses. 

These experiments may be made in a frog, the cerebrum of which has been 
previously destroyed ; and they may be confirmed in warm-blooded animals where 
sensibility has been destroyed by a section of the cord, just below the medulla, 
and respiration is kept up artificially. The spinal cord is then exposed, and the 
anterior columns are irritated in the ways already mentioned. 

The power of the cord to conduct sensory impressions is ascer- 
tained by exposing it under anaesthetics and allowing their influence 
to pass so far off that the animal is capable of giving evidence of sensa- 
tion. The posterior roots are then irritated before and after the injec- 
tion of the poison into the circulation. 

When it is found that after the poison is injected, the irritation of 
the posterior roots which previously caused evidence of sensation, no 
longer produces any effect, while irritation of the anterior columns still 
produces motion : the conclusion appears to be just, that the poison has 
paralyzed the conducting power of the sensory columns of the cord. 

This action appears to be possessed by caffeine, for Bennett found 
that while irritation of the posterior roots of the cord caused violent 
struggles and loud cries in a rabbit before the injection of caffeine into 
the circulation, similar irritation, after the injection, caused only a slight 
quiver. That this effect was not due to motor paralysis was shown by 
the fact that irritation of the anterior columns caused violent muscular 
contractions after the injection as well as before it. 1 

The action of drugs on the power of the spinal cord to conduct 
reflex stimuli both transversely and longitudinally has been carefully 
investigated by Wundt. He first ascertains the time which elapses 
between the application of a stimulus to a motor nerve and the contrac- 
tion of a muscle, the nerve used being the sciatic, and the muscle the 
ocnemius of a frog. This time, which includes that requisite for 
the stimulus to travel down the motor nerve and to set the muscle in 
action, lie terms the direct latency. He next stimulates a sensory root 
of the Bpinal cord at the same level and on the same side as the motor 
nerve, taking care that the stimulus does not act on the motor nerve 
directly but only reflexly through the cord. The time between the 
application of the stimulus and the commencement of contraction he 
terms the total latency. By deducting the direct latency from the total 
latency he ascertains the time required for the stimulus to pass through 
the grey matter of the cord from the posterior to the anterior horn of the 
same side. This he calls the reflex time. 

Th<- time required for transverse conduction is ascertained by 
applying the stimulus to a posterior root on the other side and compar- 
ing the latency with that of stimulation to a posterior root on the same 



Bughee-Bennett, Edin. Med. Journ., Oct.. 1-7:;. 



ACTION OF DRUGS ON THE SPINAL CORD. 149 

The time required for longitudinal conduction is ascertained by 
applying a stimulus to the brachial nerve, so that it has to travel down 
the greater part of the length of the spinal cord before it can excite the 
sciatic nerve. By comparing the latent period of excitation in the 
brachial nerve with that of the sciatic on the same side 1 the length of 
time required for longitudinal transmission of stimuli in the cord is ascer- 
tained. The mode of ascertaining the time of ordinary reflex and trans- 
verse transmission in the cord is shown diagrammatically in Fig. 35. 



1STER10R 
ROOT o 



RVE, 



fS^yk SECTION OF 

) r\ M SPINAL 

{SJAJJ CORD . 



MUSCLE 



f=^ 



' — OLEI/ER 

CYLINDER 



Fig. 35 —Diagram to show the method of investigating reflex and transverse conduction in the spinal 
cord. The motor nerve is first irritated at 1. As the cylinder revolves at a known rate ; and a 
mark is made upon it by an electro-magnet at the instant the nerve is irritated, the distance 
between this mark and the commencement of the muscle curve indicates the time required for 
the irritation to travel down the motor nerve to the muscle and set it in action. The irritation 
is next applied to the posterior root on the same side (2). The distance between the commence- 
ment of contraction in this case and in that where the motor nerve was irritated gives the time 
required for simple reflex transmission of the stimulus from the posterior to the anterior horn of 
the cord. The stimulus is then applied to the posterior root on the opposite side at 3, and the 
distance between tbe commencement of the consequent contraction and that of the curve obtained 
by irritating at 2 gives the time required for transmission across the cord. 

The differences in the latent period and in the form of the muscle 
curve obtained by irritation of the motor nerve, and by simple trans- 
verse, and longitudinal reflex stimulation, are shown diagrammatically 




Fig. 36.— Diagram to show the difference between the length of the latent period and form of the 
curve in contraction induced, b, by direct irritation of the motor nerve; c, by simple reflex from 
irritation of the cord on the same side ; and d, by cross reflex from irritation of the cord on the 
opposite side to that from which the motor nerve proceeds, as shown in Fig. 35. e shows com- 
bined transverse and longitudinal reflex ; a indicates the moment at which the stimulus^was 
applied in each case.;; 

in Fig. 36. Wundt found that when a motor nerve was irritated at the 
point distant from the muscle the resulting contraction had not only a 



1 For convenience' sake both the sciatic and the brachial nerves are taken in this 
experiment on the opposite side from the muscle, so that the time of longitudinal 
conduction is ascertained by deducting the transverse from the combined transverse 
and longitudinal conduction. 



150 PHARMACOLOGY AXD THERAPEUTICS. 

longer latent period but was less in height and longer in duration than 
when the nerve was irritated close to the muscle. From a comparison 
of the curves it will be seen that a small portion of grey matter 
has a similar effect upon the stimulus which passes through it that a 
great length of nerve fibre would have. In all reflex actions, 
therefore, in the normal animal, the contraction of the muscle has a 
longer latent period, less height, and longer duration than that produced 
by direct irritation of the motor nerve. The increase in the latent 
period, diminution in height, and longer duration are greater in the case 
of transverse than of simple reflex, and greater still in the case of 
combined transverse and longitudinal reflex. 

In the normal frog a stronger stimulus is necessary to produce reflex 
contraction than would be sufficient if it were applied directly to the 
motor nerve, and strong and weak stimuli will produce strong and weak 
muscular contractions. The spinal cord has a power of summation 
similar to that already referred to in the case of contractile tissue of 
medusa}, so that a stimulus which would be powerless to produce a reflex 
contraction if applied once to a posterior root or to a sensory nerve will 
be effectual if repeated several times in close succession. Strychnine has 
an effect on the conducting power of the spinal cord which we should 
hardly expect, and so have other convulsant poisons. It increases the 
excitability so much that slighter stimuli than before will produce reflex 
action, and it destroys to a considerable extent the power of summation, 
so that instead of each stimulus producing a contraction in proportion to 
its strength, all have the same effect — a weak one which is just strong 
enough to produce an effect at all causing as great a contraction as the 
most powerful. The time required for the transmission of stimuli 
through the cord is enormously increased, so that the latent period of 
ordinary reflex, and still more of transverse and longitudinal reflexes, is 
greatly increased, sometimes, indeed, to as much as ten times the normal. 
The retardation of transverse conduction is not absolutely greater than 
of longitudinal conduction, but, as the distance through which the stim- 
ulus has to pass in the former case is much greater than in the latter, it 
follows that strychnia increases the resistance more transversely than 
longitudinally. Morphine in small doses has no very marked action 
upon the cord, but larger doses have an action almost exactly like that 
of strychnine, causing increased reflex irritability, tetanic contractions, 
and prolonged latency. Veratrine has a similar action. Nicotine and 
con'ine in Bmall doses have a similar action to strychnine, but this is 
quickly masked by the rapid appearance of paralysis. When large doses 
are used, paralysis occurs almost immediately, and is usually accom- 
panied by fibrillary twitohings. Atropine has at first an action similar 
to strychnine in causing increased excitability, prolonged latency, and 
tetanic contraction. It differs from strychnine in causing more rapid 
diminution in the irritability of the grey substance of the spinal cord 
and in diminishing the conducting power of peripheral nerves. In con- 
sequence of this, irritation of the sciatic nerve in a frog poisoned by 
atropine causes two contractions, one direct and one reflex, separated 
from each ether by a distinct interval, whereas, in a frog poisoned by 
Imme. these two contractions begin almost at the same moment and 
appear Buperimposed upon each other. 



ACTION OF DRUGS ON THE SPINAL CORD. 151 

Ordinary impressions of touch, temperature, and muscular action are 
transmitted through the posterior roots of the spinal cord to the ganglia 
of the posterior horn of the grey substance, and thence upwards by the 
fibres of the lateral columns. Painful sensations, however, appear to be 
transmitted upwards through the grey substance of the cord. The af- 
ferent nerves, which transmit impressions from one part of the cord to 
another so as to produce co-ordinated reflex movement, are contained in 
the posterior columns of the cord. 

It is evident that any injury or poison which chiefly affects the grey 
matter so as to diminish its conducting power may abolish pain while 
reflex action still persists. This condition may be produced by division 
of the grey matter of the cord, and it occurs also at a certain stage of 
the action of anaesthetics, such as chloroform and ether. 




Fig. 37.— Diagram to show the effect of chloroform, chloral, and other anaesthetics on conduction of 
painful impressions in the spinal cord. 

Action of Drugs on the Reflex Action of the Cord. — 

The action of drugs upon the reflex action of the spinal cord is usually 
estimated by the time which elapses between the application of a stimulus 
and the occurrence of reflex action, before and after the administration 
of a drug. Longer time indicates diminished, and shorter time increased, 
excitability of the cord. 

Method of Experimenting-. — The method usually employed is called 
Tiirck's method. The cerebral lobes in a frog are destroyed, and after some 
time has elapsed so as to allow it to recover from the shock, it is suspended either 
by the head or fore-legs, so that the hind-legs hang down. A very dilute solu- 
tion of sulphuric acid, the acid taste of which can be little more than perceived 
by the tongue, is put in a small beaker and raised until one foot of the frog is 
completely immersed in it. The time is then counted by means of a metronome, 
between the immersion of the foot in the acid solution, and the time when the 
leg is drawn up out of it. As soon as the foot is drawn up, the acid is carefully 
washed off with some fresh water in order to prevent any injury to the skin, 
and after a minute or two, the experiment may be repeated. When the time 
seems constant the drug is injected into the lymph sac, and the experiment is 
repeated again. The greater or less time which is required for the withdrawal 
of the foot from the acid after the injection of the poison, as compared with the 
time required before, shows the extent to which the reflex action of the spinal 
cord has been diminished or increased by the poison. 

Direct, Indirect, and Inhibitory Paralysis of the Spinal 
Cord by Drugs. — When it is found that the reflex action of the cord 
is greatly diminished or apparently entirely abolished, it must not be at 



152 PHARMACOLOGY AND THERAPEUTICS. 

once concluded that this is necessarily due to the direct paralyzing 
action of the drug itself upon the nervous substance of the cord. This 
may be the case, and is so when methyl-conine is employed, but it may 
be clue to the indirect action of the drug upon the heart, weakening 
the circulation, and lessening the function of the cord by interfering 
with its blood supply. 

In order to ascertain whether this is the case or not, it is usual to take two 
frogs as nearly alike as possible, to destroy the brain in each, and after waiting until 
they have recovered from the immediate shock of the operation, to inject into 
one the drug to be tested, and, at the moment when it stops the beating of the 
heart, to tie a ligature around the heart of the other. The persistence of reflex 
action is then tested in the usual manner, and if it is found that it disappears much 
sooner in the poisoned frog than in the other one where the heart has been 
ligatured, it is concluded the drug has paralyzed the substance of the cord 
itself 

Indirect Paralysis. — The spinal cord is very rapidly paralyzed 
in mammals if the blood supply to it is stopped. This is readily shown 
by Stenson's experiment of gently compressing the abdominal aorta in a 
rabbit with the thumb or finger, so as to arrest the circulation for four or 
five minutes. On releasing the animal its hinder extremities are found 
to be paralyzed, and this paralysis, though it may be partly due to inter- 
ference with the blood supply of the muscles and nerves of the lower ex- 
tremities themselves, is chiefly due to the arrest of circulation in the 
spinal cord. The spinal cord in frogs is less rapidly affected, but if the 
circulation be arrested for half an hour or so symptoms of paralysis 
usually begin to appear, the time varying, however, with the temperature 
and other conditions. Indirect paralysis is produced by aconitine, di- 
gitalin, and large doses of quinine, which arrest the circulation. It is 
frequently difficult to decide how far paralysis is due to the action of a 
drug on the circulation and how far to its direct action on the spinal cord 
itself. 

Direct Paralysis. — Paralysis of reflex movement is produced by 
a number of substances, some of which produce little or no previous ex- 
citement ; others, however, markedly increase the excitability of the 
spinal cord first, and are thus classed as spinal stimulants. 

Spinal Depressants. — The following drugs belong to this class: — 

DepreM without marked previous Excite first and afterwards paralyze. 

excitement. 

Antimony. Ammonia. 

Emetine. Apomorphine. 

Ergot. Alcohol. 

Bydrocyanic acid. Arsenic. 

Methylconine. Camphor. 

Saponine. Morphine. 

Physostigmine. Carbolic acid. 

Turpentine. Chloral. 

Zinc. Nicotine. 

Silver. Potassium. 

Sodium. Veratrine. 

Lithium. Mercury. 
uin. 



ACTION OF DRUGS ON THE SPINAL CORD. 153 

Uses of Spinal Depressants. — Such substances as morphine, 
chloral, &c, which diminish the conducting power of the grey matter of 
the cord for painful impressions, are useful as anodynes, though their 
action in lessening pain is probably often due to their effect on the brain 
as well as on the spinal cord. Spinal depressants which lessen reflex 
action are employed in diseases where there seems to be increased exci- 
tability of various parts of the cord, as evidenced by spasm either tonic 
or clonic. They are therefore employed in tetanus, trismus neonatorum, 
chorea, writer's cramp, and paralysis agitans. The pathology of many 
nervous diseases is imperfectly known, and as the action of spinal depress- 
ants is frequently a complex one of combined stimulation and depression, 
some of the drugs included in this class are used in paraplegia due to 
myelitis, locomotor ataxy, and general paralysis. 

They are also used as antagonists in cases of poisoning by spinal 
stimulants like strychnine. 

Inhibitory Paralysis. — The higher parts of the nervous system 
have the power of lessening the action of the lower, and in the frog this 
power seems to be especially marked in the optic lobes. Irritation of 
these either mechanically by a needle, chemically by a grain of salt laid 
upon them, or electrically, will lessen or entirely abolish the reflex ac- 
tion in the cord, but this again returns when the irritation is removed, or 
when its influence is destroyed by cutting the cord across, below the 
point of irritation. This fact was discovered by Setschenow, and thus 
parts of the optic lobes concerned in this inhibitory action are known as 
Setschenow's centres. 

An inhibitory action appears to be exerted by the cranial centres in 
higher animals also, for McKendrick observed that on decapitating a 
pigeon the body lies comparatively still for a second or two, and then 
violent convulsions set in. If the body be held firmly during these con- 
vulsions, and a moderately strong faradaic current be applied to the upper 
part of the spinal cord, the convulsions may be altogether arrested while 
it continues, again commencing when it stops. In this experiment the 
application of the current to the cut end of the cord is regarded as supply- 
ing a stimulus in place of that which would normally pass downwards 
from the brain. 

Quinine causes great depression of reflex excitability, and this was 
stated by Chaperon to be due to the action of the drug on Setschenow's 
centres. 




Fig. 38.— Nervous system of a frog, showing the cerebral and optic lobes, the medulla oblongata, and 
the spinal cord with nerve-roots. The brain is shown on a larger scale at p. 170. 

Almost immediately after injection of quinine into the dorsal lymph 
sac, the reflex excitability of the frog becomes very greatly reduced or 



154 PHARMACOLOGY AND THERAPEUTICS. 

almost entirely abolished, but if the spinal cord be now cut across at its 
upper part, just below the medulla oblongata, the reflex excitability be- 
comes as great, or even greater, than the normal. 

This loss of excitability has been ascribed by Binz to the action of 
quinine on the heart, causing weakening of the circulation, and thus in- 
directly producing paralysis of the cord. This kind of paralysis does 
occur with large doses and after considerable time, but it is quite differ- 
ent from the inhibitory paralysis described by Chaperon, which comes 
on almost immediately after the injection of the drug into the lymph sac, 
and disappears immediately on section of the cord below the medulla. 

I have repeated Chaperon's experiments, and can fully confirm their 
accuracy. In doing so, however, it struck me that the result was most 
marked when a solution of quinine was concentrated and somewhat 
strongly acid. It therefore appeared probable that the inhibition was 
not due to the direct action of the quinine upon Setschenow's centres 
after it had been carried to them by the blood, but only to its reflex action 
upon them. It irritates locally the sensory nerves of the lymph sac into 
which it is injected, and this stimulus being transmitted to the optic lobes 
excites them so that they produce inhibition of that reflex action which 
would usually occur in the cord when the foot is irritated by acid. On 
testing this hypothesis by injecting acid alone into the lymph sac, Mr. 
Pardington and I found that it also caused reflex inhibition like that pro- 
duced by quinine. "We may therefore conclude that there is nothing 
special in the action of quinine upon the inhibitory centres ; it merely 
acts like other irritants on sensory nerves. 1 Probably digitalis and 
sanguinaria also act in a similar way. 

NATURE OF INHIBITION. 

Inhibition and the action of drugs on inhibitory centres play a very 
important part indeed in pharmacology, and on the present hypothesis 
they are very puzzling. 

By inhibition we mean the power of restraining action which some 
part- of the nervous centres possess. At present it is usually supposed 
that certain parts of the nerve centres, instead of having a sensory or. 
motor function, have an inhibitory one peculiar to themselves. As it is 
found, however, that inhibitory powers are not confined to Setschenow's 
centres, already mentioned, page 153, but that almost any part of the 
nervous Bystem may have an inhibitory action on other parts, it becomes 
almost necessary to abandon the old hypothesis. It is found, for example, 
thai not only is reflex action more active in the frog when the optic lobes 
are removed, but that when the spinal cord is taken away in successive 
slices from above downwards, the reflex action in the part below goes on 
increasing. On the old hypothesis we are almost obliged to assume that 
each nerve cell has two others connected with it, one of which has the 
function of increasing or stimulating, and the other of inhibiting its 
action. bfosl of the phenomena which we find can be explained in a 
much simpler way by supposing that nervous stimuli consist of vibra- 
tion in the nerve fibres or nerve cells, just as sound consists of vibrations. 



St. Bartholomew's Bxpttal Reports, 1876, p. 155. 



ACTION OF DRUGS ON THE SPINAL CORD. 



155 



Interference. — In the case of both sound and light we find that if 
two waves should fall upon one another so that their crests . coincide, the 
intensity of the sound or light is increased (Fig. 39), while if they fall 





Fig. 39. — Diagram to show increased intensity of 
vibration by coincidence of waves. 



Fig. 40.- 



-Diagram to show abolition of vibration 
by interference of waves. 



on each other so that the crest of one wave fills up the trough of the 
other, they interfere so as to destroy each other's effect (Fig. 40) ; and 
thus two sounds produce silence, or two waves of light, darkness. This 
is shown in the case of sound by a tube (Fig. 41), which divides into 



© — 



v- 



p- 



Fig. 41. — Diagram of apparatus for demonstrating the interference of waves of sound, a and b, 
branches of a tube ; c, sliding piece by which the branch b can be lengthened or shortened at will; 
d, tuning-fork ; e, the ear. 

two branches, and these again re-unite. The length of one branch may 
be altered at will so that the sound travelling through one branch has 
further to go than the other. It may thus be retarded so far as to throw 
it half a wave-length behind the other, and silence is produced. If 




Fig. 42. — Diagram showing the beats or alternate increase and diminution of the wave-heights by the 
interaction of two systems of waves of different wave-lengths. At a two systems, having a rela- 
tion to each other of 3 to 1, are indicated separately by dotted and complete lines. At b the result- 
ant of the interaction of the two systems is shown. With such a relation as that shown in the 
diagram, and with those of a vibrating rod generally, such as n, 3n, 5n, &c, the interference of 
the systems is not complete, and silence cannot be produced by the interference of sounds. (From 
Ganot's Physics.) 

lengthened still further, so as to throw the one sound a whole wave- 
length behind the other, the crests again coincide, and the sound is again 



156 PHARMACOLOGY AND THERAPEUTICS. 

heard. Increasing the length still further, so that the one sound is 
thrown a wave-length and a half behind the other, they again interfere, 
and silence is again a second time produced. This may be repeated ad 
infinitum, silence occurring whenever the one sound falls behind the other, 
by an odd number of half wave-lengths. 

In the case just mentioned, the waves are of the same length, but if 
they are of different lengths, instead of constantly reinforcing and inter- 
fering with others, they may sometimes strengthen and sometimes weaken 
each other. The result is more or less rhythmical increase and diminu- 
tion of action, or, as it is termed, "beats." This is shown in the accom- 
panying diagram (Fig. 42). 

Instances of rhythm occur in the body, which strongly remind us of 
this condition, for example, the different rhythms of the heart under 
various conditions. 

Interference in Xervous Structures. — Supposing nervous 
stimuli to consist of vibrations like those of light or sound, the action 
which any nerve cell would have upon the others connected with it 
would be stimulant or inhibitory according to its position in relation to 
them. If its relation be such that a stimulus passing from it to another 
cell will there meet with a stimulus from another quarter in such a way 
that the waves of which they consist coincide, the nervous action will be 
doubled : but if they interfere, the nervous action will be abolished. If 
they meet so as neither completely to coincide nor to interfere, the nervous 
action will be somewhat increased, or somewhat diminished, according to 
the degree of coincidence or interference between the crests of the waves. 

Thus if the relations of the nerve cells s, s r and M, u ; in the diagram 
(Fig. 43) are such that when a stimulus passes from a sensory nerve s 




i" Illustrate Inhibition in the spinal cord, s, s', and s" are sensory nerves, m, iri, 
and B" are sensory eell^, m, m', and m" are motor cells in the spinal 
-'■n-orv and KB R motor cell in the brain. 

motor aerve //>. «. 11( . part of it travels along the path s, S, M, m, and 

ther along \i. w, or s, s, s\ m', m, m, at such a rate that the 

Its of the wav.s coincide at the motor cell M, they will increase each 

other's effect, [f thej interfere, the effect of both will be diminished or 

. inhibition will occnr. 

Effect of Utered Elate of Transmission.— But it is evident 

that the coincidence or interference of nervous stimuli travelling along 



ACTION OF DRUGS ON THE SPINAL COED. 157 

definite nerve paths, will vary according to the rate at which they travel, 
so that when stimuli, which ordinarily interfere with one another, are 
made to travel more slowly, one may be thrown a whole wave-length, 
instead of half a wave-length, behind the other : and thus we get coinci- 
dence and stimulation, instead of interference and inhibition. When 
stimuli, whose waves ordinarily coincide and strengthen each other's 
action, are made to travel more slowly, one may be thrown half a wave- 
length behind the other, and thus we shall have interference and inhibi- 
tion instead of stimulation. 

On the other hand, when the stimuli travel more quickly, the one 
which was half a wave-length behind the other, and interfered with it, 
may be thrown only a small fraction of a wave-length behind it. It will 
thus, to a great extent, coincide and cause stimulation, while the one 
which normally coincides with, and helps another, may, by travelling 
with increased rapidity, get half a wave-length in front of the other, and 
cause inhibition. 

Opposite Conditions Produce Similar Effects. — We see then 
that results, apparently exactly the same, may be produced by two oppo- 
site conditions, increased rapidity or greater slowness of transmission of 
stimuli. 

The Same Conditions may Cause Opposite Effects. — We see 
also that the same conditions may produce entirely opposite effects, by 
acting more or less intensely. Thus, the application of cold, or of any 
agent which will render the transmission of stimuli along nervous chan- 
nels slower than usual, may throw one which ordinarily coincided with 
another a small fraction of a wave-length behind it, then half a wave- 
length, then three-quarters, next a whole wave-length, and then in addi- 
tion to the whole wave-length it will throw it as at first a small fraction 
or a half wave-length behind, and so on. 

We will thus have the normal stimulation passing into partial, then 
into complete inhibition, which will gradually pass off as the crests of 
the waves come more nearly together, until they coincide, when we will 
again have stimulation as at first. As the action proceeds, this second 
stimulation will again pass into inhibition. In the same way a gradual 
retardation of transmission will cause impulses which normally interfere, 
gradually to coincide until inhibition gives place to complete stimulation, 
and this again passes into inhibition. By quickening the transmission 
and throwing one wave more or less in advance of another, various 
degrees of heat will likewise produce opposite effects. 

Stimulation and Inhibition on this Hypothesis are merely 
Consequences of Relation. — They are not due to any particular 
stimulating or inhibitory centres, they are merely dependent on the 
wave-length of nervous stimuli or the rapidity of transmission, and on 
the length of the paths along which they have to travel. Any nerve cell 
may therefore exercise an inhibitory or stimulating action on any other 
nerve cell, and the nature of this action will be merely a question of the 
length and arrangement of its connections, and the rapidity with which 
stimuli travel along them. 

Test of the Truth of the Hypothesis. — If the hypothesis be 
true we ought to be able to convert inhibition into stimulation, and vice 



158 PHARMACOLOGY AND THERAPEUTICS. 

/". by either quickening or slowing the transmission of stimuli. We 
can quicken transmission by heat, and we can render it slower by cold. 
On this hypothesis we would expect to find that either excessive 
quickening or" excessive slowing of the passage of stimuli between the 
cells of the nerve centres might cause a number of stimuli which would 
ordinarily interfere to coincide and produce convulsions. This is what 
actually "does occur, for extreme heat and extreme cold both cause con- 
vulsions. But it is unsafe to lay too much stress upon this point, as the 
cause of convulsion may be very complex. We find, however, that, as 
we would expect on this hypothesis, the inhibitory action of the vagus is 
destroyed by cold. 1 

Explanation of the Actions of Certain Drug's on this 
Hypothesis. 

There are certain phenomena connected with the action of drugs on 
the spinal cord which are almost inexplicable on the ordinary hypothesis, 
but which are readily explained on that of interference. Thus belladonna 
when given to frogs causes gradually increasing weakness of respiration 
and movement, until at length voluntary and respiratory movements are 
entirely abolished, and the aiferent and efferent nerves are greatly weak- 
ened. Later still, both afferent and efferent nerves are completely par- 
alyzed, and the only sign of vitality is an occasional and hardly perceptible 
beat of the heart, and retention of irritability in the striated muscles. 
The animal appears to be dead, and was believed to be dead, until Fraser 
made the observation that if allowed to remain in this condition for four 
or five days, the apparent death passed away, and was succeeded by a 
state of spinal excitement. The fore-arms passed from a state of com- 
plete tlaccidity to one of rigid tonic contraction. The respiratory move- 
ments reappeared : the cardiac action became stronger, and the posterior 
extremities extended. In this condition a touch upon the skin caused 
violent tetanus, usually opisthotonic, lasting from two to ten seconds, and 
succeeded by a Beries of clonic spasms. A little later still the convulsions 
change their character and become emprosthotonic. These symptoms 
arc due to the action of the poison upon the spinal cord itself, for they 
continue independently in the parts connected with each segment of the 
cord when it has been divided. 

This action may be imitated by a combination of a drug which will 
paralyze the motor nerves with one which will excite the spinal cord. 
Fraser concludes that the effects of large doses of atropine just described, 
»re due to a combined stimulant action of this substance on the cord, and 
a paralyzing one on the motor nerves. The stimulant action on the cord 
is masked by the paralysis of the motor nerves, and only appears after 
the paralysis has passed off. lie thinks that the difference in the rela- 
tion- of these effects to each other, which are seen in different species of 
a in ma Is ina v ho explained by this combination acting on special varieties 
of organization. In Bupporl of his views he administered to frogs a mix- 
chnine whir}, stimulates the spinal cord, and of methyl 



Horwatli. Pfliiger'a Archiv, 1876, 



ACTION OF DRUGS ON THE SPINAL CORD. 159 

strychnine, which paralyzes the motor nerves, and found that the mixture 
produced symptoms similar to those of atropine. Notwithstanding this 
apparently convincing proof it would appear that the paralysis in the frog 
is due to the action of the atropine on the spinal cord, and not to a paraly- 
zing effect on the motor nerves. For Ringer and Murrell have found 
that when the ends of the motor nerves in one leg are protected from the 
action of the poison by ligature of the artery there is no difference between 
it and the unpoisoned leg, while if Eraser's ideas were correct the un- 
poisoned leg ought to be in a state of violent spasm. 

A condition very nearly similar to that caused by atropine is produced 
by morphine. When this substance is given to a frog, its effects are ex- 
actly similar to those produced by the successive removal of the different 
parts of the nervous system from above downwards. Goltz has shown 
that when the cerebral lobes are removed from the frog, it loses the power 
of voluntary motion, and sits still ; when the optic lobes are removed, it 
will spring when stimulated, but loses the power of directing its move- 
ments. When the cerebellum is removed, it loses the power of springing 
at all ; and when the spinal cord is destroyed, reflex action is abolished. 

Now these are exactly the effects produced by morphine, the frog 
poisoned by it first losing voluntary motion, next the power of directing 
its movements, next the power of springing at all, and lastly, reflex ac- 
tion. But after reflex action is destroyed by morphine, and the frog is 
apparently dead, a very remarkable condition appears, the general flaccid- 
ity passes away, and is succeeded by a stage of excitement, a slight touch 
causing violent convulsions just as if the animal had been poisoned by 
strychnine. 1 

The action of morphine here appears to be clearly that of destroying 
the function of the nerve centres from above downwards, causing paralysis 
first of the cerebral lobes, next of the optic lobes, next of the cerebellum, 
and next of the cord. But it seems probable that the paralysis of the 
cord first observed is only apparent and not real, and in order to explain 
it on the ordinary hypothesis we must assume that during it the inhibi- 
tory centres in the cord are intensely excited so as to prevent any motor 
action, that afterwards they become completely paralyzed, and thus we 
get convulsions occurring from slight stimuli. 

Ammonium bromide also causes first complete loss of voluntary 
movement and reflex action, but at a later stage in the poisoning convul- 
sions accur. 

On the hypothesis of interference, the phenomena produced both by 
atropine and by morphine can be more simply explained. These drugs, 
acting on the nervous structures, gradually lessen the functional activity 
of the nerve-fibrils which connect the nerve- cells together ; the impulses 
are retarded, and thus the length of nervous connection between the 
cells of the spinal cord, which is calculated to keep them in proper rela- 
tion in the normal animal, just suffices at a certain stage to throw the 
impulses half a wave-length behind the other, and thus to cause com- 
plete inhibition and apparent paralysis. 



1 Marshall Hall, Memoirs on the Nervous System, p. vii. (London, 1837). Wit- 
kowski, Archiv.fiir exper. Path, und Pharm., Band, vii., p. 247. 



160 PHARMACOLOGY AND THERAPEUTICS. 

As the action of the drug goes on, the retardation becomes still 
greater, and then the impulses are thrown very nearly, but not quite, a 
whole wave-length behind the other, and thus they coincide for a short 
time, but gradually again interfere, and therefore we get, on the appli- 
cation of a stimulus, a tonic convulsion followed by several clonic ones, 
and then by a period of rest. This explanation is further borne out by 
the fact observed by Fraser, that the convulsions caused by atropine 
occurred more readily during winter, when the temperature of the 
laboratory is low and the cold would tend to aid the action of the 
drug in retarding the transmission of impulses. 1 

The effect of strychnine in causing tetanus is very remarkable ; a 
verv small dose of it administered to a frog first renders the animal 
most sensitive to reflex impulses, so that slight impressions which would 
normally have no effect, produce reflex action. As the poisoning pro- 
ceeds, a slight stimulus no longer produces a reflex action limited to a 
few muscles, but causes a general convulsion throughout all the body, all 
muscles being apparently put equally on the stretch. In man the form 
assumed by the body is that of a bow, the head and the heels being bent 
backwards, the hands clenched, and the arms tightly drawn to the body. 

My friend Dr. Ferrier has shown that this position is due to the 
different strengths of the various muscles in the body. All being con- 
tracted to their utmost, the stronger overpower the weaker, and thus the 
powerful extensors of the back and muscles of the thighs keep the body 
arched backwards and the legs rigid, while the adductors and flexors of 
the arms and fingers clench the fist and bend the arms, and draw them 
close to the body. 2 The convulsions are not continuous, but are clonic ; 
a violent convulsion coming on and lasting for a while, and then being 

seeded by an interval of rest, to which after a little while another 
convulsion succeeds. The animal generally dies either of asphyxia 
during a convulsion, or of stoppage of the heart during the interval. 

When the animal is left to itself, the convulsions — at least in frogs — 
appear to me to follow a certain rhythm, the intervals remaining for 
-Mine little time of nearly the same extent. 

A Blight external stimulus, however, applied during the interval — 
<>r at least during a certain part of it — will bring on the convulsion. 
B this i^ not the case during the whole interval. Immediately after 
each convulsion has ceased I have observed a period in which stimulation 
applied t<» the surface appears to have no effect whatever. 

It is rather extraordinary, also, that although touching the surface 
produces convulsions, irritation of the skin by acid does not do so. 3 

The cause of those convulsions was located in the spinal cord by 
Magendie in an elaborate series of experiments, which will be described 
I 

Other observers have tried to discover whether any change in the 

pheral aervee also took part in causing convulsion; but from further 



TWmftft Hont Of the Royal Society of Edinburgh, vol. xxv., p. 467. 
/Iran,. \<,\. i\ .. \>. 313. 

i:< kii.o.i. Bermann'a Eandb. rf. Physio!.. Band ii. Th. 2, p. 43. 



ACTION" OF DRUGS ON THE SPINAL COED. 161 

experiments it appears that the irritability of the sensory nerves is not 
increased. 1 

According to Rosenthal, strychnine does not affect the rate at which 
impulses are transmitted in peripheral nerves ; according to him. how- 
ever, it lessens the time required for reflex actions. Wundt came to the 
conclusion that the reflex time was on the contrary increased. 

In trying to explain the phenomenon of strychnine tetanus on the 
hypothesis of interference, one would have been inclined by Rosen- 
thal's experiments to say that strychnine quickened the transmission of 
impulses along those fibres in the spinal cord which connect the differ- 
ent cells together. 

The impulses which normally by travelling further round fell behind 
the simple motor ones by half a wave-length, and thus inhibited them, 
would now fall only a small fraction of a wave-length behind, and we 
should have stimulation instead of inhibition. 

Wundt' s results, on the other hand, would lead to the same result 
by supposing that the inhibitory wave was retarded so as to fall a whole 
wave-length behind the motor one. On the assumption, however, that 
the fibres which pass transversely across from sensory to motor cells, and 
those that pass upwards and downwards in the cord connecting the cells 
of successive strata in it, are equally affected, we do not get a satisfac- 
tory explanation of the rhythmical nature of the convulsions. By sup- 
posing, however, that these are not equally affected, but that the resist- 
ance in one — let us say — that in the transverse fibres is more increased 
than in the longitudinal fibres, we shall get the impulses at one time 
thrown completely upon each other, causing intense convulsions, at 
another half a wave-length behind, causing complete relaxation, which 
is exactly what we find. 

This view is to some extent borne out by the different effect produced 
by a constant current upon these convulsions, according as it is passed 
transversely or longitudinally through the spinal cord. Ranke found 
that when passed transversely it has no effect, but when passed longi- 
tudinally in either direction it completely arrests the strychnine con- 
vulsions, and also the normal reflexes which are produced by tactile 
stimuli. 

Ranke's observations have been repeated by others with varying re- 
sult, and this variation may, I think, be explained by the effect of tem- 
perature. 

The effect of warmth and cold upon strychnine tetanus is what we 
would expect on the hypothesis of interference. With small doses of 
strychnine warmth abolishes the convulsions, while cold increases them. 
When large doses are given, on the contrary, warmth increases the con- 
vulsions and cold abolishes them. 2 

We may explain this result on the hypothesis of interference in the 
following manner : — 



1 Bernstein, quoted by Eckhard, op. cit., p. 40. Walton, Ludwig's Aroeiten, 1882. 

2 Kunde and Virchow, quoted by Eckhard, op. cit., p. 44 ; Foster, Journal of Anat- 
omy and Physiology, November, 1873, p. 45. 

11 



162 PHARMACOLOGY AND THERAPEUTICS. 

If a small dose of strychnine retard the transmission of nervous im- 
pulses so that the inhibitory wave is allowed to fall rather more than half 
a wave-length, but not a whole wave-length, behind the stimulant wave, 
we should have a certain amount of stimulation instead of inhibition. 
Slight warmth, by quickening the transmission of impulses, should coun- 
teract this effect, and should remove the effect of the strychnine. Cold, 
on the other hand, by causing still further retardation, should increase 
the effect. With a large dose of strychnine the transmission of the in- 
hibitory wave being still further retarded, the warmth would be sufficient 
to make the two waves coincide, while the cold would throw back the 
inhibitory wave a whole wave-length, and thus again abolish the con- 
vulsions. 

The effect of temperature on the poisonous action of guanidine is 
also very extraordinary, and is very hard to explain on the ordinary hy- 
potheses, although the phenomena seem quite natural when we look at 
them as cases of interference due to alterations in the rapidity with which 
the stimuli are transmitted along nervous structures. 

Another cause of tetanus that is difficult to understand on the ordi- 
nary hypothesis of inhibitory centres is the similar effect of absence of 
oxygen and excess of oxygen. When an animal is confined in a closed 
chamber without oxygen, it dies of convulsions ; when oxygen is gradually 
introduced before the convulsions become too marked, it recovers. But 
when the pressure of oxygen is gradually raised above the normal, the 
animal again dies of convulsions. This is evidently not the effect of 
mere increase in atmospheric pressure, but the effect of the oxygen on 
the animal, inasmuch as twenty-five atmospheres of common air are re- 
quired to produce the oxygen convulsions, while three atmospheres of 
pure oxygen are sufficient. This effect is readily explained on the hy- 
pothesis of interference, by supposing that the absence of oxygen retards 
the transmission of impulses in the nerve-centres ; so that we get those 
which ought ordinarily to inhibit one another, coinciding and causing con- 
vulsions. Increased supply of oxygen gradually quickens the transmis- 
sion of impulses until the waves first reach the normal relation, and then, 
the normal rate being exceeded, the impulses once more nearly coincide, 
and convulsions are produced a second time. 1 

The effect of various agents also in arresting or inhibiting muscular 
action suggests the possibility that such inhibition is due to interference 
with vibrations in muscle. The vibrations of the parts which occur in 
the muscle during the passage of a constant current have already been 
mentioned. Winn a constant current is passed for a length of time and 
then Stopped, tetanic contraction of the muscle occurs and lasts for some 
'i' 1 "- but it can be at once arrested by again passing the constant current 
through the muscle. 

The idea that coincidence or interference of contractile waves in 
muscle have much to do with the presence or absence of contraction of a 



i or other observations on interference as a cause of inhibition, vide Wundt, Un- 

o- M-rhmnk <{,,- Nerven und Nerven centren. 1876. (Stuttgart: T. 

; Ranvier, Lecona tPAnatomie QSnSrale. A nn/e 1877-78. (Paris: J. B. Bail- 

and Lauder Brunton, " On the Nature of Inhibition and the Action 

ol Drngi upon it. -- [Nature, March, L883, and reprint.) 



ACTION OF DRUGS ON THE SPINAL CORD. 163 

muscle has been advanced by Kiihne in order to explain the phenomenon 
observed by A. Ewald. When the sartorius of a frog is stimulated at 
each end by electric currents passing transversely through the ends, the 
secondary contraction which can be obtained from it is strongest in the 
middle of the muscle, while the points exactly intermediate between the 
middle and the end, do not produce any secondary contraction at all. 
This absence of secondary contraction Kiihne thinks is due to interfer- 
ence, and the powerful secondary contraction from the middle to coin- 
cidence of waves. 1 

Inhibition may also be produced by direct irritation of involuntary 
muscular fibre. Thus I have noticed under Ludwig's direction that 
stimulation of veins as a rule very frequently causes dilatation at the 
point of irritation, and if the muscular fibre of a frog's heart be injured 
by pinching at one point, that point is apt to remain dilated when the 
rest is contracted. Protoplasmic structures appear to be similarly af- 
fected, and the passage of an interrupted current through the heart of a 
snail will arrest its rhythmical pulsations, although the heart in this an- 
imal appears to be a continuous protoplasmic structure and destitute of 
nerves. 2 

Stimulating* Action of Drugs on the Reflex Powers of the Cord. 

The reflex action of the cord is greatly increased by certain drugs, 
more especially by ammonia and by strychnine. The action of strychnine 
was first investigated by Magendie, and his research is not only the first 
example of the systematic investigation of the physiological action of a 
drug leading to its therapeutical employment, but is such a model of this 
method of research that it is worth giving in detail. 

He first introduced a little of the upas poison, of which strychnine 
was the essential ingredient, under the skin of the thigh of a dog, and 
found that for the first three minutes no symptoms at all were produced. 
Then the action of the poison began to manifest itself by general malaise 
succeeded by marked symptoms. The animal took shelter in a corner 
of the laboratory; and almost immediately afterwards convulsive con- 
traction of all the muscles of the body occurred, the fore-feet quitting the 
ground for a moment on account of the sudden extension of the spine. 

This contraction was only momentary, and almost immediately after- 
wards ceased ; the animal remained calm for several seconds, and was 
then seized with a second convulsion, more marked and prolonged than 
the first. These convulsions succeeded each other at short intervals, grad- 
ually becoming more severe. The respiration was hurried, the pulse 
quick, and it was observed that each time the animal was touched a con- 
vulsion immediately followed. Finally, death occurred at an interval 
increasing with the age and strength of the animal. These symptoms 
suggested to Magendie the following explanation of the action of the 
poison. It was, he thought, absorbed from the wound into the blood, by 
which it was carried to the heart, and thence to all the organs of the 

1 Untersuchungen a. d. Physiolog. Inst., Heidelberg, 1879. SonderabdrucJc, p. 40. 

2 M. Foster, Pfliiger's Archiv. 



164 PHARMACOLOGY AND THERAPEUTICS. 

body. On arriving at the spinal cord it acted upon it as a violent excitant, 
producing the same symptoms as mechanical irritation or the application 
of electricity. Magendie was not content until he had tested his theory 
by experiment. The first question to be settled was whether the 
poison were absorbed or not. 

To test this supposition he applied the poison first to the serous 
membranes, the peritoneum and pleura, from which, as he had learned 
by previous experience, absorption takes place with extreme rapidity. 
The result showed that his supposition was correct. The symptoms 
appeared almost immediately after the injection of the poison into the 
pleura, and within twenty seconds after it had been injected into the 
peritoneum. In order to ascertain whether absorption took place from 
mucous as well as from serous surfaces, he isolated a loop of small intes- 
tine, by means of two ligatures, and injected a little of the poison into 
the part between them. In six minutes symptoms of poisoning appeared, 
showing that absorption had occurred, but they were less intense than 
when the poison was applied to a serous surface. 

Further experiments showed that absorption took place from the 
large intestine, from the bladder, and from the vagina; but that it was 
comparatively feeble and slow. When introduced into the stomach 
along with food upas invariably caused death; but the symptoms did 
not appear until half an hour after it had been taken. This delay might 
have been due either to absorption from the stomach having taken place 
very slowly or not at all, so that the drug had passed on to the small 
intestine, and thence been absorbed into the blood. To determine this 
point, he isolated the stomach by ligatures applied to its cardiac and 
pyloric orifices, and then injected a little of the poison into its cavity. 

Under such conditions, symptoms of poisoning were only observed 
after the lapse of an hour. This showed that while absorption from the 
stomach did occur, it was much slower than from the small intestine. 

The second question was, Does the poison act through the 
circulation? If so, reasoned Magendie, the first symptoms of the 
action of the poison will come on more slowly when it has far to travel 
to the spinal cord from the point of introduction, and vice versa. On 
testing this by experiment he found that when the poison was injected 
into the jugular vein tetanus occurred almost instantaneously, and death 
took place in less than three minutes, for the upas had only to pass 
through the pulmonary circulation and heart to the arteries of the cord. 
When injected into the femoral artery (at D, Fig. 44) the distance to be 

elled before reaching the cord would be greatly increased, for the 
poison must first pass through the artery itself, through the capillaries, 
and along the vena cava, traversing the whole distance marked DAB 
in Fig. 1 \ before it reached the point where it entered the circulation 
when il was injected into the jugular. Under these conditions the 
action should he slow, and experiment showed this to be actually the 

. for no symptoms appeared until seven minutes after the injection. 
Although these experiments of Magendie's appear to prove completely 
that the upas poison acts through the circulation, a number of persons 
nevertheless considered that the symptoms were produced through the 
nervous system by means of 30-called sympathy. In order to remove 



ACTION OF DRUGS ON THE SPINAL CORD. 



165 



their doubts, Magendie narcotized a dog by means of opium, and then 
divided all the structures of one leg with the exception of the artery and 




MUSCLES OF 
FORE LEC jlfifi 



Fig. 44.— Diagram illustrating Magendie's method of investigating the mode of action of upas 
(strychnine), a, femoral vein; b, peritoneum; c, pleura; D, femoral artery; e, f, g, spinal cord, 
to which small arteries are seen passing from the aorta. At f is indicated a"point of section of the 
cord. 

vein. Into this almost isolated limb he then introduced a little of the 
poison. This was followed by the usual symptoms almost exactly as if 
the limb had been intact. By pressing upon the vein which passed 
from the limb to the body when the symptoms of tetanus appeared he 
was able to arrest their further development, and by releasing the vessel 
and allowing circulation to have free course, the symptoms reappeared. 
Lest by any chance the poison might have acted through nerves or 
lymphatics contained in the walls of the artery and vein, he divided 
these structures also, connecting their several ends by means of quills 
through which circulation then took place. When the poison was 
applied to the severed limb connected with the body only by these 
quills, the same succession of phenomena occurred as when the limb 
was uninjured. The possibility of the action being due to sympathy 
between the nervous system and the point of application of the poison 
was thus completely excluded, and the operation of the poison through 
the circulation triumphantly demonstrated. 

The next question was whether the convulsions were caused 
hy the action of the drug* on the brain or the cord. To ascer- 
tain its action upon the brain, a little of the solution was injected into 
the carotid artery. The effects produced were the same as those of any 
irritating liquid. The intellectual faculties disappeared, the head was 
laid between the paws, and the animal rolled over and over like a ball. 
These effects passed off as the circulating blood removed a quantity of 
the drug from the brain, and were succeeded by the ordinary tetanic con- 
vulsions when sufficient time had elapsed for it to reach the spinal cord. 
The question whether it really acted upon the cord, still remained 
to be put to a crucial test. If its effects were really due to its action 
upon the spinal cord they ought to cease upon the destruction of that part 
of the nervous system, and to occur when the drug was applied to it alone. 
The cord was therefore destroyed by running a piece of whalebone down 
the vertebral canal at the moment of injection. When this was done no 
tetanus occurred. In another experiment, Magendie waited until the 



166 PHARMACOLOGY AND THERAPEUTICS. 

tetanic spasms had been induced by the upas, and then destroyed the 
spinal cord by slowly pushing the whalebone down the vertebral canal. 
As the whalebone advanced, the tetanus disappeared, first in the fore- 
legs, when the dorsal part of the cord was destroyed, and then in the 
hind-legs, when the whalebone had reached the lumbar vertebrae. 

In another experiment, an animal was narcotized by means of opium, 
and the spinal canal laid freely open. The upas was then directly placed 
on a part of the spinal cord. Tetanus immediately occurred in that part 
of the body, and in that part only to which the nerves arising from this 
portion of the cord were distributed. When the poison was successively 
applied to other parts of the cord, the convulsions spread to the corres- 
ponding regions of the body. 

The question whether a drug- exercises a convulsant action 
through the brain or spinal cord is now frequently tested, not by 
destroying the whole cord as Magendie did, but simply by dividing the 
spinal cord transversely between the occiput and the atlas. Convulsions 
depending upon stimulation of the motor centres in the brain and medulla 
oblongata then cease after section, while those dependent upon the spinal 
cord do not. 

The experiment of dividing the spinal cord transversely about its 
middle is also sometimes performed in order to test whether the convul- 
sions are of really spinal origin. If they are, they should persist in both 
the anterior and posterior parts of the body, but if they are of cerebral 
origin, they occur in the anterior but not in the posterior part. 

The effect of strychnine and allied substances upon the cord is usually 
ascribed to increased excitability of the nerve cells, but it is not improb- 
ably due partly to alteration in the comparative rate at which stimuli are 
transmitted from one cell to another ; but this subject has already been 
more fully discussed under "Inhibition," q.v. 

Some curious results obtained by Dr. A. J. Spence may be explained 
od the latter hypothesis which would be inexplicable on the former. 
After removing the blood from the body of a frog, and exposing the brain, 
lie placed some nux vomica upon it, so that it could gradually diffuse 
along the spinal cord. As it passed downwards he observed that at first 
irritation of the fore-feet caused spasm only in them ; later it caused spasm 
of* both front and hind-feet, while irritation of the hind-feet still produced 
ordinary reflex ; and later still irritation of the fore-feet caused no spasm 
in the hind-legs while irritation of the hind-feet would still cause spasm 
in the fore-legs. 1 

The action of strychnine on the conducting power of the spinal cord 
has already been discussed. It diminishes or abolishes the power of 

bui ation, but Increases the reflex excitability, so that stimuli will 

produce reflex action which are too feeble to do so when the spinal cord 
is in its normal condition. The difference between the reaction to strong 
and weak stimuli is also to a great extent abolished, and both produce 
tetanic contractions. This condition, however, is absent for a short time 
after the application of each stimulus, and then strong and weak stimuli pro- 
duce corresponding Strong and weak action, much as in the normal cord. 2 



Edin. Med. Journ. t July, 1866. 

Ludwig and Walton, Ludwig'a Arbcitm, 1*8:2. 



ACTION OF DRUGS OX THE BRAIN. 167 

The effect of nicotine as a spinal stimulant is very extraordinary ; 
for Freusberg found that when frogs had been decapitated for twenty- 
four hours, and reflex action was almost entirely gone, the injection of a 
small quantity of the poison increased the reflex excitability so much 
that irritation of the skin caused well-marked movements. This increase 
lasted from one to three days, and the bodies of frogs poisoned by nico- 
tine retained a fresh appearance for a long time. 

Spinal Stimulants. 

Spinal stimulants are remedies which increase the functional activity 
of the spinal cord. 



Ammonia. 


Thebaine. 


Strychnine. 


Gelsemine. 


Brucine. 


Buxine. 


Absinthe. 


Calabarine 


Nicotine. 





The most marked of these are strychnine, brucine, and thebaine, 
which in small and moderate doses greatly increase the reflex excita- 
bility, and in large doses cause tetanic convulsions. Besides these there 
are some others, such as opium, morphia, and belladonna, which, although 
they appear at first to have a sedative action, when given in very large 
doses produce convulsions. 

Uses. — The want of an exact knowledge of the intimate pathology 
of spinal diseases renders the rational use of spinal stimulants difficult. 
They are employed in cases of general debility without any evidence of 
distinct disease, and in paralysis where there is no evidence of inflamma- 
tion ; this paralysis may be local, or affect the whole side of the body, as 
in hemiplegia, or the lower half, as in paraplegia. 

When strychnine is given in cases of paralysis until it begins to ex- 
hibit its physiological action in slight muscular twitches, these twitches 
begin sooner and are more marked in the paralyzed than the healthy 
parts. 



CHAPTER VIII. 

ACTION OF DRUGS ON THE BRAIN. 

We are able to judge to a certain extent of the order and kind of action 
of drugs upon the different parts of the nerve centres, by watching their 
effect upon the movements of animals after their injection. 

By removal of successive portions of the nervous system in the frog, 
Goltz has shown that the cerebral lobes have the function of voluntary 



168 PHARMACOLOGY AND THERAPEUTICS. 

movement, so that when they are removed, the animal lies quiet, unless 
acted upon by some external stimulus. 

The optic lobes, which correspond to the corpora quadrigemina of the 
higher animals, have the function of directing and co-ordinating move- 
ments but not of originating them, so that a frog in which they are 
uninjured, but from which the cerebral lobes have been removed, will 
remain perfectly quiet, except on the application of an external stimulus, 
when it will leap like a normal frog. 

As the optic lobes have the power of directing and co-ordinating 
movements, when they are destroyed the animal will jump, but will be 
unable to direct its movements. 

The cerebellum has also the power of co-ordination, so that when it 
is removed the animal cannot jump at all, although one leg may answer 
by a kick or other motion to the application of a stimulus. But even 
when all those parts have been removed, the frog will still recover its 
ordinary position after it has been laid upon its back. 

The co-ordination requisite for this pow T er of retaining or recovering 
its ordinary position appears to be situated in the medulla oblongata, for 
when this is removed the frog will lie upon its back, and will not attempt 
to recover its ordinary position. 

The legs will still respond by movements to irritation applied to the 
foot, but when the spinal cord is now destroyed these reflex movements 
also cease. 

In frogs poisoned by opium, the movements are gradually abolished 
in the order just mentioned, and we therefore conclude that opium affects 
the nerve-centres in the order of their development, the highest being 
paralyzed first, and the lowest last. This order is usually not quite the 
same in higher animals, inasmuch as the last centre to be paralyzed by 
opium or other anaesthetics is usually the medulla oblongata, and more 

icially that part of it which keeps up the respiratory movements. 
b we shall afterwards see, however, the respiratory centre is really a 
lower or more fundamental centre than either the brain or spinal cord. 

In higher animals, such as rabbits and guinea-pigs, the cerebral 
hemispheres are comparatively much more developed than in the frog, 
and their removal interferes very much with the animal's motions. At 
it is utterly prostrate, but after some time its power of movement 
returns to some extent, though it remains much less than in the normal 
animal. As we should expect, the weakness is most marked in those 
parts of the body that are most under the control of the cerebrum, and 

• in those whose movements are regulated by the lower centres. Thus 
m rabbits the fore-paws are capable of being used for complex motions 
;ir the will of tin- animal, Buch as washing the face, holding food, and so 
"ii, :md in ill. in the weakness caused by removal of the cerebrum is much 
more marked than in the hind limbs, which are simply used for pro- 
i U. After the operation the animal can still stand, although it is 
unsteady, and the fore-legs tend to sprawl out. When pinched it bounds 
forward, but, unlike the frog, it is unable to avoid any obstacle in its 
path. If it be pinched at all severely, it not only moves, but will cry 
Loudly and plaintively, and this condition is frequently noticed in rabbits 
under chloroform, although they have received no injury whatever. The 



ACTION OF DRUGS ON THE BRAIN. 



169 



pupils contract on the stimulus of light, and the eyes wink if the finger 
is brought near them. Bitter substances cause movements of the tongue 



Effects of removing the part of brain 
included in brackets. 



Voluntary motion lost. 



Cannot direct movements. 
Cannot jump 



Cannot recover position when laid 
on its back 




Olfactory nerves. 
Olfactory lobes. 

Cerebral lobes. 
Pineal gland. 
Optic thalamus. 
Optic lobes. 
Cerebellum. 

Rhomboid sinus. 
Medulla oblongata. 



Fig. 45.— Diagram of the higher nerve-centres of the frog. 

and mouth, and ammonia to the nostrils may cause the head to be drawn 
back, or the animal to rub its nostrils with its toes. 1 



1 Ferrier, Functions of the Brain, p. 38 



170 



PHARMACOLOGY AND THERAPEUTICS. 



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ACTION OF DRUGS ON THE BRAIN. 171 

Where the cerebral hemispheres are still more developed, as in cats, 
dogs, and. monkeys, their removal causes so much prostration, and inter- 
feres so greatly with motor power as almost entirely to destroy equilib- 
rium and co-ordinate progression. 

The motor and sensory centres of the brain have been more exactly 
localized in monkeys by Ferrier, Fritsch, Hitzig, and others, and the re- 
sults of their experiments, especially those of Ferrier, agree so well with 
those of pathological observation in men that we may assume that there 
is a general agreement between the position of the centres in man and 
monkey. 

The motor centres are arranged along the two sides of the fissure 
of Rolando, the order of their arrangement being exactly what is required 
for the purpose of (1) seeing food ; (2) conveying it to the mouth ; (3) 
masticating it ; (4) throwing away the refuse ; and (5) advancing to get 
more 1 (vide Fig. 46, brain of monkey). 

The sensory centres lie in the posterior and lower parts of the 
brain. The centre for sight is situated in the angular gyrus and is 
marked 14 and 15 in the diagram : that for hearing is situated in the 
superior temporo-sphenoidal and is marked 16 in the diagram ; those for 
smell and taste lie at the tip of the temporal sphenoidal lobe, and the 
centre for general sensation appears to be towards the interior of the brain, 
in the hippocampal region. 

When the motor centres in the monkey are slightly irritated by a 
faradic current, a single co-ordinated movement is produced, but if the 
irritation be continued longer, and especially if a strong current be used, 
epileptiform convulsions may occur, succeeded by choreic movements after 
the current has ceased. Epileptic convulsions are easily produced by 
irritation of the cerebral cortex in the cat and dog, as well as the monkey. 
It is difficult to produce them by cortical irritation in the guinea-pig or 
rabbit, and impossible in birds, frogs, and fish. 2 

Depressant Action of Drugs on the Motor Centres. 

The excitability of the brain may be altered either by conditions 
which modify the nerve cells or the circulation. A deficient circulation 
greatly depresses the excitability, and it is very low when much haemor- 
rhage has occurred. 

One method of investigating the action of drugs on the excitability 
of the brain consists in trephining so as to expose the cortical substance 
and then stimulating it by a faradaic current before and after the admin- 
istration of a drug, either by inhalation or injection. Another method 
has been employed by Albertoni, who first trephines on one side, and 
having estimated the strength of current sufficient to produce an epileptic 
convulsion when applied to a motor centre, he allows the wound to heal, 
and then gives for a length of time the drug on which he wishes to ex- 
periment. He then exposes the corresponding motor area on the other 



1 Lauder Brunton, "On the Position of the Motor Centres in the Brain in regard 
to the Nutritive and Social Functions," Brain, vol. iv., p. 1 

2 Francois Franck and Pitres, Arch, de Physiol, July, 1883, p. 39. 



1 i 2 PHARMACOLOGY AND THERAPEUTICS. 

side and observes whether the strength of current required to produce an 
epileptic convulsion is greater or less than before. 

The excitability of the motor centres is greatly lowered by anaesthetics, 
so that as anesthesia becomes deeper, irritation of the motor centres has less 
and less effect, and when anaesthesia is very profound, such irritation has no 
action whatever. 1 The motor centres, however, are less affected than the 
sensory ones by anaesthetics, so that they will still re-act to faradic irrita- 
tion when the sensation of pain has been completely abolished. 

Alcohol also diminishes the excitability of the motor centres, so that 
the epileptic convulsions which usually follow the application of strong 
currents to the cortex are less readily produced after its administration, 
as well as after ether and chloroform. 2 

Bromide of potassium, according to Albertoni, when given for several 
weeks together, greatly diminishes the excitability of the motor centres so 
that when dogs are thoroughly under its influence it is almost impossible 
to produce epileptic convulsions by irritation of the cortical substance. 
Atropine in small doses increases the excitability of the brain in monkeys, 
but in large doses paralyzes it. It greatly increases the tendency to epi- 
leptic convulsions in dogs, so that they can be produced by very much 
slighter stimuli than usual, and strychnine, absinthe, and cannabine have 
a similar action in this respect. 3 Physostigma appears to increase the 
excitability of motor centres in the brain; for when guinea-pigs have 
been rendered epileptic by section of a sciatic nerve, the administration 
of physostigma greatly increases the number of fits. 

Irritant Action of Drugs on Motor Centres in the Brain. 

Certain drugs when administered to animals or taken by man produce 
convulsions. The muscular actions which occur in these convulsive 
movements may be induced by (a) irritation of the motor centres in the 
spinal cord, (7/) the motor centres in the medulla oblongata and pons varolii, 
cerebral cortex. These centres maybe irritated directly by the 
action of the drug upon them, or they may be stimulated indirectly by 
the drug causing the blood in them to become venous through its action 
on the respiratory or circulatory organs. Convulsions of this sort, al- 
though caused by the administration of a poison, are really asphyxia!, and 
milar in character to those produced by suffocation. 

Convulsions are usually ascertained to be of spinal origin by di- 
viding tin- cord either at the occiput or lower down in its course and 
finding that they still persist in those parts of the body which derive their 
innervation from the spinal cord below the point of section. If they cease 
in parts of the body innervated by the spinal cord alone, but continue in 
the parts which retain their nervous connection with the brain, they are 

irded as of cerebral origin. 



T1 ' rved in the case of ether by Hitzig, Untcrsuchunrjcn iiber das Gehirn, 

Berlin, 1874. I have had Beveral opportunities of observing the same tiling in regard 
to chloroform when assisting my friend Dr. Ferrier in experiments on the brain. 

Franck and Pitres, op, i it. 

ich and Pitres, Arch. <i<- Physiol, July, 1883, i>. 39. 



ACTION OF DEUGS ON THE BKAIN. 173 

It has already been mentioned that irritation of the motor areas in the 
cortex of the brain will produce epileptic convulsions, but it is probable 
that such cortical irritation acts through lower ganglionic centres and 
especially through the medulla oblongata and pons varolii. Epileptic 
convulsions can be still more readily produced by irritation of this part 
of the brain than by irritation of the cerebral cortex, and may be induced 
by slight lesion of the pons and medulla by a needle. It is to irritation 
of this part of the brain by venous blood that asphyxial convulsions are 
due, for they can still be induced by suffocation or by ligature or com- 
pression of all the arteries leading to the brain after all the parts of the 
brain above the pons have been removed, and they cease when the spinal 
cord is divided just below the medulla, or the medulla itself divided at its 
lower end. It is evident that, if the spinal cord be paralyzed the con- 
vulsions will not occur though the medulla and pons be irritated : and it 
has been found that, if its blood-supply is stopped at the same time as 
the circulation in the pons by ligaturing the aorta in place of the cerebral 
vessels alone, convulsions do not occur. Probably the absence of convul- 
sions in slow asphyxia is due, at least in some degree, to gradual paralysis 
of the cord by the long-continuecl circulation of venous blood through it. 

The centre for convulsions in the frog appears to be in the medulla 
oblongata. 

Asphyxial convulsions are usually of an opisthotonic character, 
because, all the muscles being stimulated at once by the action of the 
venous blood on the motor centres, the stronger overpower the weaker, 
and the extensor muscles of the back being more powerful than the flexors 
bend the spine backwards. Asphyxial convulsions only occur in warm- 
blooded animals and not in frogs, where the respiratory processes are 
slow, and entire stoppage of the respiration for a length of time does not 
render the blood sufficiently venous to act as a powerful irritant. If any 
drug therefore produces convulsions in the higher animals and not in frogs, 
the probability is that its convulsive action is indirect and the convulsions 
it produces are asphyxial. If on the other hand it produces convulsions 
in frogs as well as higher animals, its convulsive action is in all probabil- 
ity due to the direct effect of the drug upon the nerve centres. In order 
to ascertain this definitely, however, the usual plan is to see (1) whether 
the convulsions which occur after the drug has been injected disappear 
when artificial respiration is commenced, and (2) whether these convul- 
sions are prevented by artificial respiration begun before the injection of 
the drug and kept up during its action. But even this does not entirely 
show whether the convulsive action of a drug is direct or indirect, for 
artificial respiration will not prevent asphyxial convulsions if these should 
depend upon the action of the drug in stopping the heart and thus arrest- 
ing the circulation. If it is found that the convulsions occur very shortly 
after the heart stops, the usual plan is to paralyze the vagus in the heart 
by atropine, and ascertain whether the convulsive action then occurs. If 
the drug still produces convulsions when respiration is kept up and the 
heart is not stopped, it is almost certain that its action is direct upon the 
nerve centres. 

Experiments to ascertain whether convulsions are asphyxial or not 
may be conveniently made upon fowls, for the venous or arterial condition 



17^ PHARMACOLOGY AND THERAPEUTICS. 

of the blood is readily ascertained by the color of the comb. Thus, 
in fowls killed by cobra poison, the convulsions come on at the moment 
the comb becomes livid, and when artificial respiration is begun the con- 
vulsions disappear as the comb again regains its normal color. It is 
evident that the color of the comb will indicate the condition of the blood 
supplying the brain, even though a venous condition of it should be due 
to stoppage of the heart and not to failure of the circulation. 

Camphor has a curious exciting action both upon the brain and upon 
the medulla. It produces first rapid succession of ideas, great desire to 
move, hallucinations which are generally agreeable, and a wish to dance 
and laugh. In animals it has a similar action, causing wild excitement 
and constant motion, succeeded by clonic epileptiform convulsions during 
which death often occurs. Usually, if they survive the convulsions, they 
recover ; but in man the convulsive stage may be succeeded by paralysis, 
coma, and death, the parts of the nervous system which are first excited 
being apparently finally paralyzed. The action upon frogs is different 
from that in warm-blooded animals, for in them it produces such rapid 
paralysis both of the spinal and motor nerves that convulsions do not 
occur. 

Among other drugs having a powerful convulsant action due to irri- 
tation either of the cortical centres or of the medulla and pons are picro- 
toxine (the active principle of Anamirta cocculus or Cocculus indicus), 
cicutoxine (the active principle of Cicuta virosa), and the active principle 
of the nearly-allied ((Enanthe crocata, coriamyrtine (from Coriaria myrti- 
folia), digitaliresin and toxiresin, which are products of the decomposition 
of the active principles of digitalis. 

The method of localizing- the parts of the brain upon which cer- 
tain drugs exert a convulsant action, consists in extirpating- some 
of the motor centres and then giving these drugs, such as picrotoxine, 
cinchonidine, and quinine, 1 which produce epileptic convulsions. 2 The 
results of these experiments are that the epileptic convulsions produced 
by these poisons appear to have a two-fold origin, (a) in the brain, and 
(6) in the medulla, the centre in the brain being the most sensitive to 
the action of the poison. In consequence of this, when the poison is 
given after the destruction of the motor centres on one side in such 
quantities as not to cause general convulsions, the weakness of the 
opposite Bide, due to the lesions, becomes still more evident, probably 
from the motor excitability of the sound side being increased. When 
convulsions axe produced they are unsymmetrical. Those of the sound 
side arc much stronger, are generally clonic, and apparently arise from 
irritation of the cerebral centres. Those of the paralyzed side are much 
weaker, are more tonic, and apparently arise from irritation of the 
medulla. 



I have Been a case in which an epileptic convulsion appeared to be caused by 

iindiiinal d086fl of <|iii i) i ih-. 

BoTighi e Santini, Publicazioni del R. IneKt. di stud, superiori in Firenze Sizione 
U h nadir. 1882, b. 1. 



ACTION OF DRUGS ON THE BRAIN. 175 

ACTION OF DRUGS ON THE SENSORY AND PSYCHICAL CENTRES IN 

THE BRAIN. 

The effect of drugs upon the higher mental functions can only be 
ascertained satisfactorily in man. These functions vary in complexity 
from simple choice to the highest efforts of genius. 

The effect of drugs upon the time required for mental pro- 
cesses is observed by ascertaining, first, the time required for the 
performance before and after the administration of a drug, and com- 
paring these two times with one another. 

The processes generally investigated are, (a) the time required for 
simple reaction; (b) for discrimination; (c) for selection. The simple 
reaction is ascertained by marking on a chronograph the time when a 
signal is made, such as for example the exhibition of a colored flag. As 
soon as this is seen by the individual experimented upon he marks the 
time upon the same chronograph by placing a finger upon a key which 
is connected with the registering electro-magnet. The difference of time 
between the exhibition of the flag and the time registered by the electro- 
magnet is equal to the time required for the transmission of the sensory 
impulse to the brain, for its transmission from the sensory to the motor 
tracts of the brain, for its passage down the motor nerves, and the latent 
period of the muscles. 

The time required for selection is ascertained in the same way, but 
either a red or blue flag may be shown, and he has to discriminate 
between them, and only to press when the one previously agreed upon 
is shown. The difference between the time of this experiment and the 
former gives the time required for discrimination. 

The time required for decision is ascertained in the same way as the 
previous one, excepting that a different signal is to be made on the 
appearance of the red and of the blue. 

Simple reaction has been found by Kraepelin 1 to be little affected by 
nitrite of amyl : sometimes it is a little quicker and sometimes a little 
slower than normal. It is rendered slower by ether and much slower 
by chloroform, although exceptionally it may be quickened by chloro- 
form, probably when used in small doses. 

The time required for discrimination is not definitely affected by 
nitrite of amyl, being sometimes increased and sometimes diminished. 
It is generally increased, though it may be diminished, by small doses 
of ether and also by chloroform. 

The time for selection is sometimes increased and sometimes dimin- 
ished by nitrite of amyl. It is increased by ether and also by chloro- 
form : and if the quantity given be great, the increase may be very large. 

The influence of alcohol upon psychical processes is curious; for, 
while it renders them much slower, the individual under its influence 
believes them to be much quicker than usual. 



1 Kraepelin, Ueber die Einwirhung einiger medicamentose Stoffe auf die Bauer ein- 
f acker psychischer Vorgdnge, 1882. Abstract in Bevista Sperimentale di Freniatria, anno 
ix., 1883, p. 124. 



176 PHARMACOLOGY AND THERAPEUTICS. 

Drugs which Increase the Functional Activity of the Brain. 

Nerve Stimulants. 

These are remedies which increase the nervous activity of the 

cerebro-spinal system. They are subdivided into those which act on the 
cerebrum, or cerebral stimulants, and those which affect the spinal cord, 
or spinal stimulants. Spinal stimulants have been already discussed 
(p. 167). 

Cerebral Stimulants. 

In popular language the name of stimulant is generally applied to 
drugs which have the power to increase the activity of the brain. From 
their producing a feeling of comfort and mirth they are also called 
exhilarants. The functional activity of the brain, like that of other 
organs, depends upon the tissue change which goes on in the cells and 
fibres which compose it, and the amount of tissue change is regulated to 
a great extent by the quantity and quality of the blood supplied to the 
organ. A free supply of blood to the brain may be obtained by general 
excitement of the circulation, i.e., more powerful and rapid action of the 
heart and contraction of the vessels in other parts of the body driving 
blood into the brain, or by local dilatation of the cerebral arteries allow- 
ing blood more ready access to the brain, or by a combination of these 
factors. 

Free circulation through the cerebral arteries may be induced to 
some extent by posture : thus, some men can think best when the head 
is low, and almost every one naturally assumes the sitting posture with 
the head bowed down and held between the hands when suffering from 
the effects of mental depression. This posture is not, as is often sup- 
1. merely consequent on the depressed condition of the nerve centres ; 
it is voluntarily assumed because it affords an actual sense of relief. In 

r conversation also the body generally stoops forward and the head 
is held low bo as to allow of a free supply of blood to the brain. 1 



&M& 



pidity of circulation in the carotid of a horse during masti- 
. (After M 

Local dilatation of the- arteries of the brain appears to be pro- 

I m animals by the movements of mastication and probably also 

." food or irri bstances in the mouth. It is probably on 



i the human brain is admirably shown by a tracing 
tnrein the sknll by Francois Franck and 1 

"in. iii.. p. 147. 



ACTION OF DRUGS OX THE BRAIN. 177 

this account that so many substances are chewed for their stimulant 
action, such as tobacco, betel nut, cola nut, and raisins. The effect of smok- 
ing is probably to a great extent due also to its action on the cerebral cir- 
culation through the stimulating effect of the smoke on the nerves of the 
mouth and nares, and so is the use of alcohol in sips by men such as 
journalists, who are engaged in writing. It is probable that tea and 
coffee also cause local dilatation of the arteries supplying the brain. 
Suction also causes an increased supply of blood to the brain. 1 

The effect of local dilatation of the cerebral vessels is very greatly 
increased, if in addition to it the general circulation is increased and the 
blood-pressure raised by contraction of the arterioles in the body gener- 
ally, or by more vigorous action of the heart. 

General excitement of the circulation is induced by exercise 
short of fatigue, and a brisk walk will sometimes remove a condition of 
low spirits. Sometimes the supply of blood to the brain is but slightly 
increased during continuous exercise, as a large portion of the blood is 
then diverted to the muscles; but after the exertion is over, the excite- 
ment of the circulation continues for some time, and then the supply to 
the brain is increased. In some persons a cold wind acts as an exhila- 
rant, causing contraction of the vessels with consequent increase in the 
general blood-pressure and increased circulation in the brain. In per- 
sons who are debilitated and feeble, on the contrary, the cold may have 
an opposite effect by depressing the action of the heart. 

Some men can think best when walking about, on account of the ex- 
citement in the circulation which the exertion produces, but many such 
people, when they come to a very difficult point, will stand still or sit 
down, so as to allow the blood to flow more to the head and less to the 
muscles. 

Where the circulation is feeble, so that the heart is not much stimu- 
lated by walking about, men often find that they can think better when 
lying down, or sitting with their head in their hands, so as to gain the 
advantage of the greater flow of blood to the head in these positions. 

Stimulation of the mucous membrane of the nose by smelling the 
vapor of strong ammonia, carbonate of ammonia, or acetic acid, raises 
the blood-pressure generally throughout the body by reflexly stimulating 
the vaso-motor centre, and thus increases the circulation of blood in the 
brain. Smelling salts or aromatic vinegar are therefore frequently 
employed, not only to enable people to attend more readily to any sub- 
ject in which they are engaged, and to prevent them from falling asleep, 
but also to arouse them from syncope. 

The action of sipping is a powerful stimulant to the circulation, for, 
as Kronecker has shown, the inhibitory action of the vagus on the heart 
is abolished while the sipping continues, and the pulse rate is very greatly 
increased. A glass of cold water slowly sipped will produce greater 
acceleration of the pulse for a time than a glass of wine or spirits taken 
at a draught. Sipping cold water has been recommended to allay the 
craving for alcohol in drunkards endeavoring to reform, and probably its 

1 Frangois Franck, Marey's Travaux, 1876, p. 354. 
12 



178 PHARMACOLOGY AND THERAPEUTICS. 

use is owing to this stimulant action on the heart. It is sometimes said 
that a single glass of ale sucked through a straw will intoxicate a man, 
although three times the quantity would not do so if taken in large 
draughts. If this be true, the more rapid intoxication caused by suck- 
ing is probably due to the conjoined effects of the alcohol and of tempo- 
rary paralysis of the vagus caused by the suction. 

One of the most typical stimulants is alcohol. In small quantities 
it increases the arterial tension by locally stimulating, first the sensory 
nerves of the mouth, and afterwards those of the stomach, and thus 
causing reflex contraction of the vessels, and reflex acceleration of the 
beats of the heart. This effect occurs before its absorption, and is best 
marked when the alcohol is strong, and is but slightly marked when it is 
diluted. It is possible that by inducing local dilatation of the cerebral 
arteries while the heart still continues active, it may have a stimulant 
action on the cerebral functions, besides that which it induces by merely 
exciting the circulation generally. 

Any stimulant action on the brain beyond what may be explained in 
this way is very slight, if indeed it exist at all. Its further actions are 
those of paralysis exerted on the nerve centres in the order of their de- 
velopment, the higher centres being paralyzed first. 

At or about this point its stimulating action ceases and its narcotic 
action commences. Its exhilarating 1 effect, however, may be most 
marked just at this point, because it is just here, while the circula- 
tion of the brain remains increased, the restraining or inhibitory 
parts of it begin to be paralyzed. Thus, imagination and emotion are 
more readily excited and expression is free and unrestrained ; external 
circumstances are less attended to, and a boyish or childish hilarity occurs. 

It is probable that some substances, such as strychnine, increase the 
mental powers by a direct action on the brain tissue itself, and possibly 
caffeine may do so also. 

Drugs which lessen the Functional Activity of the Brain. 

These drugs are soporifics or hypnotics ; narcotics ; anodynes or 
analgesics; and anaesthetics. 

Most of the substances belonging to those classes have a certain re- 
semblance to one another in their action. Most of them stimulate the 
mental functions when given in very small doses. In larger doses they 
have also a stimulating action at first, i. e., while only a small quantity 
has beeD absorbed, but later on they diminish or abolish the mental facul- 
ties. The same drug, as, for example, opium or alcohol, in different doses 
may thus ad as a stimulant, narcotic, soporific, and anaesthetic. 

In a certain stage of their action opium and alcohol do not merely 
Lessen the functional activity of the brain, but they disturb the normal 
relations of one part to another, so as to produce disorder of the mental 
functions. Bromide of potassium, on the other hand, appears simply to 
lessen the functional activity of the brain without disturbing the relation 
of one part to another. Wo do not know what the cause of this differ- 
ence in their action is, bul with some degree of probability we may 

jider thai Buch substances as bromide of potassium, or the normal 



ACTION OF DRUGS ON THE BRAIN. 179 

products of tissue-waste, such as lactic acid, simply diminish the functional 
activity of the nerve- cells without disturbing the nervous paths by which 
they communicate with one another, so that we have merely a general and 
even diminution of the mental faculties, as in natural sleep. Such sub- 
stances as alcohol, on the other hand, may be supposed not only to diminish 
the functional activity of the cells, but to disturb the rate at which the 
impulses pass from one cell to another, or to alter the direction in which 
these impulses are sent, so that instead of the mental activity being les- 
sened in degree but natural in kind, as after the administration of bro- 
mide of potassium, we have a disturbance of the functions resembling 
that which we find in delirium or madness. 

Hypnotics or Soporifics. 

These are remedies which induce sleep. Although many of them 
are also narcotic, yet we may distinguish between hypnotics and narcotics. 
Pure hypnotics are substances which in the doses necessary to produce 
sleep do not disturb the normal relationship of the mental faculties to the 
external world. 

In sleep the cerebro-spinal system, with the exception of the medulla 
oblongata, is to a great extent functionally inactive, and even the respir- 
atory centre and the vaso-motor centre in the medulla, undergo a diminu- 
tion in their functional activity, so that the respiration becomes slower, 
the vessels of the surface dilate, and the arterial tension falls. 

Certain parts of the nervous system may still remain functionally 
active, so that, for example, when the nose is tickled with a hair, reflex 
movements of the face or hand may occur without awaking the sleeper ; 
and certain parts of the brain may also be active, so that dreams occur, 
which may be afterwards remembered as distinctly as real occurrences, or 
may produce at the time various movements of the body. 

But while individual parts may be active, the whole cerebro- 
spinal system is not active together, and thus any co-ordination 
which may occur between either sensations or motions is incomplete ; the 
dreams are incoherent and the motions do not affect the whole body, as is 
seen in sleeping dogs, where the legs make a movement of running, but 
the animal continues to lie on its side. The functional inactivity of the 
whole or of the greater part of the cerebro-spinal system is associated 
with a condition of anaemia, and probably depends to a certain extent 
upon it. At the same time it is probable that sleep depends also on func- 
tional inactivity of the cerebral cells due to accumulation of the products 
of tissue waste in or around them. 

The arteries of the brain during sleep are contracted, the brain is 
anaemic, and its bulk is small. On awaking, the arteries become dilated, 
the circulation becomes rapid, and the brain increases in bulk. Where 
parts of the brain are active, as in dreaming, increased circulation occurs, 
but probably this is local and not general. 

In considering the circulation of the brain, however, a marked 
distinction must be drawn between the condition of the arteries and veins. 
So long as the blood is in the arteries it is available for the nutrition of 
the nervous structures, but once it is in the veins, it is no longer available, 



180 PHARMACOLOGY AND THERAPEUTICS. 

and its accumulation there will tend to impair nutrition, both by the 
pressure it exerts on the nervous structures, and by its interference with 
the supply of arterial blood. 

In normal sleep the arteries and veins are both contracted, and the 
brain appears anaemic. In the very act of waking the brain may slightly 
contract, and this has been thought by Mosso, to whom we owe the ob- 
servation, to show that sleep does not depend upon anaemia of the brain ; 
but this contraction may be due to the removal of venous blood, prepara- 
tory to further arterial supply. 

Observations on the brain by trephining appear to show that during 
ordinary sleep, whether it has come on naturally, or has been induced by 
narcotics, such as a small dose of opium, the brain is anaemic. During 
functional activity, either of the whole or of its parts, there is arterial dil- 
atation, with a free supply of blood. During coma the veins become 
dilated and the brain congested. 1 This congestion, however, is utterly 
different from the arterial congestion of functional activity, for in coma 
the blood, though abundant in quantity, is stagnating in the veins, and 
useless for the tissues. 

In order to produce sleep, then, two things are necessary : — 

1st. To lessen the circulation in the brain as much as possible by 
diverting blood from it or quieting cardiac action. 
2d. To lessen the functional activity of the organ. 

Blood may be diverted from the brain by dilating the vessels else, 
where. In weak conditions of the body, with feeble vascular tone, this 
may occur simply from -position, and such persons become drowsy when 
standing or Avalking about, or when sitting. As soon as they lie down, 
however, the cerebral vessels also having little or no tone, the blood floods 
the brain, and they are unable to sleep. In such persons, sleep may be 
sometimes obtained by raising the head with high pillows. In such cases, 
also, vascular tonics, such as digitalis, by increasing the contractile 
power of the arteries leading to the brain, may enable them to resist the 
increased pressure in the recumbent position and thus prevent the brain 
being Hooded with blood and allow sleep to be obtained. 

The largest vascular area into which the blood may be drawn away 
from the brain is that of the intestinal canal. When the vessels in the 
intestine are contracted, it is almost impossible to obtain sleep. Conse- 
quently both man and animals, when exposed to cold which, acting through 
the thin abdominal walls, would cause contraction of the intestinal vessels 
and drive the blood to the brain, instinctively keep the intestines warm 
bv curling themselves up before going to sleep, and thus covering the 
abdomen with the thick muscles of the thighs. 

Warmth to the abdomen also by means of a large poultice outside, 
will tend to produce Bleep; or, in place of a poultice, a wet compress, 
consisting of linen or flannel wrung out of cold water, and covered with 
oil-silk, and with two thicknesses of dry flannel placed above it, tends 
greatly to in. luce sleep and is most useful for this purpose, especially in 
children. 



Hammond, On Wakefulness, 18(50, ]). 20. 



ACTION OF DRUGS ON THE BRAIN. 181 

Warmth to the interior of the stomach has a somewhat similar action, 
but it differs from warmth to the exterior in this, that it may, to a certain 
extent, stimulate the heart as well as dilate the abdominal vessels. Stim- 
ulation of the heart is of course objectionable, as it tends to maintain the 
activity of the brain. 

On this account the food or drink should be tolerably warm, but not 
very hot. Warm milk, either alone, or with bread soaked in it, warm 
gruel, thin corn-flour, or ground rice, sago, or tapioca, warm beef-tea or 
soup, or a glass of hot wine and water or spirits and water at bed time, 
may all act as soporifics by withdrawing the blood from the brain to the 
stomach. In the sleeplessness of fever a wet pack, by restraining the 
movements and by diverting blood from the brain to the body generally, 
is often an efficient soporific. 

Cold feet also tend to keep up the tension in the vessels and prevent 
sleep, and therefore they ought to be warmed either by the use of an 
india-rubber bag filled with hot water, and covered with flannel, or by 
rubbing them briskly in cold water and drying them thoroughly before 
going to bed, or by both means combined. 

Cardiac excitement may be lessened by sedatives, one of the most 
useful of which is cold. After hours of weary tossing, sleep may some- 
times be induced by walking about in a night-dress until cool, or by 
sponging the surface either with cold or hot water. 

The chief hypnotics or soporifics are — 

Opium. Bromide of potassium. 

Morphine. Bromide of sodium. 

Chloral-hydrate. Bromide of calcium. 

Butyl-chloral-hydrate (croton- Bromide of zinc. 

chloral). Monobromo-camphor. 

Hyoscyamus. Hop. 

Cannabis. Lettuce. 

Paraldehyde. Lactic acid. 

The most powerful hypnotics that we possess are undoubtedly 
opium and morphia, and they seem to act by depressing the functional 
activity of the brain itself, although along with this depression an 
anaemic condition of the organ sets in. Besides their action in pro- 
ducing sleep, even in health opium and morphine have the power of 
lessening pain and thus removing the effect which painful stimuli have 
in maintaining a wakeful condition. Bromide of potassium and bromide 
of ammonium in large doses have also a hypnotic action, and even in 
smaller doses, when they would not of themselves produce sleep, they 
appear to lessen cerebral excitement and allow sleep to come on when 
other conditions are favorable. Chloral probably causes sleep both by 
acting on the brain itself and by causing dilatation of the vessels gene- 
rally. It is therefore a useful hypnotic in persons suffering from 
Bright' s disease, in which there is high tension of the vessels and con- 
sequently a tendency to sleeplessness. 

A combination of hypnotics sometimes answers much better than 
any one singly. Thus morphine or opium alone sometimes simply cause 



182 PHARMACOLOGY AKD THERAPEUTICS. 

excitement, but when chloral is given, either along with, or after them, 
the excitement is quieted and sleep occurs. 

A combination also of small quantities, such as five or ten minims, 
of solution of opium or morphine with five grains of chloral and ten to 
thirty of bromide of potassium, is sometimes more useful than any one 
of the three used alone. 

Indian hemp also is sometimes used to procure sleep, and lettuce and 
lactucarium are also said to have a hypnotic action. Lettuce certainly 
does seem to have such an action, but how much of it depends upon the 
juice and how much upon the mechanical effect of the indigestible fibres 
of the lettuce upon the stomach in drawing blood to it, it would be hard 
to say. Hops are said to be hypnotic, and their combination with lettuce 
in the form of a supper consisting chiefly of beer and salad has some- 
times a very marked soporific action. 

Narcotics. 

Narcotics are substances which lessen our relationships with the 
external world. They are closely related, as I have already stated, to 
stimulants ; and alcohol, in the various stages of its action, affords us a 
good example of both stimulant and narcotic action. Alcohol at first 
excites the cerebral circulation and then begins to paralyze various parts 
of the brain in the inverse order of their development. 

But this order differs in different individuals, for in watching the 
growth of children we find that the order of development of the nerve 
centres in them is not always the same ; some talking before they can 
walk, and others walking before they can talk. In all, however, the 
powers of judgment and self-restraint are among the last to be com- 
pletely developed. 

While the circulation of the brain is still active, the restraining or 
depressing effect of present external circumstances, and the restraining 
effect of training, during previous life, which is stored up as it were in 
the inhibitory centres, are lessened. The fancy is thus allowed free play 
and a condition of joyousness and volubility like that of a child occurs. 
The imagination and memory fail next in some, while the emotions become 
prominent, and to this follows paralysis or paresis of the power of co-ordi- 
nation. In others the power of co-ordination is impaired before the 
mental faculties are much affected, the speech becomes thick and the 
walk in-- becomes staggering and uncertain. At this stage reflex action 
Mill persists, hut afterwards it diminishes, and finally paralysis of the 
respiratory centre occurs. The effect of other drugs, such as ether and 
chloroform, is much the same as that of alcohol. 

In tie- case of opium and Indian hemp, however, there is but little 
excitement of the circulation, and their effects appear to be due more to 
alterations in the relative functions of the different parts of the brain. 

Belladonna, hyoscyamus, stramonium, and their allies, have a curious 
effect They produce delirium of an active character, the patient 
having a constant desire to speak, move about, or be doing something, 
while at the same time he feels great languor. It is probable that this 
effed is due to the combined stimulant action of these drugs on the 



ACTION" OF DRUGS ON THE BRAIN. 183 

nerve centres in the brain and spinal cord and their paralyzing action 
on the peripheral ends of motor nerves. 

Anodynes or Analgesics. 

Anodynes are remedies which relieve pain by lessening the ex- 
citability of nerves or of nerve centres. They are divided into local or 
general : — 

Local Anodynes. General Anodynes. 

Cold — Anaesthetics in small doses. 

Cold water. Atropine. 

Ice bags. Belladonna. 

Warmth — Butyl chloral. 

Poultices. Chloral. 

Fomentations. Conium. 

Aconite. Conine. 

Acupuncture. Gelsemium. 

Atropine. Hyoscyamus. 

Belladonna. Hyoscyamine. 

Blood letting — Lupulus. 

Leeches. Lupuline. 

Cupping. Morphine. 

Carbolic acid. Opium. 

Carbonic acid. Stramonium. 
Creasote. 
Conium. 
Gelsemium. 
Hydrocyanic acid. 
Morphine. 
Opium. 

Action. — The sensation of pain is due to a change in some part of 
the cerebrum, and is usually excited by injury to some part of the body. 

According to Ferrier the hippocampal region is the seat of sensation. 
Pain may be of central origin, for if these convolutions should from any 
cause undergo changes similar to what usually take place in them on the 
application of a painful stimulus to a nerve, pain will be felt, even 
although no injury whatever has been done to the body. Something of 
this sort appears to occur in certain cases of hysteria. 

Conversely, if the changes which ordinarily occur in these convolu- 
tions on severe irritation of a sensory nerve are prevented from taking 
place, pain will not be felt, however great the stimulus to the nerve 
may be. 

The sensory nerves of the head pass directly to the brain, but all 
other sensory nerves have to pass for a greater or less distance along the 
spinal cord before they reach the brain. 

The transmission of painful impressions along the spinal cord occurs 
in the grey matter, and the effect of anaesthetics in preventing the trans- 
mission of painful impressions while tactile stimuli are still conducted has 
been already discussed. 



184 PHARMACOLOGY AXD THERAPEUTICS. 

Pain may be occasioned by irritation applied to nerves anywhere be- 
tween the brain and the periphery ; and whatever its point of application 
may be, it is usually referred to the peripheral distribution of the 
nerve. Sometimes irritation of a nerve, instead of being referred by the 
brain to the proper spot, is referred to a branch of the same nerve going 
to a different point. 

Pain maybe caused by violent stimulation of the peripheral distri- 
bution of a nerve, of its trunk, of the spinal cord through which the 
fibres pass to the brain, or of the encephalic centres themselves. 

Pain may be relieved by (a) removing the source of irritation, (b) 
by preventing the irritation from affecting the cerebrum. Thus, if necrosis 
of the jaw should give rise to intense pain, the pain will at once cease on 
dividing the sensory nerve by which the impulses are transmitted to the 
brain. It may be relieved, also, while the source of irritation still remains 
by lessening the excitability of the peripheral terminations of the sensory 
nerves which receive the painful impression ; or of the nerve trunks ; or 
of the spinal cord along which the impression travels ; or of the cerebral 
centres in which it is perceived. 

Opium probably acts on them all, diminishing the excitability of the 
cerebral centre, of the spinal cord, and of the sensory nerves ; and bro- 
mide of potassium is also supposed to affect all these structures, though 
to a much less degree than opium. 

Chloral, butyl-chloral, lupulin, gelsemium, and cannabis indica proba- 
bly act on the cerebral centres. 

Belladonna and atropine lessen the excitability of the sensory nerves, 
and probably this is effected also by hyoscyamus, stramonium, aconite, 
aconitia, and veratrine. 

Uses. — It is evident that if the nerve centre by which pain is per- 
ceived is deadened, the pain will cease wherever its seat may be ; and, 
therefore, opium and morphia are used to relieve pain, whatever may be 

cause. Cannabis indica and bromide of potassium, having likewise a 
central action, may also be employed, but they are very much less efficient 
than opium. Chloral and butyl-chloral have an anaesthetic action when 
given in very large doses, but in moderate doses their power to relieve 
pain is not so marked as their hypnotic action. Butyl- chloral, however, 
seems to have a special sedative action on the fifth nerve, and sohasgel- 
Beminm ; consequently both of them are used in the treatment of facial 
neuralgia. 

As belladonna, aconite, and veratrine have a local action on the peri- 
pheral ends of the sensory nerves, they are usually applied directly to 
the painful purl in the form of ointment, liniment, or plaster. Local 
injections of morphine, atropine, and ether, in the neighborhood of the 
painful part, are often of the greatest service. 

Adjuncts <<» Anodynes. — As pain depends on the condition of 
the cerebral centre by which it is perceived as well as on irritation of 
nerves, it is obvious that it may vary with the condition of these 
centres, although the irritation remains. Thus a decayed tooth does not 
alwayi cause toothache, and when the toothache comes on, it. may fre- 
quently be removed bv means of a brisk purgative, even although the 
be not extracted. It is possible that the purgative may act partly 



ACTION OF DEUGS ON THE BKAIN. 185 

by lessening congestion around the tooth, but partly also by altering the 
condition of the cerebral centres. When the attention is fixed upon 
other things, also, the pain may be to a great extent, or even completely, 
abolished, as in mesmerism or hypnotism. The sensory stimuli, also, 
which would usually produce pain, may be diverted voluntarily or involun- 
tarily into motor channels. Thus, during the heat of action, the pain of 
a wound is not felt ; and the pain felt during the extraction of a tooth is 
lessened by the employment of violent muscular effort, as in grasping 
the arms of the dentist's chair. Other most powerful adjuncts are 
electricity applied along the course of the nerves, and counter- 
irritation, especially by means of the actual cautery to the painful 
part, and, when other means fail, stretching the nerve may succeed. 

Cold, also, applied to the surface over a painful part, will relieve pain, 
and so may dry heat, applied by a sand-bag or hot cloth, or moist heat 
in the form of a poultice: for the mode of action of these vide "Action 
or Irritants." 

Pain has been ascribed by Mortimer Granville to vibrations of 
nerves or of the sheaths ; and, in order to lessen it, he proposes to pro- 
duce vibrations of a different nature : this he does by percussing over 
the painful nerve with a small hammer, worked either with clockwork or 
electricity. For a dull heavy pain he uses quick and short vibrations of 
the hammer, and for a sharp lancinating pain he uses large and slow 
vibrations. 

Anaesthetics. 

Anaesthetics are remedies which destroy sensation. 

It has already been mentioned that both sensation and pain require 
for their perception a certain condition of the cerebral centres and of the 
sensory nerves and spinal cord by which impressions are conveyed to 
these centres. 

The difference between anaesthetics and anodynes is to a great extent 
one of degree. Anodynes affect more particularly the cerebral centres 
by which pain is perceived, or the conducting paths by which painful 
impressions are transmitted, and thus in moderate doses lessen pain with- 
out destroying reflex action. They only affect the ordinary centres for 
reflex action when the dose is considerably increased. Anaesthetics, on 
the other hand, affect the cerebral and spinal centres more equally, and 
so abolish pain, ordinary sensation, and reflex excitability more nearly at 
the same time, though their abolition is by no means completely simul- 
taneous. 

According to Eulenberg, in chloroform narcosis the patellar reflex is 
abolished first, then reflex from the skin, then from the conjunctivae, and 
lastly from the nose. As the anaesthesia passes off they return in the 
inverse order, patellar reflex being the last to reappear. A stage of ex- 
citement generally precedes the disappearance of patellar reflex, both in 
man and animals. 

Narcosis by ether differs from that of chloroform in the much greater 
increase of patellar and other tendon reflexes, both in extent and dura- 
tion. 



186 PHARMACOLOGY AND THERAPEUTICS. 

Chloral hydrate and potassium bromide have an action like chloro- 
form, but much weaker. Like chloroform, they paralyze patellar reflex 
before corneal reflex, but butyl-chloral (croton-chloral) paralyzes the 
corneal reflex before the patellar. 

In ordinary sleep, reflexes disappear in the same order as in chloro- 
form narcosis, but in mesmeric sleep the reflexes are increased as in 
narcosis from ether. In hysterical conditions diminution of the cerebral 
reflexes from nose and cornea with persistence of patellar reflexes has 
been observed. 

The reflex power of the vaso-motor centre is very quickly paralyzed 
by chloroform, so that irritation of a sensory nerve will no longer raise 
the blood-pressure. Its reflex power is much less affected by ether. 1 

Anesthetics may be divided into local and general. The local 
are those which abolish the sensibility of the peripheral nerves of a par- 
ticular area. The general are those which act on the central nervous 
system in the way already described, and abolish sensation throughout 
the whole body. 

The chief local anaesthetics are cold and carbolic acid. Iodoform 
is also employed as a local anaesthetic. 

For the purpose of producing local anaesthesia, cold is generally 
applied by means of ether spray, until the part is all but frozen and is 
insensible, when slight operations may be made without the patient feel- 
ing any pain. The ether may perhaps have itself a certain amount of 
physiological effect in diminishing sensibility when applied in this manner. 
Carbolic acid painted over the surface also causes it to become white and 
to lose its sensibility, and may thus be used to lessen the pain of opening 
an abc 

General anaesthetics are — 

Nitrous oxide. Trichlorhydrin. 

Ether. Bi-chloride of methylene. 

Chloroform. Paraldehyde. 

Bromoform. Bi-chloride of ethidene. 

Tetrachloride of carbon. Bromide of ethyl. 

With the exception of nitrous oxide they all belong to the class of 
alcohols and ethers, and the substitution-compounds having an anaesthetic 
action arc probably almost indefinite in number. Even alcohol itself 
produces general anaesthesia when volatilized and inhaled. 

General anaesthetics may destroy the sensibility of the nerve 
(•••ntre- indirectly or directly. Anaesthesia is induced indirectly by 
Btopping the circulation in the brain, and thus arresting the process of 
oxidation and tissue change in the nerve cells which are necessary for 
their functional activity. 

This result may be produced by draining the blood from the head into 
other parte of the body. Thus in some of the hospitals at Paris, before 
anaesthetics were introduced, a plan was sometimes employed of rendering 



If I'. Bowdltch and C. B. Mi not, Boston Med. and Surg. Journ., May 21, 1874. 



ACTION OF DRUGS ON THE BRAIN. 187 

a patient insensible before an operation, by laying him flat on the 
ground, and then lifting him very suddenly to a standing posture by the 
united efforts of six or eight men. 

Local arrests of the circulation to the brain by ligature or by com- 
pression of the arteries has a similar effect. Waller has recommended 
diminution of the cerebral circulation, by the combined effects of simul- 
taneous pressure on the carotid arteries and vagi nerves, as an easy 
means of producing anesthesia for short operations. 

Slight anaesthesia, usually accompanied by some giddiness, may be 
produced by taking a number of deep breaths in rapid succession. This 
may be used in order to lessen the irritability of the pharynx in laryn- 
goscopy examinations, and to lessen the pain of opening boils or 
abscesses. The anesthesia thus produced may perhaps depend on 
anemia of the brain, although this is not certain. 

Anesthesia may also be produced by diminishing the internal 
respiration of the nerve cells through a gradually increasing venous 
condition of the blood. Thus gradual suffocation by charcoal fumes or 
carbon monoxide causes complete insensibility, and the inhalation of 
nitrogen and of nitrous oxide has a similar action. 

Anesthesia may be caused by the direct action of drugs on the 
nerve cells themselves. Chloroform, ether, and other allied substances 
belonging to the alcohol series appear to act in this way. Although 
their action is generally exerted through the blood by which they are 
conveyed to the brain when inhaled, yet they will also produce a similar 
action if locally applied to the nerve centres. Thus Prevost 1 found that 
chloroform applied directly to the brain of a frog narcotizes it when the 
aorta is tied. When the aorta is again unligatured, so that the current 
of blood can again wash the chloroform away, the narcosis disappears. 
Chloroform and ether when inhaled appear to act like alcohol, producing 
paralysis of the nerve centres, commencing with the highest and pro- 
ceeding downwards. The rate of paralysis, though the same in order, is 
more rapid than that caused by alcohol. 

These anesthetics are, however, not nerve poisons only, they are 
protoplasmic poisons affecting simple organisms, such as amoebe 
and leucocytes, and destroying also the irritability of muscular fibre. 
Their action upon muscular fibre is much more marked in lower than in 
higher animals, although it exists in both. In leeches they appear to 
destroy muscular irritability, and to coagulate the muscles, rendering 
them rigid before they affect the nervous system. This has been shown 
by some experiments of Krukenberg, in which he applied two ligatures 
to a leech, so as to divide it into three parts. The middle part, being 
immersed in a mixture of water with ether or chloroform, became per- 
fectly rigid, and its muscular fibres no longer contracted when stimu- 
lated electrically. The conducting power of the nerves in this part 
appeared, however, unimpaired, so that the two ends of the leech acted 
co-ordinately. When the middle part of a leech similarly ligatured, was 
rendered rigid by hot water, both muscles and nerves were destroyed, 



1 Prevost, Practitioner, July, 1881. 



188 PHARMACOLOGY AND THERAPEUTICS. 

and the two ends of the leech then acted independently of each other, 
and not in accordance with one another, as they did when chloroform was 
used. 

This action of chloroform and ether upon muscular fibre is one of 
considerable importance in reference to the occasional stoppage of the 
heart and consequent death during the administration of anaesthetics. 

The action of anaesthetics may be divided into four stages : — 

1st. The stimulant stage. 

2d. The narcotic and anodyne stage. 

3d. Anaesthetic stage. 

4th. Paralytic stage. 

Stimulant stage. — Chloroform and ether, as already mentioned, 
resemble alcohol in their actions, and like it in small doses will produce a 
condition of stimulation and acceleration of the circulation passing gradu- 
ally into one of narcosis, in which the action of the higher nervous centre 
is more or less abolished, while that of the lower centres still remains. 

In small quantities chloroform and ether are sometimes taken, 
either internally or by inhalation, for their stimulant effect. They are 
useful in lessening pain and spasm, as in neuralgia, and biliary, renal, or 
intestinal colic, when given till the stimulant is just passing into the nar- 
cotic stage. 

Narcotic stage. — When pushed still further, sensibility becomes 
more impaired, reflex action still continues, and sometimes, just as in 
drunkenness, there is a form of wild delirium and great excitement. 
This is much less marked in feeble or debilitated persons than in strong 
men. In the latter the struggles which occur in this condition are some- 
times exceedingly violent, the patient raising himself forcibly from the 
couch, and his muscles being in a state of violent contraction, the face 
livid, the veins turgid, and eyeballs protruding. Usually this condition 
quickly subsides and passes into the third stage — that of complete 
anaesthesia. 

In order to lessen the pains of labor, anesthesia is usually carried to 
the commencement of the second stage. 

Anaesthetic stage. — The third stage differs from the second, in 
the functions of the spinal cord being abolished, as well as those of the 
brain; ordinary reflex is consequently abolished, and the most common 
way of ascertaining whether this stage has set in or not is by drawing up 
the eyelid and touching the conjunctiva. If no reflex contraction of the 
eyelid occurs, the anaesthesia is complete. By careful and judicious 
administration pf the anaesthetic, this condition may be kept up for a 
length of time, even for hours, or days; but if the inhalation be carried 

far, the anaesthetic passes into the fourth stage. 

The third stage is the one employed for surgical operations. 

Paralytic Stage. — In the fourth the respiratory centre becomes 
paralyzed, respiration ceases, and the beats of the heart become feebler 
and ' je altogether. 



ACTION OF DRUGS ON THE BRAIN. 189 

Uses of Anaesthetics. 

Anaesthetics are used not only to lessen pain but to relax muscular 
action. They are chiefly employed to lessen pain in surgical operations, 
in labor, and in biliary and renal colic. They are used to lessen mus- 
cular action and spasm in tetanus, in poisoning by strychnine, in hydro- 
phobia, and in the reduction of dislocations, fractures, and hernia. They 
are also of assistance in diagnosis, by allowing careful examination to 
be made of parts which are too tender or painful to be examined without 
it, and by causing the phantom tumors due to spasmodic contraction of 
the muscles to disappear. 

Dangers of Anaesthetics.— (1) One danger is that just men- 
tioned of paralysis of the respiration from an overdose. This, 
however, is one of the least of the dangers, and if the enfeeblement of 
the respiration be observed in time, it is generally possible to save the 
patient by stopping inhalation, and keeping up artificial respiration for 
a little while if necessary. 

(2) Another danger is from paralysis of the heart by a too con- 
centrated chloroform vapor. This is indicated by a sudden stoppage of 
the heart, paleness of the face, and dilatation of the pupil, while the 
respiration may continue. 

If this accident should occur, the body of the patient should be 
inclined so that the head should be lower than the feet, and artificial 
respiration should be kept up briskly, the expiratory movements being 
made by pressure on the thorax and especially over the cardiac region, 
so that the mechanical pressure should stimulate the heart if possible to 
renewed action. The vapor of nitrite of amyl may also be administered 
by holding a piece of blotting-paper or cloth, on which a few drops have 
been sprinkled, before the nose, while artificial respiration is kept up. 
The inspiratory movements may be made by drawing the arms back- 
wards over the head, as in Sylvester's plan. 

(3) A third danger arises from stoppage of the heart by a combina- 
tion of chloroform narcosis and shock. This is one of the most 
dangerous conditions. It may occur even during full chloroform nar- 
cosis in animals from operations on the stomach; but it is much more 
common in men from imperfect anaesthesia. In very many cases 
of so-called death from chloroform during operations, we find it noted as 
a matter of surprise that death should have occurred, as the quantity of 
chloroform given was so small. The reason that death occurred prob- 
ably was because the quantity of chloroform given was so small. Had 
the patient been completely anaesthetized, the risk would have been very 
much less. The reason why imperfect anaesthesia is so dangerous is, that 
chloroform does not paralyze all the reflexes at the same time. A 
very large proportion of the deaths from chloroform occur during the 
extraction of teeth, and we may take this operation as a typical one in 
regard to the mode of action, both of the sensory irritation and of the 
chloroform. When a tooth is extracted in a waking person, the irrita- 
tion of the sensory nerve produced by the operation has two effects : — 
1st, it may, acting reflexly through the vagus, cause stoppage of the 
heart and a consequent tendency to syncope. 2d, it causes reflex 



190 PHARMACOLOGY AND THERAPEUTICS. 

contraction of the arterioles, which tends to raise the blood-pressure and 
counteract any tendency to syncope which the action of the vagus might 
have produced. 

In complete anesthesia all these reflexes are paralyzed, and thus 
irritation of the sensory nerves by the extraction of the teeth has no 
effect either upon the vagus or upon the arterioles. In imperfect anaes- 
thesia, however, the reflex centre for the arterioles may be paralyzed 
(vide p. 188), while the vagus centre is still unaffected. The irritation 
caused by the extraction of the tooth may then cause stoppage of the 
heart, and there being nothing to counteract the tendency to faint, 
syncope occurs and may prove fatal. 

With nitrous oxide there is very much less danger, inasmuch as the 
nitrous oxide causes a venous condition of the blood, with consequent 
contraction of the arterioles and rise in the blood-pressure, so that any 
tendency to syncope through vagus irritation is efficiently counteracted. 

With ether, also, the danger is very much less, probably because it 
has a more equal effect on the centres (vide p. 188). 

(4) Another danger is that of suffocation from blood passing into 
the trachea in operations about the mouth or nose, or from the contents 
of the stomach being drawn into the larynx when vomiting has occurred 
during partial anaesthesia. In consequence of this, it is better, instead 
of giving chloroform or ether during the whole of an operation on the 
mouth or nose, to give it only at the commencement, and to administer 
along with it, or before it, a hypodermic injection of one-sixth to one- 
third of a grain of morphine. The chloroform anaesthesia thus passes 
into the morphine narcosis, and the operation can be finished without 
pain and without danger. 

To prevent the occurrence of vomiting, it is advisable not to give 
solid food for some hours before an operation, though if necessary a little 
beef-tea or stimulant may be given half an hour or so before the 
administration of the anaesthetic. 

Mode of Administering' Anaesthetics. — In order to obtain 
the <ii 'Si stages of the action of anaesthetics, as in cases of intestinal, 
biliary, or renal colic, intense neuralgia, or parturition, the best means of 
administration consists of a tumbler, at the bottom of which is placed a 
piece of blotting-paper .or linen thoroughly wetted with chloroform or 
ether. The patient holds the tumbler to the nose with his, or her, own 
hand. On account of the form of the tumbler, sufficient air always gets 
in at the sides, and the patient cannot inhale the vapor in too concen- 
trated a condition. As soon as the anaesthetic begins to take effect, the 
hand drops, and the inhalation ceases. As the effect again passes off, 
the patient resumes the inhalation. In employing anaesthetics in this 
way. however, great care must be taken that the bottle containing the 
chloroform is never entrusted to the patient, but is always kept on a table 
;it some little distance from the bed, and that the blotting-paper or lint 
m th.- tumbler is supplied with fresh chloroform by an attendant. If the 
bottle itself be entrusted to the patient, as the anaesthetic takes effect and 
produces Btupidity, the stopper may fall out, the whole contents of the 
bottle may be Bucked up bythe pillow, bolster, bed, or bedclothes, and the 
rapor being inhaled, fatal suffocation may ensue. 



ACTION OF DRUGS ON THE BRAIN. 191 

Another method of administering chloroform, which is very convenient 
when complete anaesthesia is required for a length of time, and when the 
supply of chloroform is limited, was devised by Sir James Simpson : it 
consists of either a cup-shaped inhaler, consisting of a wire framework 
covered with flannel, or else simply of a single fold of a pocket-hand- 
kerchief thrown over the face : the chloroform is dropped upon the 
flannel or handkerchief just under the nostrils in single drops at a time. 
Another plan is to pour some chloroform on to a folded towel or pocket- 
handkerchief, and then place it over the patient's face, taking care that 
it does not come so close over the nose as to interfere with a free admix- 
ture of air with the chloroform vapor. There is this difference between 
ether and chloroform, that whereas it is highly inadvisable to give chloro- 
form vapor in a concentrated condition, it is requisite to give the ether 
vapor very strong, in order to produce an anaesthetic effect. A combined 
administration of nitrous oxide and ether is" now used to a considerable 
extent : the nitrous oxide producing rapid anaesthesia which is kept up 
by the ether. 

Anaesthesia in Animals. 

In the course of many investigations into the action of drugs on 
animals it is necessary to perform experiments which would be painful 
unless the animals were anaesthetized. The easiest way of doing this 
with frogs or small animals, such as mice, rats, or rabbits, is to put them 
under a bell-jar with an opening at the top. Into this opening a piece 
of cotton-wool or blotting-paper is put, and chloroform dropped on it. 
The vapor being heavier than air falls to the bottom, and the animal 
soon becomes insensible. The best way of anaesthetizing cats, small dogs, 
or very large rabbits, is to put them into a wooden box or tin pail, and 
stretch a towel tightly over the top. An assistant then pours some chlo- 
roform on the towel and anaesthesia is quickly produced. Rats are most 
readily anaesthetized by completely covering the cage in which they are 
with a towel, and dropping chloroform upon it. 

For very large or savage dogs an old packing-case without a lid may 
be simply placed over the animal and held firmly down, or one of the 
sides may be furnished with hinges so as to convert the case into a sort 




Fig. 48.— Diagram of a stopcock by which air or vapor, or two kinds of gas, may be given alone, or 
mixed together in any proportion. 

of kennel. After the dog is safely housed large pieces of blotting-paper 
or of cloth on which chloroform is poured are pushed through cracks in 
the top of the case or holes specially made for the purpose. The outer 
ends of the blotting-paper or cloth remaining outside, fresh quantities of 
chloroform can be introduced as required until complete anaesthesia is 



192 PHARMACOLOGY AND THERAPEUTICS. 

produced. Anesthesia may be maintained for almost any length of time 
that is required by putting a piece of cloth loosely round the animal's 
nose and dropping chloroform upon it. This requires careful attention, 
however, in order to prevent danger from an overdose on the one hand, 
or partial recovery on the other. I find the most convenient way of 
maintaining the anaesthesia induced by chloroform in the way already 
mentioned is to put a cannula in the trachea and connect it with a flask 
containing ether, so that the inspired air passes over the surface of the 
ether, and carries a quantity of the vapor with it into the lungs of the 
animal. By means of a peculiar stopcock, the construction of which is 
indicated in the diagram (Fig. 48), pure air or air loaded with ether vapor 
or a mixture of both may be given. 

The advantages of employing this method and of using ether rather 
than chloroform are that complete anaesthesia may be kept up for hours 
together with little or no attention on the part of the operator, and with- 
out the respiration or blood-pressure being seriously affected by the 
anesthetic. 

Another plan of maintaining anaesthesia for a length of time is to in- 
ject some laudanum or liquid extract of opium into a vein after anaesthesia 
has been induced by chloroform. Before the effect of the chloroform has 
passed off, such complete narcosis is produced by the opium that no pro- 
cedure, however painful it might otherwise be, will produce the slightest 
evidence of sensation. When the effect of the anaesthetic or of the opium 
would interfere with the investigation of the action of a drug on the cir- 
culation or reflex action, the animal may be anaesthetized by chloroform, 
and the crura cerebri divided. The channels by which painful impressions 
are conveyed to the brain being thus destroyed no pain can be felt, 
although the reflex action of the cord again returns after the effects of 
the chloroform have passed off. 

History of the Discovery of Anaesthesia. 

This is a subject of considerable interest, and has given rise to much 
discussion. The starting point of the discovery seems to have been Sir 
Humphrey Davy's observations on the properties of nitrous oxide, regard- 
ing which he said, "as nitrous oxide in its extensive operation seems capa- 
ble of destroying physical pain, it may probably be used with advantage 
dining surgical operations." The property of this gas and also of ether 
vapor to produce excitement when inhaled, caused these substances to 
be osed in sport, and during their action bruises were frequently received, 
but Dot felt. This circumstance excited the attention of Dr. Crawford 
\V. Long, of Athens, Georgia, and in 1842, he anaesthetized a patient 
with ether in order to remove a tumor. He was encouraged to do this 
by the feci thai Dr. Wilhite in a frolic had rendered a negro boy com- 
pletely insensible without any bad results. Mr. Horace Wells, without 
knowing whal Dr. Lone had done, used nitrous oxide as an anaesthetic 
in 1844. Bis pupil, Mr. Morton, wishing to use it also, asked him how 
to make it. and WH8 referred to a scientific chemist, Dr. Jackson. Jack- 

advised Morton to use sulphuric ether, as it had similar properties 
to uitroufi oxide and was easier to get. Acting on this suggestion Morton 






ACTION OF DRUGS ON THE BRAIN. 193 

used ether in dentistry, and induced Drs. Warren, Haywood, and Bigelow 
to perform important surgical operations on patients whom he anaesthe- 
tized by it. From this time onwards anaesthesia has been regularly used 
in medical operations. Shortly afterwards, Sir J. Y. Simpson discovered 
the use of chloroform as an anaesthetic, and it has been chiefly employed 
in Great Britain, but in America ether has always retained its original 
place. 

Antispasmodics. 

These are remedies which prevent or relieve spasm. 

Spasm is contraction of voluntary or involuntary muscles, in a way 
that is unnecessary or injurious to the organism generally. The spas- 
modic contraction of muscles may sometimes be excessive in degree, as 
in the calves of the legs in cramp, or in the fibres of the intestinal walls 
in colic. Sometimes they are not excessive in degree, but are merely 
out of place, as, for example, in the slight twitchings of the face or fingers 
which occur in mild cases of chorea. 

Spasm may affect single muscles, or it may affect groups of muscles 
and the nerve centres by which they are set in action ; these centres may 
sometimes be very limited in extent, but sometimes a great number, or 
indeed most of the motor centres in the body, may be involved, as in the 
convulsions of hysteria. Spasm is, indeed, a kind of insubordination in 
which the individual muscles or nerve centres act for themselves without 
reference to those higher centres which ought to co-ordinate their action 
for the general good of the organism. It may be due therefore, either to 
excess of action in the muscles or local centres, or diminished power of 
the higher co-ordinating centres. As a rule it is due to diminished ac- 
tion of the co-ordinating or inhibitory centres, rather than to excess of 
action in the motor centres ; it is, therefore, a disease rather of debility 
and deficient co-ordination than of excessive strength. 

Cramps in the muscles may come on from their exhaustion by exces- 
sive exertion, the waste products of their functional activity appearing to 
act as local irritants. This is relieved by the removal of these waste 
products ; as, for example, by shampooing. In the intestine, cramp may 
be due to the presence of a local irritant, which ought in the normal con- 
dition to produce increased peristalsis, and thus insure the speedy removal 
of the offending substance. From some abnormal condition the muscular 
fibres around the irritant contract excessively, and do not pass on the 
stimulus to those adjoining. From this want of co-ordination painful 
and useless spasm occurs. In order to remove it we apply warmth to 
the abdomen so as to increase the functional activity, both of the muscular 
fibres and of the ganglia of the intestine. Peristalsis then occurring in- 
stead of cramp, the pain disappears, and the offending body is passed 
onwards and removed. Or we give internally aromatic oils, which will 
have a tendency to increase the regular peristalsis ; or yet again, we may 
give opium for the purpose of lessening the sensibility of the irritated 
part, or the nerves connected with it, and thus again bringing it into re- 
lationship with other parts of the body. 
13 



194 PHARMACOLOGY AND THERAPEUTICS. 

General antispasmodics may act either — 

(1) By increasing the power of the higher nervous centres to keep 
the lower ones and the muscles in proper subordination, or — 

(2) By lessening the activity of over-excited muscles or lower nervous 
centres. 

On this account we find stimulants and antispasmodics very much 
classed together. Those drugs which stimulate the circulation and 
increase the nutrition of the higher nerve centres and the co-ordina- 
ting- power, tend to prevent spasm. Thus, small quantities of alcohol 
and ether, by acting in this way, tend to prevent general spasm, as in 
hysteria, nervous agitation, or trembling, or remove local spasm, as in 
colic. 

Valerian, assafcetida, musk, castor, and other aromatic substances, 
have an antispasmodic action which we do not understand. It is pos- 
sible that they affect some part of the brain particularly, so as to increase 
its regulating power. 

Camphor, which is frequently used as an antispasmodic, has a stimu- 
lant action on the brain, spinal cord, circulation, and respiration. It is 
probable that such antispasmodic powers as it possesses are due to its 
exciting the higher centres, and increasing their inhibitory powers over 
the lower. Bromo-camphor has a somewhat similar action. It is possible 
that castor, musk, &c, act in much the same way as camphor. 

Other antispasmodics, such as bromide of potassium, lessen the 
irritability of motor centres. Borneol and menthol have a depressing 
and finally paralyzing effect upon motor, sensory, and reflex centres in 
the brain and spinal cord. In this respect they differ greatly from 
ordinary camphor, which has an exciting action upon these structures, 
though they may perhaps be still more useful as antispasmodics. 

Other antispasmodics, instead of lessening the irritability of nerve 
centres, may paralyze the structures through which the nerves act. 
Thus, nitrite of amyl appears to arrest the spasm of the vessels in 
angina pectoris, by causing paralysis of the vessels themselves or of the 
peripheral ends of the vaso-motor nerves. 

Adjuvants. — As spasm is usually an indication of deficient nervous 
power, tonics, as quinine, iron, cod-liver oil, arsenic, sulphur, cold 
baths, and moderate exercise, are useful as adjuvants. 

It has already been mentioned that a healthy condition of the various 
pints of the body depends on proper nutrition and proper removal of 
waste. Therefore, when there is a tendency to spasm, the diet should 
be plain, but nutritious. Those conditions which tend to cause excessive 
waste Bhould be avoided, such as exciting emotions, excessive bodily or 
mental work, a close atmosphere, and late hours. Attention must be 
paid also to the proper removal of all waste by the use of purgatives, 
cholagOgu< \s. or diuretics if necessary. 

Grreal irritability of the nervous system is usually observed in gouty 
subjects before ai) attack of gout comes on. It is uncertain to what this 
irritability is due but it may not improbably be caused by the retention 
within the body of products of tissue-waste. Some years ago there was 
considerable discussion regarding the active ingredient of bromide of 
potassium, some attributing it- antispasmodic action to the bromine, and 



ACTION OF DRUGS ON THE BRAIN. 195 

others to the potassium. It occurred to me that possibly its action 
might be partly due simply to its action as a saline leading the patient 
to drink more water, and thus assisting the elimination of the products 
of tissue-waste. I accordingly tried 30-grain doses of chloride of sodium 
in cases of epilepsy. In some it did little or no good, but in a few it 
appeared to have nearly as powerful an action as bromide of potassium. 

Uses. — Antispasmodics are used in convulsive diseases. 

The drugs employed in hysteria are : — 

Assafcetida. Valerian. Alkaline bromides. 

Galbanum. Musk. Sumbul. 

Ammoniacum. Castor. 

In epilepsy, laryngismus, and infantile convulsions, bromides of 
potassium, sodium, ammonium and calcium, nitrite of soda, salts of 
silver, zinc, and copper. 

In chorea, arsenic, conium, copper, zinc. 

In spasmodic asthma, lobelia, stramonium. 

In spasm of the blood-vessels, nitrite of amyl, and other nitrites. 

Action of Drugs on the Cerebellum. 

The chief function of the cerebellum appears to be the maintenance 
of equilibrium. Symmetrical lesions on both sides of the organ or 
division of it down the centre from before backwards, cause very little 
disturbance of the equilibrium, but when a lesion is unsymmetrical the 
equilibrium is disordered. 

According to Ferrier, if the lesion affects the whole of a lateral lobe, 
there is a tendency for the animal to roll over towards the affected side. 
In an animal standing on all fours or lying on the ground, we regard 
the centre of the back as the point of movement, but in a man standing 
upright we usually take the face, and therefore what we should regard 
in an animal as rolling towards the affected side, would be equivalent in 
man to a rotation towards the sound side. If the lesion is limited to one 
part of the lateral lobe, it may not cause rotation, but only falling 
towards the opposite side. When the anterior part of the middle lobe of 
the cerebellum is injured, the animal tends to fall forward, and in walk- 
ing usually stumbles, or falls on its face. When the posterior part of 
the middle lobe of the cerebellum is injured, the head is drawn back- 
wards and there is a continual tendency to fall backwards when moving. 1 

Injuries of the cerebellum are frequently associated with a certain 
amount of nystagmus, and in all probability the complete or partial ina- 
bility to walk or stand which alcohol produces, is due to its action on the 
cerebellum. 

Different kinds of spirit appeared to have a tendency to affect different 
parts of the cerebellum, for good wine or beer is said to make a man fall on 
his side, whisky, and especially Irish whisky, on his face, and cider or perry 

1 Ferrier, Functions of the Brain, p. 94. 



196 PHABMACOLOGY AND THERAPEUTICS. 

on his back. 1 These disturbances of the equilibrium correspond exactly with 
those caused by injury to the lateral lobes, and to the anterior and posterior 
part of the middle lobe of the cerebellum respectively. Apomorphia in 
large doses appears also to have an action on the cerebellum or corpora 
quadrigemina, as the animal poisoned by it does not vomit, but moves 
round and round in a circle. 

The action of alcohol on frogs is peculiar, and differs from that of 
other narcotics, inasmuch as it appears to affect unequally the two sides 
of the nervous apparatus by which the equilibrium is maintained, so that 
in a certain stage of alcoholic poisoning they excite similar manege move- 
ments to those which occur after division of the corpora quadrigemina on 
one side. 2 



CHAPTER IX. 

ACTION OF DRUGS OX THE ORGANS OF SPECIAL SENSE. 
Action of Drugs on the Eye. 

Action on the Conjunctiva. — Before light can reach the retina, 
it has to pass through the cornea, and alterations in this part are therefore 
important. The chief drugs employed in the treatment of disease of the 
cornea are astringents and sedatives, especially nitrate of silver and bella- 
donna. There are two astringents which ought to be avoided, these are 
solutions of lead and of alum. Lead salts are objectionable, because if 
there is any ulceration on the cornea they may form an insoluble albumi- 
nate and cause permanent opacity. Salts of alum are perhaps still 
more objectionable, because alum has the power of dissolving the cement 
by which the fibrillre of the cornea are held together, and this is, accord- 
ing to Tweedy, very apt to give rise to perforation of the cornea whenever 
the epithelium is removed by injury or inflammation. 

The chief effects which drugs produce on the eye, besides those just 
described, are alterations in the size of the pupil, in the power of accom- 
modation, in the intra-ocular pressure, in the sensitiveness of the retina 
to impressions, and in the apparent color of objects. 

Action of Drugs on the Lachrymal Secretion. — The great 
power of certain volatile oils, such as those of onion or mustard, to irritate 
the eyes and cause secretion of tears, is well known. The prolonged 
action of atropine diminishes the secretion. Eserine abolishes the action 
of at i-(, pine and quickly increases the secretion. 3 



■ Bhorthouse, Baily'a Magazine of Sports, 1880, vol. xx.w, p. 396. 
• I ntertuchungeD zurMecbanik der Nervenund Nervenceutren." Von Wilhelm 
Wundt. Zweite Abtheilang, 1H7(;. Stuttgart. 

Ifaynaxd, Vtrchotc's Arckh, vol. iwxiw, p. 258. 



ACTION OF DRUGS ON SPECIAL SENSE. 



197 



Projection of the Eyeball. — The non- striated muscular fibres 
which are contained in the orbital membrane and in both eyelids push 
the eyeball forward and draw the eyelids back when they contract. Like 
the dilatator pupillge they are innervated by the sympathetic, and conse- 
quently some degree of protrusion of the eyeball is frequently produced 
by such substances as dilate the pupil. Excessive pain, or an asphyxial 
condition of the blood, has a powerful action in producing this effect, so 
that in men subjected to torture in the Middle Ages protrusion of the eye- 
balls was noticed ; and both in animals and men dying from rapid as- 
phyxia the eyeballs may seem as if starting from the head. 

Action on the Pupil. — The iris is usually said to consist of two 
muscles, the sphincter, which has circular fibres and contracts the pupil, 
and the dilator, which has radial fibres and dilates the pupil. All ob- 
servers are agreed regarding the sphincter muscle of the eyes, but some 
deny the existence of the dilator muscle. In the following description, 
however, I shall take the view which is usually accepted. 

The sphincter receives its motor nervous supply from the third nerve, 
and the dilator from the cervical sympathetic. The nervous centre for 
the contraction of the pupil probably lies in or near below the corpora 
quadrigemina. The nerve centre for the dilatation of the pupil lies in the 
medulla oblongata according to some, while others think it is located 
higher up, close to the centre for contraction. The contracting nerves 
are contained in the third nerve, and pass to the ciliary ganglion, and 
thence to the eye. Along with them motor fibres pass also to the ciliary 




Fig. 49.— Diagram to show the nervous supply of the eye. a, nerves to the ciliary muscle regulating 
accommodation; b, nerves to the contracting fibres, and c, nerves to the dilating fibres of the iris; 
d, vaso-motor nerves to the vessels of the eye. The iris is put apparently behind instead of in front 
of the iris for convenience in showing the passage of nerves to it. 

muscle. This muscle when contracted lessens the tension of the suspen- 
sory ligament on the lens, allowing the latter to become more spherical, 
and thus accommodating the eye for near objects. Such accommodation 
and contraction of the pupil generally accompany one another. The 
arrangement of the nerves of the eye is very diagrammatically shown in 
Fig. 49. A few of the dilating fibres are contained in the fifth nerve, 
but most of them pass down the spinal cord to the cilio-spinal region in 
the lower cervical and upper dorsal part of the cord, and thence through 



198 PHARMACOLOGY AND THERAPEUTICS. 

the inferior cervical and superior dorsal nerves into the cervical sympa- 
thetic, in which they again ascend to the eye. Along with the dilating 
fibres others pass to supply the orbital muscle at the back of the orbit, 
which causes protrusion of the eyeball, as already mentioned. There are 
also other fibres from the sympathetic which supply the muscular coats 
of the arteries of the ciliary vessels. 

The dilating centre may be stimulated directly by venous blood cir- 
culating in it. In consequence of this the pupils usually dilate much 
when the respiration is imperfect, as during dyspnoea; but when the 
asphyxia becomes complete the centre again becomes paralyzed and the 
size of the pupil diminishes. It may be stimulated reflexly by irritation 
of sensory nerves, so that dilatation of the pupil has been used as an indi- 
cation of sensation in animals paralyzed by curare. It seems to be readily 
stimulated by irritation of the genital organs. This is probably the rea- 
son why dilatation of the pupil frequently occurs in persons suffering from 
irritation of the genital organs. It is probably also readily stimulated 
by irritation of the intestinal canal, and such irritation may be the cause 
of dilatation of the pupil in children suffering from worms, and in cases of 
poisoning by drugs which irritate the gastro -intestinal canal, like aconite. 

The drugs which act upon the iris are divided into two classes : My- 
driatics which dilate, and 3Ivotics which contract the pupil. The most 
important of these are such drugs as have a local action on the eye, and 
they alone are used in ophthalmic medicine. They are indicated in the 
following list by an*. 

Mydriatics. Myotics. 

Anaesthetics. Anaesthetics. 

* Atropine. * Calabar bean. 

*Belladonna. 
Belladonnine. 
Benzoyltropine. 
Daturine. 
I iboisine. 
Gelsemine locally. Gelsemine internally. 

*Homatropine (oxytoluylic- Jaborandi. 

acid-tropine). Lobeline internally. 

Morphine internally. 
Muscarine locally (?) Muscarine internally. 

locally. 
Narcissine. Nicotine locally. 

Piturine. Opium. 

Stramonium. *Physostigmine (eserine). 

Pilocarpin. 

Ansestheticfi occur in both classes, because they cause contraction 

towards the commencement of their action, while later on, they cause 

dilatation. The probable reason of this is that at first they lessen reflex 

action, so that the reflex dilatation of the pupil by stimulation of sen- 

bolished. Later on when they begin to paralyze the 



ACTION OF DRUGS OX SPECIAL SENSE. 199 

respiration, the accumulation of venous blood causes irritation of the 
dilating centre and widens the pupil. Dilatation of the pupil during the 
administration of anaesthetics is therefore to be regarded as a sign of 
failing respiration. 

The contraction caused by morphine is also central and probably 
due to a similar cause. 

It is possible that the local application of drugs to the eyes may 
have an action on the pupil due merely to their effect as irritants, and 
independent of any special action on the iris, for E. H. Weber * found 
that local irritation at the margin of the cornea causes partial dilatation. 
Irritation in the middle of the cornea causes rather contraction of the 
pupil. Localized irritation at the margin of the iris may cause dilata- 
tion at that part. 

The reason why muscarine has been found by Ringer and Morshead 
to dilate the pupil when applied locally is probably that the solution 
they used was very irritating, either from its strength or for some other 
reason, while Schmiedeberg and Harnack found it to contract the pupil 
both when given internally and applied locally. 

The contraction of the pupil noticed by Rossbach in rabbits imme- 
diately after the application of atropine, may also have been due to local 
irritation. The occurrence of dilatation in one case and of contraction 
in the other may possibly have been due to the solution being dropped 
into the eye in a different way in the two cases. 

The most important local mydriatics and myotics are atropine 
and physostigmine (eserine). 

When a solution of atropine is dropped into the eye, the pupil dilates 
and the ciliary muscle becomes paralyzed, so that the accommodation for 
near objects is no longer possible, and the eye remains focused for dis- 
tant objects. When a solution of physostigmine is dropped into the 
eye, the pupil contracts and the ciliary muscle becomes spasmodically 
contracted, so that the eye is accommodated for near objects. 

It is very difficult to explain their mode of action satisfactorily, 
and authorities are by no means agreed regarding it. That the action 
is local is shown by the fact that when either atropine or physostigmine 
is applied to one eye its action is limited to it and the other remains 
unaffected. If care be taken to limit the application of a solution of 
atropine to one side of the margin of the cornea, local dilatation of the 
corresponding part of the pupil may be produced. 

Dilatation of the pupil may be due to paralysis of the sphincter 
or excessive action of the dilator. 

Paralysis of the sphincter may be due to (1) imperfect action or 
paralysis of the oculo-motor centre in the corpora quadrigemina, (2) to 
paralysis of the ends of the third nerve in the sphincter iridis, or (3) to 
the action of the drug upon the muscular fibres of the sphincter itself, 
or to one other or all of those together. 

Along with the factors just mentioned might be associated excessive 
contraction of the dilator muscles, which may be due (1) to stimulation 



Quoted by Landois, Physiologie, 1880, p. 799. 



200 PHARMACOLOGY AND THERAPEUTICS. 

of the sympathetic centre in the medulla, (2) of the ends of the sympa- 
thetic in the dilator muscle, or (3) stimulation of the dilator muscle 
itself. 

Excluding for the present the question of excessive action of the 
dilator muscle and confining ourselves to the causes of paralysis, we see 
that paralysis of the cerebral oculo-motor centre as a factor in dilatation 
of the pupil by atropine is excluded by the local action of the drug, 
and also by the experiments of Bernard and others, which show that 
dilatation occurs from the local action of atropine, when the ciliary gan- 
glion is extirpated and all the nerves of the eye with the exception of 
the optic have been divided. We can now limit its action either to 
paralysis of the ends of the oculo-motor nerve, or paralysis of the 
muscular fibres of the sphincter. 

That the ends of the oculo-motor nerve in the sphincter iridis are 
paralyzed is shown by the experiment that when the pupil is under the 
full action of atropine, irritation of the third nerve will not produce 
any contraction in it, although the sphincter will still contract when 
stimulated directly. 

Here also we find the same relation between the action of atropine 
on nerves supplying striated and non-striated muscle that we have 
already noticed in the case of the oesophagus, for in most animals the 
iris consists of unstriated muscular fibre, and atropine causes dilatation ; 
but in birds the iris consists of striated muscular fibre, and atropine 
causes no dilatation. Paralysis of the ends of the oculo-motor nerve in 
the iris itself may be looked upon as one of the factors in dilatation by 
atropine, and similar paralysis of the fibres supplying the ciliary muscle 
may be regarded as the cause of loss of accommodation. 

In addition to this, however, when the dose of atropine is large, the 
muscular fibres of the sphincter themselves become paralyzed, and fail 
to contract even when directly irritated. 

The question now arises whether in addition to paralysis of the oculo- 
motor nerve there is not also excessive action of the dilator. That such 
action of the dilator is actually present appears to be shown by the fol- 
lowing fact, viz., that the dilatation caused by atropine does not appear 
to be merely passive, but occurs with such force as to tear the iris away 
from the lens, and break down adhesions which may have formed be- 
tween them. This conclusion has been considered to be supported also 
by the facts: — (a) That when the oculo-motor nerve is divided the pupil 
- not dilate nearly to the same extent as it does from the application 
of atropine. This is shown both by a comparison of measurements of 
the eye under the two conditions and by the observation that after the 
nerves have been divided and partial dilatation produced atropine causes 
the piij.il to dilate -till more, (b) When the pupil is dilated by atropine, 
section of the sympathetic in the neck lessens the dilatation. 

We may consider, then, with tolerable certainty, that dilatation 
caused by atropine is due to increased action of the dilator as well as 
diminished action of the sphincter muscles of the iris. 

Contraction of the pupil may be due to excessive action of the 
sphincter, or paralysis of the dilator. That the contraction caused by 
pnysoetigmine is not due to paralysis of the dilator is shown by the pupil 



ACTION OF DRUGS ON SPECIAL SENSE. 201 

dilating somewhat when shaded, even when the drug is exerting a well- 
marked action. Excessive action of the sphincter must therefore be 
regarded as the cause of the myosis. Such action may be due to (1) 
stimulation of the oculo-motor cerebral centre, (2) of the ends of the 
oculo-motor nerve in the sphincter, or (3) to increased action of the mus- 
cular fibres in the sphincter from the direct effect of the drug upon them. 
The local action of physostigmine upon the eye excludes the cerebral 
centre, and leaves for our consideration stimulation of the ends of the 
nerves and of the muscular fibres themselves. 

These two structures seem to be specially affected by different drugs — 
so that local myotics may be divided into two classes — 

1st. Those which act upon the peripheral ends of the oculo-motor 
nerve. 

2d. Those which affect the muscular fibre of the iris. 

The first class includes muscarine, pilocarpine, and nicotine. Phy- 
sostigmine belongs to the second. 

Muscarine, pilocarpine, and nicotine, when applied to the eye, cause 
contraction of the pupil and spasm of accommodation. Atropine, as we 
have already seen, not only paralyzes the ends of the oculo-motor nerve, 
which these drugs stimulate, but has also an action on the muscular fibre 
itself. Its subsequent application will therefore remove the effect of 
these drugs, and they will not act after atropine has been applied first. 
As physostigmine stimulates the muscular fibre itself, it will cause con- 
traction in an eye which is dilated by atropine. 

The contraction produced by muscarine in the eye of the cat is so 
great as to reduce the pupil to a mere slit, and is much greater than that 
caused by the physostigmine, for muscarine acting only on the ends of 
the oculo-motor produces spasm in the sphincter without affecting the 
dilator, while physostigmine acting on the muscular fibres stimulates 
those of the dilator as well as the sphincter, and thus renders the con- 
traction less complete. 1 

It has already been pointed out, however, that the action of atropine 
is not confined to the ends of the oculo-motor nerve, but affects the mus- 
cular fibre itself, and thus it will counteract the effect of physostigmine, 
which it would not do if it acted only on the nerves. 

Atropine consists of the combination of a base, tropine, with tropic 
acid. Tropine itself has no mydriatic action, but when an atom of 
hydrogen in it is displaced by an acid residue it acquires this action. A 
number of combinations of tropine with different acids have been artifi- 
cially prepared by Ladenberg, who terms them tropeines. Amongst 
these are homatropine, in which the tropine is combined with oxytoluylic 
acid, and also benzoyl-tropine. Atropine appears to be identical with 
daturine. Hyoscyamine is also a combination of tropine with tropic 
acid, but it appears to be only isomeric with and not identical with atro- 
pine, though it appears to be identical with duboisine. 

Action of Drug's on accommodation. — The accommodation of 
the eye depends upon the ciliary muscle. When the eye is at rest the 



Schmiedeberg, Arzneimittellehre, p. 71. 



202 



PHARMACOLOGY AXD THERAPEUTICS. 



lens is flattened by the elastic tension of the zonule of Zinn. During 
accommodation for near objects the ciliary muscle draws the zonule 
forward and allows the lens to become more convex. The ciliary muscle 
is innervated by the third nerve : the centre for it appears to be in the 
posterior part of the floor of the third ventricle. Those drugs which 
affect the iris, also affect the power of accommodation. Their action on 
the iris and on accommodation do not, however, always begin at the 
same time, nor have they the same duration. The action of physostig- 
mine and atropine on accommodation usually begins after, and passes 
away long before, the affection of the pupil. 

Action on intra-ocular pressure. — The intra-ocular pressure 
depends chiefly on the relation between the amount of fluid poured into 
the anterior chamber of the eye, and the amount which passes out in a 
given time. This fluid is chiefly secreted by the ciliary processes. It 
passes out from the anterior chamber of the eye by a number of small 
openings (/, Fig. 50) close to the junction of the cornea and iris into the 
canal of Schlemm (c, s, Fig. 50), thence into the perichoroidal space, 
and out through the lymphatics. 

The intra-ocular pressure may be increased by (a) more rapid secre- 
tion from the ciliary processes, or (6) interference with its outward flow 
from the eye, or (<?) by increased quantity of blood in the vessels of the 
iris. It may be diminished by the contrary conditions. 

More rapid secretion from the ciliary process probably takes place 
under nervous conditions which are not at present well known. Inter- 
ference with the flow of the aqueous humor out of the anterior chamber 
may occur in aquo capsulitis, in which the openings from the anterior 
chamber into the spaces of Fontana are probably blocked by a coating 
of inflammatory lymph ; in glaucoma where these openings are blocked 
by the iris being pressed forward against them as in Fig. 50, and in iritis 




I i'.. 50.— i his diagram (which I owe to the kindness of Mr. J. Tweedy) represents a section through 

rneo-eclera] region, ciliary body and iris, of a healthy eye (left side), and of a glaucomatous 

•• 'right Bide): /.-, oornea: I, sclerotica; i, iris; /spaces of Fontana; c s, canal of Schlemm. In 

the glaaoomatoui eye the ciliary body is atrophied, and the iris lies against the cornea preventing 

(lie escape of fluids through the spaces of Fontana and canal of Schlemm. 

Ifhere the iris is much congested and the openings in it perhaps occluded 
by lymph. The secretion is probably diminished by the action of atro- 
pine. The outward flow through the spaces of Fontana is increased by 
( alabar bean, which, causing contraction of the circular fibres, flattens 
the arch of the iris and draws it away from the cornea so as to widen the 
angle between the cornea and iris, and aid the passage of fluid into the 
of Fontana. 1 



J. Tweedy, Practitioner, Nov., 1883, vol. xxxi., p. 321. 



ACTION" OF DRUGS ON SPECIAL SENSE. 203 

There are few or no experiments on the tension in the vitreous humor 
of the eye, and by the term intra-ocular tension is usually intended the 
pressure in the aqueous humor. This is usually ascertained by simply 
pressing the finger upon the eye and observing whether it is harder or 
softer than usual, or by pressing upon it with an ivory point attached to a 
registering spring, and noticing the pressure required to produce an in- 
dentation. These methods of experiment are very inaccurate, and it is 
much more exactly ascertained by passing a small trocar into the anterior 
chamber and connecting it with a manometer. The results of experi- 
ments even by this method are not entirely in accordance. 

The most recent ones by Graser 1 appear to show that the tension de- 
pends to a great extent upon the height of the blood-pressure generally : 
contraction of the pupil diminishes, and dilatation increases the intra- 
ocular tension. 

Atropine in doses sufficient to dilate the pupil increases the tension. 
This action of atropine and its allies in increasing the tension makes 
them dangerous in cases of glaucoma, and where this disease has been 
impending it has been at once brought on by the use of atropine or du- 
boisine. Eserine causes temporary increase at first, but after contraction 
of the pupil comes on, the tension is diminished. Eserine is therefore 
useful in glaucoma. 

Uses of Mydriatics and Myotics. — Belladonna is employed 
locally for its sedative action to relieve pain and irritation in the con- 
junctiva. 

Mydriatics and myotics are used not only for their action upon the 
pupil but for their action upon accommodation and intra-ocular pressure. 

Mydriatics are employed to dilate the pupil for the purpose of facili- 
tating ophthalmic examination, assisting the detection of cataract com- 
mencing in the periphery of the lens, or allowing the patient to see round 
the margin of a cataract when this is central in position, and would 
obstruct the vision with a pupil of normal size. They are used to pre- 
vent prolapse of the iris, or to restore it to its normal position when 
already prolapsed in cases of perforating ulcer or mechanical lesion of 
the cornea. They are employed in iritis, to afford rest to the inflamed 
tissues of the eye, and to keep the iris as far as possible off the surface 
of the lens and prevent adhesions of its posterior surface to the anterior 
surface of the lens. 

Myotics are used to contract the pupil in cases of photophobia, or to 
counteract the effect of mydriatics which have been previously employed. 
They are used also to counteract deficiency in tension of the ciliary 
muscles, as in paralysis of accommodation consequent on diphtheria, as- 
thenopia, and hemeralopia. 

Mydriatics and myotics may be employed alternately in order to 
ascertain the presence of any adhesions of the iris, and to break them up 
if present. 

Mydriatics are employed to paralyze the ciliary muscle, and thus 
destroy the power of accommodation in order to test the condition of the 

1 Graser, Archiv f. exp. Path. u. Pharm., Bd. xvii., Heft 5. 



2<>4 PHARMACOLOGY AND THERAPEUTICS. 

refractive media of the eye in cases of astigmatism, or in cases where the 
patients either suffer from spasm of the ciliary muscle or are unable 
voluntarily to relax the accommodation. 

Myotics are useful in cases of commencing glaucoma, from their power 
to lessen intra-ocular tension, and in such cases mydriatics on the other 
hand are injurious and may hasten the appearance of the disease. 

In glaucoma the tension within the anterior chamber is greatly in- 
creased, and the increase, according to Tweedy, is due to the natural 
channel of escape for the aqueous humor through the spaces of Fontana 
and the canal of Schlemm being blocked by the iris lying against the 
cornea. This condition is relieved by myotics, which, by causing con- 
traction of the pupil, draw the iris away from the cornea, and thus allow 
the fluid to escape through the spaces of Fontana. When the anterior 
chamber of the eye is shallow and the iris is lying close to the cornea, so 
as nearly, though not quite, to obstruct the spaces of Fontana, atropine 
may bring on an attack of glaucoma by dilating the pupil and thus 
packing the tissue of the iris into the angle between it and the cornea, so 
as to render the obstruction to the spaces of Fontana complete. 

Action of Drugs on the Sensibility of the Eye. — The sensi- 
tiveness of the eye to impressions is increased by strychnine, the field of 
vision becoming larger, and the sight more acute, so that objects can be 
distinctly observed at a greater distance, and the field of color is increased 
for blue. This action appears to be to a certain extent local, as it occurs 
more distinctly on that side where the strychnine has been injected hy- 
podermically. The sense of color is affected in a remarkable way by 
santonin, which at first causes objects to appear somewhat violet and after- 
wards of a greenish yellow. The yellow color has been ascribed to stain- 
ing of the media of the eye by santonin, as it becomes yellow when exposed 
to the light ; others again have supposed the alteration in the apparent 
color of objects to be due, first to a stimulation, and then to a paralysis 
of those constituents of the retina by which the violet color is perceived. 

The sensibility of the eye for red and green appears to be sometimes 
diminished by physostigmine. 

Action of Drugs in Producing Visions. — It may be well here 
to mention the effect of some drugs in causing subjective sensations of 
Bight, although these probably depend rather upon the action of the drugs 
on the brain, than on the eye itself. The centres for sight, according to 
Fender, are the angular gyrus (14 and 15, Fig. 46, p. 170), and the 
occipital lobes. In delirium tremens arising from alcoholic excess the 
patients often complain much of visions of the most disagreeable charac- 
ter, which often take the form of demons or of animals. 

Cannabis indica produces in some persons, though not in all, visions 
which may he pleasant or laughable. These chiefly occur just before 
Bleep. 1 

Salicylate of soda in some persons tends to cause most disagreeable 
visions whenever the eyes are shut, and I have seen it have this effect 



Compere Schroff, Pharmacologic, lth edition, p. 535, and Wood, Materia dfedica, 
3d i -in ion, p. •-i.',< l . 



ACTION OF DRUGS ON SPECIAL SENSE. 205 

even in such a small dose as five grains. Large doses of digitalis may 
cause subjective sensations of light, and after taking nearly one grain of 
digitalin in the course of forty-eight hours, I suffered from the centre of 
the field of vision being occupied by a bright spot surrounded by rainbow 
colors. Digitalin when introduced into the eye locally causes at first 
smarting and lacrymation, which soon passes off, but after four or five 
hours, when a light is looked at, a halo is seen surrounding it which is 
not improbably due to some opalescence in the cornea. 1 

Action of Drugs on Hearing*. 

The sense of hearing depends on the transmission of sonorous vibra- 
tions from the air to the auditory nerve by means of the membrana 
tympani and the ossicles of the ear, and upon the perception of those 
vibrations by the brain. 

The centre for hearing, according to Ferrier, is in the superior tem- 
poro-sphenoidal convolution (16, Fig. 46, p. 170). It is probable that 
subjective sounds not depending on disturbance of the auditory apparatus, 
such as the sounds of voices, &c, heard in delirium or mania, or as the 
prodromata of an epileptic fit in certain individuals, or during intoxica- 
tion by cannabis indica, are due to irritation of these centres. 

The sense of hearing may be dulled by any interference with the 
passage of the sound into the ear, as by wax in the auditory meatus, by 
disease of the auditory nerve or of the brain itself. 

The hearing may be rendered more acute by the removal of any ob- 
stacle in the way of transmission of sound to the auditory nerve, or by 
drugs which increase the excitability of the auditory nerve or of the brain ; 
thus the wax may be removed by simply syringing ; thickness and catarrh 
of the Eustachian tube which interfere with vibrations in the middle ear 
may be lessened by the inhalation of camphor and ammonia, or by the 
application of a solution of ammonium chloride and sodium bi-carbonate 
to the posterior nares either by the spray or nasal douche. The excita- 
bility of the auditory nerve or of the brain is increased by strychnia 
which renders the hearing more acute. 

Subjective noises in the ear, such as humming, buzzing, or ringing, 
are often very troublesome. Bubbling noises may be due to mucus in 
the Eustachian tube. Buzzing or humming are probably generally 
caused by vascular congestion either of the external^meatus, of the middle 
ear, or of the Eustachian tube. Where the bubbling noises are due to 
the presence of mucus they may be to a considerable extent removed by 
washing out the mucus with a solution of carbonate of soda applied by a 
nasal douche. Noises in the ears due to hyperemia may be lessened or 
removed by cholagogue purgatives and by hydrobromic acid. Where 
chronic thickening of the membrane is present, relief is usually afforded 
by iodide of potassium, or iodide of ammonium, both applied locally and 
taken internally. Subjective noises in the ears are caused by quinine in 
large doses, and also by salicylate of soda. Both of these drugs have 
their effect upon the ear to a great extent neutralized by hydrobromic 



1 Lauder Brunton, On Digitalis, &c. 



206 PHARMACOLOGY AND THERAPEUTICS. 

acid, and ergot 1 is said to have a similar power to prevent or remove the 
unpleasant singing. It is uncertain whether the singing caused by qui- 
nine and salicylates is due to their action on the auditory apparatus, or 
the cerebral centres, but the fact that in larger doses they may cause de- 
lirium indicates that even the earlier symptom of buzzing in the ears may 
be due in part at least to their action on the cerebral centres. 

Action of Drug's on Smell. 

Many drugs, such as musk and ethereal oils, have a marked and 
characteristic smell due to their effect upon the terminal branches of the 
olfactory nerve. This nerve is soon exhausted, so that in a very short 
time the smell is no longer perceived with anything like the intensity it 
was at first. Such smells as these just mentioned cannot be perceived 
by persons suffering from anosmia, but certain drugs, such as ammonia 
or acetic acid, can be recognized by them. The reason of this is that 
although such persons are incapable of perceiving any true smell, the 
nasal branches of the fifth nerve are irritated by pungent vapors, and 
thus produce a certain kind of sensation. The power of distinguishing 
smells seems to be increased by strychnine ; which appears at the same 
time to render such disagreeable odors as those of assafoetida, garlic, and 
valerian agreeable. This effect may be due to the action of strychnine 
on the olfactory apparatus, but it is very probably due rather to the ac- 
tion of the drug on the cerebral centre for smell, which, according to 
Ferrier, is situated at the tip of the temporo-sphenoidal lobe. The power 
to distinguish smells is diminished by such drugs as lessen the sensibility 
of the brain, or by those which cause alterations in the nasal mucous 
membrane, as, for example, iodide of potassium given in such doses as to 
produce coryza. 

Action of Drugs on Taste. 

Most of the substances used in medicine have a strong taste, and 
many a very unpleasant taste. 

What is usually termed taste frequently depends on a mixture of 
taste and smell, and if the sense of smell is abolished for the time being, 
the characteristic taste of the substance cannot be distinguished. This 
18 the reason why castor-oil, which owes its nauseous taste almost entirely 
to its odor, can be swallowed without being so readily distinguished if 
the nose is held during the act of swallowing. In addition to the taste 
they produce in the mouth, certain substances leave an impression 
termed "after-taste" on the tongue after they have been swallowed or 
ejected; and this is sometimes quite different from that of the taste of 
the Bubstance itself: thus bitters leave a sweet after-taste in the mouth. 
[f quinine is taken in a nearly neutral solution, it leaves a persistent 
hitter taste from the sparingly soluble alkaloid being precipitated on the 
tongue and remaining there for a length of time, but if the quinine be 
taken with excess of acid, so as to keep it entirely in solution, and 



Schilling, Aertzl. Inlelligenzblatt, 1883. 



ACTION OF DRUGS ON RESPIRATION. 207 

washed out of the mouth immediately with a draught of water, it leaves 
a sweet after-taste. 

Some substances after their entrance into the blood are excreted by 
the saliva and may cause a somewhat persistent taste in the mouth ; this 
is observable in the case of iodide of potassium. 

Iodine appears also to have the power of causing other substances 
to be excreted by the saliva, when they are combined with it, and thus 
Bernard found that iodide of iron was secreted by the saliva, though 
lactate of iron was not ; and I have sometimes thought that iodine has a 
similar effect upon quinine, because I have very frequently noticed 
patients complain of a persistent bitter taste in their mouth when I have 
given quinine combined with iodide of potassium, although they did not 
complain of this when either of the drugs has been given without the 
other. 



CHAPTER X. 






ACTION OF DRUGS ON RESPIRATION. 
Respiratory Stimulants and Depressants. 

It is usually supposed by naturalists that in the descent of man from 
some organism low in the scale of existence, he has passed at a remote 
period through a stage resembling the Ascidians or Tunicata. In these 
animals respiration is maintained by water being driven through a per- 
forated sac in the meshes of which the nutritive fluids of the animal 
circulate. The contractile motions of the sac by which the circulation of 
fluid is maintained probably depend on a nervous ganglion situated 
between the oral and anal apertures as represented in the diagram (Fig. 
51). We do not know whether or not this ganglion may influence the 
circulation which is maintained by the rhythmical contractions of the 
simple tube which serves as a heart. These drive the fluid first in one 
direction, and then after a while the action of the tube is reversed, and 
its contractions drive the fluid in the opposite direction. This ganglion 
in its functions would correspond with the medulla oblongata in the 
vertebrata, and thus the medulla oblongata may be looked upon as a lower 
and more fundamental centre than the brain or spinal cord. 

We see this more distinctly perhaps by looking at the two diagrams 
(Figs. 52 and 53) representing an amphioxus and a fish. In the am- 
phioxus respiration is kept up in much the same way as in the ascidian, 
the water passing from the pharyngeal to the atrial sac and through the 
atrial aperture or abdominal pore. There is no head and no organs of 
special sense, and so we have no brain whatever. But the body is elon- 
gated so as to remind us of an ascidian, having its ganglion and the part 



208 



PHABMACOLOGY AXD THERAPEUTICS. 



of the body wall containing it so much extended as to remove the anal 
considerably from the oral aperture. The muscles of this elongated body 
require innervation, and thus the ganglionic mass is elongated into a cord 
called the myelon, which represents the spinal cord as well as the medulla 
oblongata. In ascidians then we have a mass corresponding to the 
medulla : in the amphioxus we have a mass corresponding to medulla 
and spinal cord. 



Body wall 



Nerves passing from the ganglion. 



Pharyngeal sac. 

General body cavity. 

Heart. 

Intestine. 




— .__ Oral aperture. 

Part of body wall containing 

ganglion. 
— - Branchio-anal or atrial aperture. 

\o\JL f Branchial openings in the sep- 

r JsL-lL_ ~{ turn between the pharyngeal 

" ll_ (. and anal sac. 



Fig. 51.— Diagram of an Ascidian. 



Oral aperture, 



Medulla. 



Branchial 




Branchial aperture, 

abdominal pore 
Anal aperture 



'-'.— Diagram of Amphioxus. The water enters 
the oral aperture, passes through the openings in 
the pharyngeal sac into another cavity, whence it 
escapes by the abdominal pore. 



Fig. 53.— Diagram of fish. 



In a fish the pharyngeal or branchial sac, instead of opening into 
the atrial Bac, opens directly into the surrounding water. We haveahead 
and organs of special sense, and therefore we have a large nervous mass 
or brain. 

In these throe members of the animal kingdom, therefore, we have 
the medulla as the lowest or fundamental centre, next the spinal cord, 
and lastly the brain. We might therefore expect that notwithstanding 
tin- apparently higher position and greater nearness of the medulla to 
the brain than to the spinal cord, the medulla would be less readily 
affected bj many drugs than the cord or the brain, and this is 
find in the case of such drugs as alcohol, ether, or morphia, 



ACTION OF DRUGS OX RESPIRATION. 209 

which appear to paralyze the nervous centres in the inverse order of 
their development, the brain first, spinal cord next, and medulla last. 

There are some drugs, however, e.g., aconite, gelsemium and hydro- 
cyanic acid, which seem to have a special paralyzing action on the 
respiratory centre. 

If we look at the ganglionic mass in an ascidian, represented in the 
diagram, we shall see that it sends some fibres to the pharyngeal sac and 
some to the anal sac. If these two sacs were to contract together they 
would oppose each other's action, and thus the passage of water through 
the branchial apertures would be stopped, and respiration consequently 
arrested. They must therefore act alternately, and this alternate action 
is regulated by the ganglion. This ganglion consists of numerous nerve 
cells and fibres. As some of these have a more special connection with 
the pharynx, the group which they form may be called the pharyngeal 
centre or inspiratory centre. 

Similar arrangements occur in higher animals, and the terms used 
in regard to their nervous system may lead to some confusion of thought ; 
thus we speak of the respiratory, of the inspiratory, of the expiratory, 
and of the vomiting centres. 

By nerve centres we simply mean the groups of cells and 
fibres which are concerned in the performance of certain acts. They 
are not necessarily entirely distinct from one another, and the same 
group of glanglionic cells may form a part of several centres. Thus in 
the accompanying diagram, the respiratory centre includes both 
inspiratory and expiratory centres, and the vomiting centre includes 
some ganglionic groups which form part of the inspiratory, and others 
forming part of the expiratory centres, besides other ganglion groups 
which are concerned with the simultaneous dilatation of the cardiac 
orifice of the stomach. On analyzing this subject still further also we 
find that the inspiratory centre affects many muscles, and that it does 
not always affect them to the same extent. Thus in men the diaphragm 
takes a more active share in inspiration during the day than the thoracic 
muscles. During sleep the diaphragm takes a much less active part, 
and may be entirely quiet, while the thoracic muscles are more active, 
and the chest rises and falls more than during waking. 

The inspiratory centre might be thus still further divided into 
tlioracic inspiratory centre, and diaphragmatic inspiratory centre. 

Such subdivisions appear absurd if we imagine that each centre 
represents a distinct nervous mass, and we become puzzled to under- 
stand how the medulla oblongata can contain so many distinct centres 
in a small bulk. But if we remember that the word " centre" simply 
indicates a group of cells and fibres connected with the performance of a 
particular act, and that two centres may be formed by the same gangli- 
onic groups, and differ from one another only by having a few ganglion 
cells more or less which alter the function they perform, no harm is done 
by the use of the term. 

The act of respiration consists in the alternate enlargement and 
diminution of the thoracic cavity, so that the air is alternately inspired 
and expired. 
14 



210 



PHARMACOLOGY AND THERAPEUTICS. 






The muscles by which this is effected in ordinary respiration are 
the diaphragm and intercostal and scaleni muscles. The diaphragm 
descends, and the intercostal and scaleni muscles raise the ribs during 
inspiration. 




Vomiting centre. 



Respiratory centre. 



Fig. 54.— Diagrammatic representation of various groups of ganglion cells, or "centres," in the 
medulla oblongata. The arrows indicate the direction in which the nerve-currents pass. Those 
pointing to the cells indicate sensory, those pointing from the cells indicate motor, nerves. 



Expiration is normally a passive act, 1 and is not performed by 
muscular action, but simply by the tendency of the diaphragm and 
thoracic walls to return to the position of equilibrium from which they 
had been removed during inspiration, and to the contraction of the 
elastic walls of the air-vesicles distended by inspiration. 

When the supply of oxygen is deficient, other muscles are called in 
to aid the inspiration. Expiration appears to be a passive act not 
merely in ordinary respiration but even in dyspnoea caused by the 
absence of oxygen. In some experiments by Bernstein 2 the inspiration 
and expiration were equally increased in a rabbit, when the air which it 
had breathed was replaced by hydrogen. But expiratory efforts are 
required both for the production of voice, and for the removal of irri- 
tants from the air passages by coughing or sneezing; and forcible 
expiration is produced when an irritant is applied to the mucous mem- 
brane of the nose, of the larynx, trachea, or bronchi. As every one 
who has drunk a hottle of soda-water knows, carbonic acid is an irritant 
of considerable power to these mucous membranes, and when it is 
breathed instead of air or hydrogen the expiration becomes much more 
powerful, and is no longer a passive action, but an active one, performed 
by active muscular exertion. 



Bernstein, Archiv f. Aunt. u. Physiol., 1882, p. 322. 
Bernstein, Op. <it. 



ACTION OF DRUGS ON RESPIRATION. 211 

The chief respiratory centre is situated in the medulla oblongata 
close to the end of the calamus scriptorius, at the point designated noeud 
vital by Flourens, because destruction of this point arrests the respira- 
tion and causes death. 

It extends equally on both sides of the middle line in the medulla, 
each half regulating the breathing on the same side of the body. It 
has been supposed to be double, and to consist of inspiratory and expira- 
tory centres which act alternately, but it would appear that in ordinary 
respiration the inspiratory centre only is active. 

When the centre is injured by a puncture, as in Flourens' experiment, 
or when one-half of it is destroyed, breathing usually stops entirely, but 
if the respiration be kept up artificially for several hours, the normal 
breathing again becomes established ; and the prolonged continuance of 
artificial respiration has been recommended by Schiff in apoplexy. 

When the connection between this centre and the respiratory muscles 
is cut off by dividing the spinal cord just below the medulla, respiration 
usually ceases entirely, so that at first sight it would seem that the 
respiratory centre is limited to the medulla. 

The effects of strychnine show that this is not the case. This drug 
greatly increases the excitability of the respiratory centre, and when it 
is injected into the blood before division of the spinal cord, the respira- 
tory movements still continue to some extent after the cord has been 
divided. When it is injected after section of the cord, the respiratory 
movements which had ceased again recommence to a slight degree. 

The reason appears to be that the respiratory centre is not lim- 
ited to the medulla, but extends to the upper part of the spinal cord, 
though the spinal portion is of itself too weak to keep up the respiratory 
movements, except when stimulated by strychnine. 

The amount of respiratory work which this centre excites 
appears to depend to a great extent, though not entirely, upon the 
condition of the centre itself. 

The distribution of the work is chiefly determined by the irrita- 
tion of one or other of the afferent nerves, and these nerves also influ- 
ence the amount of work. 

The centre is stimulated, and the amount of work it does increased 
by a venous condition of the blood circulating in it. An arterial condi- 
tion of its blood lessens or completely abolishes its activity, so that when 
the blood is highly aerated by forced artificial respiration, a condition of 
apncea is produced, in which no spontaneous respiratory movements 
occur. 

This condition is much more readily induced when the excitability 
of the respiratory centre is lessened by drugs. In an animal poisoned 
by chloral, for example, it is very easy to induce it, and it lasts for a 
long time. 

When the respiratory centre is excited, as by the injection of emetine 
or apomorphine into the circulation, it is difficult or impossible to pro- 
duce this condition. 

It is uncertain whether the stimulation which the venosity of the 
blood produces is due chiefly to the absence of oxygen or to the presence 
of carbonic acid. Possibly also it may be due to the products of 



212 PHARMACOLOGY AND THERAPEUTICS. 

imperfect combustion in the venous- blood. Or all these three causes 
may share in the stimulation, though to what extent each does so is 
not known. 

According to Bernstein, want of oxygen appears to stimulate the 
inspiratory and the presence of carbonic acid to stimulate the expiratory 
centre. 1 

As the blood becomes venous the activity of the respiratory centre 
increases, the respirations becoming quicker and deeper, and the acces- 
sory respiratory muscles are thrown into action. This condition is called 
dyspnoea. Finally the excitement extends to all the muscles of the 
body and we get general convulsions, which have usually an opistho- 
tonic character. The eyeballs very often protrude during these convul- 
sions, and the blood-pressure rises greatly from stimulation of sympa- 
thetic and vaso-motor centres in the medulla. 

After the convulsions cease, the animal usually lies motionless, and 
the heart, as a rule, continues to beat for a short time after the respira- 
tions have ceased. 

The excessive venosity of the blood in this condition has paralyzed 
the nerve centres, but if artificial respiration be now commenced and 
the blood becomes gradually aerated, the conditions just described are 
again passed through in the reverse order ; convulsions first reappearing, 
then dyspnoea, next normal breathing, and, if the respiration be pushed 
far enough, apnoea. 

Asphyxia! convulsions only occur in warm-blooded animals, and not 
in frogs, and when we find that any drug produces convulsions in mam- 
mals and not in frogs we usually assume that the convulsions are due to 
asphyxia produced by the action of the drug on the respiration or circu- 
lation, and not to a direct irritant action upon the motor centres. If on 
the other hand we find that the convulsions occur in frogs as well as in 
mammals, the presumption is in favor of their being due to the direct 
irritant action of the drug on motor centres. 

Blood becomes venous when the external respiration or interchange 
of gases between it and the external air is arrested while internal respira- 
tion continues. 

Internal respiration or interchange of gases occurs between the blood 
and the tissues outside the vessels which are consuming oxygen and 
deriving it from the blood. But the blood although fluid is itself a tissue 
and likewise consumes oxygen, so that it will become venous if left to 
itself in a thoroughly-stoppered glass bottle. 

External respiration may be arrested or diminished by — 
(1) Interfering with the access of air to the blood; or 
(21 " « " « blood to the air; or 

" " power of the blood to take up and 
give off oxygen. 

The fair to the blood may be prevented by obstruction to the 

air-passages or alteration in the structure of the lung; thus anaesthetics 
may obstruct respiratioD by allowing vomited matters to enter the trachea 



Bernstein, Op. cil : p. 324. 



ACTION OF DEUGS ON KESPIRATION. 213 

and plug it mechanically. Apomorphia may lead to obstruction of the 
bronchi by profuse secretion from the mucous membrane, and large doses 
of antimony may cause consolidation of the lung. 

Air may be prevented from reaching the blood by any obstruction in the 
respiratory passages. 

The respiratory passages may be obstructed by spasmodic closure of the glottis 
or of the nostrils in rabbits when an irritating vapor is inspired. This source of 
obstruction is easily avoided by putting a cannula into the trachea and allowing 
the vapor to be inspired through it. Another source of obstruction is the forma- 
tion of plugs of mucus or clots of blood in the trachea or in the cannula, which 
has been introduced into it. Occasionally a plug of mucus, and sometimes a clot 
of blood, forms in the tracheal cannula and seriously impedes the respiration, 
whether natural or artificial, without being perceived by the experimenter. In 
order to be sure that such an occurrence has not taken place and vitiated the 
results, it is always advisable on removing the cannula from the trachea at 
the end of an experiment to blow through it and see that its lumen is perfectly 
unobstructed. 

Access of air to the blood may be prevented also by paralysis of 
the muscles of respiration; thus curare will produce it by paralyzing 
the ends of the motor nerves, hydrocyanic acid by paralyzing the respira- 
tory centre, and snake poison by paralyzing both. 

The blood may be prevented from reaching the lungs by arrest of the 
circulation, either local or general, and may thus become venous either 
locally or generally. 

The venosity of the blood circulating in the medulla may be altered 
locally without any change in the rest of the body. Thus if the carotid 
and vertebral arteries are tied, the blood stagnates in the vessels of the 
medulla, and there becoming venous causes dyspnoea and convulsions, 
which again disappear when the ligatures are loosed and the circulation 
re-established. 

Dyspnoea and convulsions are likewise produced by alteration in the 
general circulation, e.g., by loss of blood, as is seen when an animal is 
bled to death, or when the supply of blood in the arteries is greatly 
diminished by ligature of the portal vein, which causes the blood to accu- 
mulate and stagnate in the capacious veins of the intestine. 

Stoppage of the heart, either by ligature directly applied to it or by 
the action of drugs upon it, causes asphyxia and convulsions. 

Arrested circulation through the pulmonary vessels by emboli has 
a similar action. This sometimes leads to error in regard to the action 
of drugs when these are injected, as is often done, into the jugular veins. 

If they contain solid particles, these may give rise to embolism in 
the pulmonary arteries and lead to the belief that the drug has a tetaniz- 
ing action, when, as a matter of fact, it has nothing of the kind. Thus, 
in making an experiment on condurango, I injected an infusion into the 
jugular vein of a rabbit, and it rapidly died with symptoms resembling 
those of strychnia poisoning. The cause of this, however, was simply 
embolism of the pulmonary vessels, due to undissolved particles in the 
infusion, and when this was avoided by injecting the drug into the per- 
itoneal cavity, no symptom whatever was produced. Gianuzzi, in his 



214 PHARMACOLOGY AXD THERAPEUTICS. 






experiments on this drug, appears to have fallen into the same error as I 
did at first. 

Altered condition of the blood also gives rise to dyspnoea, as is seen 
in the breathlessness of ansemia, where the blood is unable to take up 
the quantity of oxygen necessary for any exertion, and the patient pants 
violently after any quick movement, such as going up stairs. 

Dyspnoea and even convulsions are also caused by nitrites, e.g., 
nitrite of amyl or soda, which lessen the power of the blood to give off 
oxygen, and by carbonic oxide, which replaces the oxygen in the blood. 

It must be remembered, however, that whatever may be the remote 
cause of dyspnoea, its direct cause is the condition of the nerve cells in 
the medulla, and if these are unable to take up oxygen, and give off car- 
bonic acid to the blood, dyspnoea may occur, although the blood itself 
circulating in the medulla contains abundance of oxygen. 

In the case of carbonic oxide poisoning the blood cannot take up 
oxygen from the lungs, although there is abundance of oxygen present; 
and in a similar way the nerve cells of the medulla may possibly be 
rendered by certain drugs unable to take up oxygen from the blood cir- 
culating through the medulla. 

In simple suffocation the internal respiration of the nerve cells 
in the medulla is arrested by the general venous condition of the blood; 
in carbonic oxide poisoning by the oxygen being absent from the haemo- 
globin ; in nitrite poisoning by the oxygen being locked up in methsemo- 
globin. In all those cases the condition of the blood is betrayed to the 
eye by the appearance of the mucous membranes, which in suffocation 
and in nitrite poisoning become dark and livid, and in carbonic oxide 
poisoning of a cherry-red color. Perhaps the change is most conven- 
iently seen in the comb of a cock poisoned by these substances, and in it 
the alteration in the color of the blood produced by artificial respiration is 
readily seen. The dependence of convulsions upon the blood is also easily 
observed: the convulsions appearing as the comb becomes livid, and 
again disappearing when artificial respiration has been employed, and 
the color of the comb becomes bright. In poisoning by hydrocyanic acid, 
however, I have observed that convulsions come on while the mucous 
membranes are still of a bright color, so that we may conclude that they 
are not due to a venous condition of the blood as in ordinary suffocation. 
They might be due to the formation of a compound between the hydro- 
cyanic acid and the blood as in poisoning by nitrites or carbonic oxide, 
but accurate analyses have shown that hydrocyanic acid does not displace 
the oxygen in haemoglobin like carbonic acid, nor lock it up in the form 
of methmmoglobin like the nitrites. We are therefore obliged to con- 
sider the possibility that the dyspnoea and convulsions produced by 
hydrocyanic acid are not due so much to its effect upon the blood circu- 
lating in the medulla as by an action on the cells of the medulla itself, 
by which it prevents the ordinary internal respiration taking place in 
them. 

Action of Drugs on the Respiratory Centre. 

A nseful method of testing the action of the drug itself on the respiratory 
centre ifl to perform artificial respiration vigorously so as to produce apnoea, to 






ACTION OF DRUGS ON RESPIRATION. 215 

allow the respiration to become normal again, then to inject the drug and again 
try to produce apnoea. If the drug has excited the respiratory centre, apnoea 
will be much more difficult to produce after its injection than before, and will 
last a shorter time ; if it has depressed it, apnoea will be more easily produced, 
and will last longer. 

Apnoea lasting for a short time may be readily produced by taking five or 
six very deep breaths, and the effect of drugs on the respiratory centre may be 
readily tried by any one in the following way. Laying a watch before him, 
shutting his mouth and holding his nose, let him first ascertain how many seconds 
he can hold his breath after previous ordinary respiration. Next let him produce 
a certain amount of apnoea by six or more deep respirations, and again ascertain 
how long he can hold his breath. After repeating these observations several 
times, let him take the drug to be tested and repeat them again, taking care that 
all the circumstances should be the same as before. 

The activity of the respiratory centre is augmented by heat, so 
that the respirations become both quicker and deeper, and more respira- 
tory work is done. Strychnine, ammonia, atropine, duboisine, brucine, 
thebaine, apomorphine, emetine, members of the digitalis group, salts of 
zinc and copper, have a similar action. 

It appears to be first excited and then depressed by caffeine, colchi- 
cine, nicotine, quinine, and saponine. 

It is diminished by cold, so that the respirations become slow and 
shallow. Chloral, chloroform, ether, alcohol, opium, physostigmine, 
muscarine, gelsemine, aconite, and veratrine in large doses, all have a 
similar action. 

The action of drugs on the respiratory centre is one of great import- 
ance, not only as giving us a definite basis on which to found a plan of 
treatment in respiratory diseases, but as helping us to preserve life in 
cases of poisoning — drugs which stimulate being antagonized by those 
which depress the respiratory centre, and vice versa. 

The chief afferent nerves, by which the distribution of the respi- 
ratory movements is altered, may be divided into two classes — those 
having an inspiratory and those having an expiratory action. 

The expiratory are the nasal branches of the fifth, the superior 
laryngeal, the inferior laryngeal, and the cutaneous nerves, especially of 
the breast and belly. 

The chief inspiratory are the branches of the vagus going to the 
lung, but all sensory nerves when slightly stimulated appear also to have 
an inspiratory action. 

The vagus appears, however, to contain both expiratory and inspira- 
tory fibres, which are alternately stimulated by the condition of the lung. 
Expansion of the lung appears to stimulate mechanically the inhibitory 
or expiratory fibres; while its collapse stimulates the accelerating or 
inspiratory fibres. 

When the expiratory nerves are stimulated, the respiratory move- 
ments become slower and deeper ; and if the stimulation be strong they 
may stop altogether in expiration, with the diaphragm in complete relax- 
ation. 

Stimulation of the inspiratory nerves causes the respiration to 
become quicker and shallower, and at length to stop inspiration, the 
diaphragm being in a state of tetanic contraction. 



216 



PHARMACOLOGY AND THERAPEUTICS. 



These are the general results, but they are not quite constant. 
The reason for this inconstancy may be either that all the nerves contain 
both inspiratory and expiratory fibres, or that the same fibres may stim- 
ulate either the inspiratory or expiratory centres, according to the strength 
of the stimulus and the condition of the animal. Thus, when the vagus 
is divided, the stimulus which is conveyed to the respiratory centre being 
removed, the respirations usually become very slow; when the central 
end of the divided nerve is irritated they become quick, and a very strong 
current may stop them in inspiration. But this is not always so: when 
the nerve is very much exhausted, irritation by a strong current may 
have an entirely opposite effect, and cause the respiration to stop in 
expiration instead of inspiration. 

The probability that the same nervous fibres may, under different 
conditions, excite either inspiration, expiration, or the two alternately, is 
rendered still greater when we consider some other experiments ; and the 
contradictory results which have been obtained by various observers in 
regard to the action of drugs may depend to a great extent on the strength 
of the stimulus they have used and the state of exhaustion of the animal. 
Thus Langendorf has found that all sensory nerves in the body when 
slightly stimulated have an inspiratory, but when stimulated more strongly 
have an expiratory action. Rosenthal found that irritation of the crural 
nerves caused alternately deep inspiration and expiration in animals which 
were not narcotized. In narcotized animals, Langendorf, on slight irri- 
tation, observed an inspiratory effect, indicated by quickening of the 
respiration or slight inspiratory tetanus ; but when the experiment was 
continued long, or the irritation was increased, the contrary or expiratory 
effect was observed, indicated by a slowing of the respiration. 



Inspiratory and Expiratory Fibres) 
for voluntary alterations in Respi- > 
ration .' j 



Cutaneous Nerves of Face 

* Nasal Branch of Fifth Nerve. 



Superior Laryngeal Nerve. 
Inferior Laryngeal Nerve... 
Larynx 



Cutaneous Nerves of the Chest 



I dory Fibres of Vagus excited b J 
distension of Lung 



ofYagusexolted by 

collapse of Lung 




Eespiratory Centre in 
Medulla and Cord. 



Spinal cord. 



Ion of respiratory centre, and the afferent nerves which influence 
>t. lasfUM • lndi< ated by plain, and expiratory by dotted, lines. 



ACTION OF DRUGS ON RESPIRATION. 217 

On the hypothesis that the various actions of respiration depend upon 
individual centres, inspiratory, expiratory, and inhibitory, it is exceed- 
ingly difficult, or impossible, to understand the contradictory results of 
various experimenters, but the question seems much less intricate when 
we regard it as due to the interference of stimuli passing at different rates 
in different directions, or to different distances according to the strength 
of the stimulus and the irritability or exhaustion of the nervous system. 

In regard then to inhibitory or slowing, and to stimulating or accel- 
erating nerves or fibres, it must be carefully borne in mind that the same 
fibres may possibly have either the one or the other action, according to 
the conditions under which it is acting. 

If we keep this carefully in view we may continue to use the terms ac- 
celerating and slowing or inspiratory and expiratory nerves as a convenient 
means of expression. These are shown in the accompanying diagram. 

The movements of respiration are not only more easily counted than in any 
other way, but their depth and the relation of inspiration to expiration are best 
noted by causing them to register themselves on a revolving cylinder. Various 
means of doing this have been suggested by different authors. One of the simplest 
consists of a needle pushed into the diaphragm, and connected by a thread with 
one of Marey's levers. Marey's pneumograph consists of a cylinder of soft India- 
rubber, enclosing a spiral spring, whose extremities are connected with two pieces 
of metal which form the ends of the cylinder. A band is passed round the thorax 
of the animal, and attached to the ends of the cylinder. The interior of the cyl- 
inder is brought into communication with one of Marey's levers, and as each 
respiratory movement draws the ends of the cylinders wider apart, or allows them 
to approach, the air is rarefied or compressed, and a corresponding movement is 
transmitted to the lever. Bert has modified this, and made it more sensitive by 
making the cylinder itself of metal, and its ends of Indiarubber. Another method 
— one more ordinarily employed — is to introduce one limb of a T-tube into the 
nostril or trachea of an animal, or connect it with a tracheal cannula. The re- 
spired air passes through the other end, and the third limb is connected with one 
of Marey's levers. 

In the attempt to find out whether the alteration in respiration pro- 
duced by any drug is due to its action on the respiratory centre, or on 
some of the nerves which influence it, we may find the following table 
useful by showing at a glance the chief ways in which the respirations 
may be rendered quicker or slower : — 

( Stimulation of the vagus. 
f Excitement of nerves, -j Stimulation of optic nerve. 
The respiratory | [ Stimulation of acoustic nerve, 

movements may j f Action of brain (voluntary), 

be quickened by | Greater excitement of J Increased temperature of blood. 
L respiratory centre. 1 Increased venosity of blood. 
[ Action of drugs. 

f Diminished excite- f Diminished venosity of blood, 
ment of respiratory \ Action of drugs. 
The respiratory centre. ( Action of brain (voluntary), 

movements may | f Paralysis of vagi. 

be rendered slow -| I Stimulation of superior laryngeal nerves. 

j Stimulation of inferior laryngeal nerves. 
1 Stimulation of nasal nerves. 
j Stimulation of cutaneous nerves. 
( Stimulation of splanchic nerves. 



*y 



Nervous influences. 



218 PHARMACOLOGY AND THERAPEUTICS. 

If the drug to be experimented on be injected subcutaneously or into 
the veins, the actions on the respiratory centre and on the vagi are the 
chief points which require attention ; but if we are experimenting with a 
vapor, its local action on the nasal, laryngeal, and possibly, also, on the 
pharyngeal nerves 1 must be carefully attended to, as it may greatly mod- 
ify its general action on the respiratory centres. Thus Kratschmer has 
found that tobacco smoke inhaled by a rabbit through its nostrils, or 
blown upward into the nasal cavity from an aperture in the trachea, will 
cause arrest of breathing in a state of expiration from the irritating 
effect of the vapor on the nasal branches of the fifth, while it has no such 
effect when blown into the lungs. Ammonia, when inhaled, also arrests 
the respiratory movements in the same way ; but Knoll 2 has observed 
that if it be blown into the lungs while the nostrils are carefully pro- 
tected from its influence, it causes accelerated and shallow breathing, 
alternating with slow and deep respiration, and occasional stoppages in 
the position of expiration, obviously from its action on the different 
fibres of the vagi. 



Action of Drugs on the Respiratory Xerves. 

In experiments regarding the effect of drugs upon the respiration, 
the voluntary influence of the brain is excluded by the use of ether, 
chloroform, opium, or chloral, or by section of the crura cerebri. In the 
case of such poisons as cause sickness allowance must be made for the 
effect of gastric irritation. It will usually be found that before vomiting 
occurs the respiratory movements are very rapid, but they become slower 
after vomiting has taken place. As the chief afferent fibres from the 
stomach are contained in the vagus, the effect of irritation of the gastric, 
as well as of other fibres contained in these nerves, is prevented by their 
division. Sometimes the action of a drug on the peripheral ends of the 
vagus and upon its roots in the medulla may produce exactly opposite 
effects upon the respiration. Thus atropine appears to lessen the excita- 
bility of the respiratory fibres of the vagus, while it stimulates the re- 
spiratory centre. Such an action may be to a certain extent inferred 
from the respiration becoming slower almost immediately after the injec- 
tion of the drug into the jugular vein, and while it is still passing 
through the lungs, and by this slowing being quickly succeeded by accel- 
eration when the drug begins to circulate through the medulla. 

There are two kinds of experiment by which such a conclusion may 
be tested The one is to apply the drug first to the medulla by inject- 
ing it into the carotid artery, and seeing whether acceleration occurs at 
once and afterwards becomes less when the drug has had time to pass 
round again to the lungs. The other way is to divide the vagi before 
the injection and observe the effect. Any alteration in the respiration 
in the way of either quickening or slowing which the drug produced in 
the uninjured annual Bhould remain the same after division of the 



Kroun-S.'qii.iid, ArchitH - of Scientific and Practical Medicine, p. 94. 
<isht r. der Wnn. Acad., vol. l.wiii., Abt. 3, p. 255. 



ACTION OF DRUGS ON RESPIRATION. 219 

vagi if its effect were due to its action on the medulla, but will be absent 
if it were due to an action upon the peripheral ends of the vagi. 

This method was introduced into pharmacological research by von 
Bezold in his admirable research on atropine, and it is the one usually 
employed. 

There is one fallacy, however, which must not be entirely lost sight of, which 
is that after division of the vagi the nerves which remain in connection with 
the respiratory centre have chiefly a slowing action on the respiration ; and thus 
a drug which really renders the respiratory centre more susceptible to reflex 
influences might seem to have a depressing action upon it. 

While atropine injected into the jugular vein seems to produce first 
a slowing of the respiration, due to its paralyzing action on the vagus 
ends, and afterwards a progressive quickening as more of it is carried 
out of the lungs into the medulla, physostigmine, muscarine, and vera- 
trinehave an opposite action, quickening the respiration at first by their 
stimulating action on the vagus ends, and afterwards slowing it by their 
action on the medulla. 

In the action of veratrine upon the pulmonary branches of the vagus 
we may notice a resemblance to the stimulant action which, as already 
mentioned, it exerts upon the nerves of ordinary sensation. If the sen- 
sory branches of the vagus are affected by drugs in a somewhat similar 
way to those of ordinary sensation, as the action of veratrine might lead 
us to imagine, we should expect them to be much stimulated also by 
aconite, and, indeed, according to Boehm and Ewers, this is the case. 
The respiratory changes produced by aconite are regarded by them as 
due, in part, to irritation of the peripheral ends of the vagus, and dis- 
appear on section of the vagi or the administration of atropine. 

Sternutatories or Errliines. 

These are drugs which cause sneezing- and increased secretion from 
the nose when locally applied to it. The drugs must be in a pulverized 
condition. The chief are : — 

Tobacco (snuff). Euphorbium. 

Veratrum album. Sassy bark. 

Ipecacuanha. Saponine. 

Irritation applied to the nose is transmitted by the nasal branches of 
the fifth to the respiratory centre in the medulla oblongata, and ex- 
cites the sudden and forcible expiratory movements of sneezing. At the 
same time, however, the stimulus is transmitted to the vaso-motor centre, 
and the blood-pressure becomes considerably increased by the con- 
traction of small vessels throughout the body, even when no sneezing 
occurs. When sneezing takes place, the pressure is still further increased 
by the muscular efforts which occur in the act. It is probable that there 
is not only general rise in blood-pressure but also that local dilatation of 
the cerebral vessels is reflexly produced by the nasal irritation, and 
thus a stimulant effect is produced on the brain. Snuff is therefore 



220 PHARMACOLOGY AND THERAPEUTICS. 

employed as a luxury, giving a feeling of comfort and enabling the snuff- 
taker to think more clearly — " clearing the head" as it is often termed 
(vide p. 176). 

Uses. — Though comparatively little used now, sternutatories were 
formerly employed in failure of memory, deafness, and severe persistent 
headache. From the violent expulsive efforts which they induce, they 
were given also to cause the expulsion of foreign bodies from the air- 
passages, and to hasten the expulsion of the child in cases of lingering 
labor where no obstruction was present, but where expulsive force was 
deficient. They were given also in order to try and check diseases at the 
commencement, by what was termed " shock to the system." 

One curious thing is to be remarked, that stimulation of one part of 
the respiratory track may arrest abnormal actions in another. Thus 
Marshall Hall has shown that actual sneezing may frequently be pre- 
vented, after the inspiration by which it is usually preceded has occurred, 
by forcibly rubbing the end of the nose or by tightly compressing the 
nostrils. In a similar way irritation of the interior of the nose by snuff 
will sometimes arrest obstinate hiccough. 

Contraindications. — On account of the high blood-pressure which 
they produce their use is by no means free from danger in persons affected 
with atheroma or a tendency to pulmonary haemorrhage or apoplexy, as 
they may cause rupture of a vessel, and in those who suffer from hernia 
or from prolapsus of the uterus, they may seriously increase the gravity 
of these affections. 

Pulmonary Sedatives. 

These are substances which lessen the irritability of the respiratory 
centre, or nerves connected with it, and thus diminish cough and spas- 
modic difficulty of breathing. 

These may be divided into : (1) drugs which tend to remove the ex- 
citing irritant which acts as the cause of cough; (2) those which 
directly lessen the irritability of the respiratory centre ; and (3) those 
which lessen directly the excitability of the afferent nerves in the 
lungs. 

Cougtt consists in a deep inspiration followed by a forcible expira- 
tion with closed glottis, so that the air is driven rapidly through the 
larynx, carrying with it foreign substances, liquid or solid, which may be 
present in the air passages. As it is a modified respiratory act, the nerve 
centre by which the muscles employed in it are co-ordinated is situated in 
the medulla oblongata. 

o 

The afferent fibres by which cough may be excited are chiefly branches 
ol the vagus. One of the most powerful is the superior laryngeal nerve 
distributed to theglosso-epiglottidean folds and to the whole of the interior of 
the larynx, and this being a special expiratory nerve we find that irritation 
of the larynx and also of the trachea is usually characterized by a cough 
frith very violent expulsive efforts. Irritation of the mucous membrane 
of the trachea, especially at the bifurcation of the bronchi, and irritation 
of the substance of the lung, also give rise to cough; and irritation of 



Lungs. 



ACTION OF DRUGS OX RESPIRATION. 221 

the costal pleura and of the oesophagus does so also. 1 Irritation of the 
auditory meatus at the point to which the auricular branch of the va^us 
is distributed will also cause coughing ; and cough appears to be also in- 
duced by irritation of certain parts of the interior of the nose. These 
are the surfaces of the inferior and middle turbinated bones, the most 
sensitive part being the posterior end of the inferior turbinated bone and 



Nasal cavities. 

Larynx 

Trachea 

Bronchi 

Lungs 

Costal pleura... 



Liver 5 /"\.>:- ggF «&kS--> —Spleen 



Fig. 56.— Diagram of the afferent nerves by which cough may be excited. These nerves are shown 
passing to the respiratory centre in the following order from above downwards — from the auditory 
meatus, pharynx, upper part of oesophagus, larynx and trachea, bronchi, lung, costal pleura, 
liver, and spleen. 

the portion of the septum immediately opposite. 2 The sudden application 
of cold to the skin on various parts of the body will sometimes cause 
coughing. Probably the cough in this case is not due to the stimulus 
being conveyed directly to the respiratory centre by the cutaneous nerves, 
but to its causing congestion of the air passages as in Rossbach's experi- 
ments. The congestion then causes irritation of the sensory nerves of 
the bronchi, and occasions cough. 

I have seen irritation of the liver and spleen, induced by percussion 
over them, in a man suffering from chronic enlargement due to malaria, 
likewise cause coughing. 3 In addition to those nerves, however, it appears 
that irritation of the glossopharyngeal branches distributed to the pliar- 
ynx, where the digestive and respiratory tracts coincide as they cross one 
another, may not only excite coughing, but may also act as an auxiliary to 
irritation of the branches of the vagus. The combined action of the 
two mav thus induce cough, when irritation of the vagus alone would not 



1 Kohts, Virchoic's Archiv, 66, 191. 

2 On Nasal Cough, by John N. Mackenzie, M. D., reprint from The American Jour- 
nal of the Medical Sciences, July, 1883. 

3 These observations were made in January and April, 1879, but not published. 
Naunyn, in a paper published in the Deutsch Archiv f. Klin. Med. in March. 1379, 
recorded similar observations. 




222 PHARMACOLOGY AND THERAPEUTICS. 

do so. Thus we find that many persons begin to cough as soon as they 
lie down, but that sometimes by lying round partially on the face, the 
cough ceases. In these persons the uvula is often found to be long and 
much congested, and the tickling which it produces as it rests upon 
t le pharynx or pillars of the fauces seems to aid the irritation in the 
respiratory passages, and produce cough. 

Cough due to irritation of those parts of the respiratory tract where 
the nerves are chiefly expiratory, as the pharynx, larynx, trachea and 
large bronchi, is usually, as might be expected, loud, explosive, and 
prolonged ; while cough due to irritation of those parts where the nerves 
are chiefly inspiratory is short and hacking. 

Cough produced by irritation of the pharynx where the respiratory 
and digestive passages cross one another, is not only violent, noisy, and 
barking, but, as we would naturally expect, is not unfrequently accom- 
panied by retching or vomiting. 

Pharyngeal irritation may accompany dyspepsia, and it is probably 
the origin of the so-called stomach-cough. Irritation of the stomach 
itself, or of its nerves, causes vomiting, but does not produce cough. 

Nevertheless there is a rationale for the common expression " stomach- 
cough." In some experiments on the reflex origin of cough, R. Meyer 1 
has noticed that when some part, from which cough can be reflexly 
induced, is already in a state of irritation, cough can be brought on with 
great ease by irritation of a neighboring part which would not by itself 
cause cough. Something of this kind appears to occur with the stomach, 
for although irritation of the stomach alone will not cause coughing, yet 
it will do so if irritation of the larynx and trachea are already present. 
Thus I have observed violent spasms of coughing occur, along with 
acidity and heartburn, some time after a meal, in a person suffering from 
congestion of the pharynx, larynx, or trachea. The connection between 
the cough and the acidity was shown by the cough ceasing as soon as the 
acidity was relieved by a dose of alkali and the consequent removal of 
the irritation to the stomach, which the acidity had produced. 

Soothing- remedies applied to the pharynx greatly relieve cough, 
although they do not reach so far down as the epiglottis. Mucilaginous 
remedies are very useful for this purpose, and they may either be em- 
ployed alone or as vehicles for the local application of sedatives such as 
morphia. Thus, a piece of extract of liquorice allowed to dissolve in the 
month, a marsh-mallow lozenge, a gum-jujube, or a sip of linseed-tea, by 
covering the back of the throat with a mucilaginous coating, will lessen 
cough to a great extent. Such remedies are especially useful where the 
cough depends on congestion of the pharynx and trachea. In such cases 
uo abnormal Bound at all may be heard in auscultation, and the cough 
being due to irritation of the parts supplied by the superior laryngeal 
nerve, has a peculiarly convulsive expiratory character often termed 
"barking. 

Other remedies lessen cough by diminishing congestion of the 
reepiratoi and thus lessening the irritation which causes the 



: K. Heyer, Oo rmp o nd enzblatt d. Schweber, Aerzte, No. 1, 1876. 



ACTION OF DRUGS ON RESPIRATION. 223 

cough. Many of these, also, however, come under the class of ex- 
pectorants, inasmuch as the diminished congestion is frequently 
associated with increase of the expectoration. Others, again, although 
they diminish cough, are included rather under the head of "cardiac 
tonics, " or sedatives. Digitalis is an example of this. In the conges- 
tion due to cardiac disease, and even in that due to bronchitis, the digi- 
talis, by strengthening the heart and by contracting the vessels, may 
lessen the congestion in the lungs, and give the patient relief. Squill 
and a number of other drugs have an action on the blood-vessels similar 
to that of digitalis. 

Other remedies, such as the vapor of hydrocyanic acid, conium, 
stramonium, and tobacco, have a local sedative action on the lung, 
and may lessen cough; they also are used in order to diminish local 
spasm of the bronchioles, and thus to relieve spasmodic asthma. 

The chief drugs which diminish the excitability of the respiratory 
centre are opium and its principal alkaloid, morphia. Hydrocyanic acid 
has also a sedative action on it, but is by no means so powerful as the others. 

Belladonna and stramonium have a rather peculiar action, stimula- 
ting the respiratory centre, and at the same time appearing to lessen the 
excitability of the ends of the vagi in the lungs. Morphine and opium 
have a double action in lessening cough : they not only lessen the 
excitability of the respiratory centre, but they diminish the secretion of 
mucus in the bronchial tubes, and probably thus also lessen the irritation. 

Atropine has but a very slight and uncertain action on the respira- 
tory centre in preventing cough, if indeed it has any at all. It has, 
however, a powerful effect — much more powerful than that of opium, — 
in completely arresting the secretion from the bronchial tubes. The 
cases in which it is useful are therefore those where the cough depends 
upon excessive secretion. In cases where the mucous membrane is 
already too dry, it would be injurious rather than beneficial. When 
apomorphine and morphine are given together they do not destroy each 
other's action, so that from the combination we get increased secretion 
from the mucous membrane, with diminished irritability of the respira- 
tory centre, and consequently lessened cough. The cases in which this 
combination, then, is useful, are those where there is difficulty of breath- 
ing, continual cough, and thick, tenacious mucus. When morphine and 
atropine are given together, also, they do not destroy each other's 
action; and thus dryness of the mucous membrane is produced along 
with diminished irritability of the centre for coughing. This combina- 
tion is therefore useful in cases of catarrh, emphysema, and phthisis, 
where there is copious secretion of mucus. In phthisis it is especially 
indicated on account of the beneficial action of atropine in also lessening 
sweating. Where the copious expectoration depends upon the presence 
of a cavity, and not on excessive secretion from the bronchi, it will not 
be much affected by the use of these remedies. 

Expectorants. 

Expectorants are remedies which facilitate the removal of secre- 
tions from the air passages. The secretion may be rendered more 



224 PHARMACOLOGY AND THERAPEUTICS. 

easy of removal, either by an alteration in its character rendering it less 
adhesive and more easily detached from the air passages, or by increased 
activity of the expulsive mechanism. 

Our knowledge of the use of expectorants is founded chiefly on 
empiricism. We are almost entirely indebted to the recent experiments 
of Rossbach for any precise information as to their mode of action. 1 

The secretion from the air passages, like other secretions, depends 
partly upon the condition of the circulation, and partly on the secreting 
cells themselves. 

In healthy conditions the increased secretion and increased circula- 
tion of blood in the mucous membrane go together, but just as in the 
case of the sweat glands, these two factors may occur independently of 
each other, and secretion may take place rapidly when the circulation is 
diminished and the mucous membrane is anaemic, and, on the other hand, 
it may stop altogether when the vessels are dilated and the mucous 
membrane is congested. The latter happens both in cases of disease and 
in animals poisoned by atropine. 

The secretion from the normal respiratory mucous membrane con- 
sists of a thin solution of mucin which dries very slowly, and is only 
secreted in sufficient quantity to keep the mucous membrane moist. It 
is slightly adhesive, and any particles of dust, &c, which may have 
found their way into the trachea, will stick to the walls of the air passages 
and will be gradually moved up towards the mouth by the cilia with 
which the cells of the mucous membrane are furnished. Any excess of 
mucus secreted in consequence of irritation will also be moved upwards 
by the cilia in a similar manner. In the ciliated cells of the mucous 
membrane we recognize a structure which is frequently met w T ith in ani- 
mals lower down in the scale of existence, and the mucous membrane of 
the respiratory passages appears to resemble the parts of lower organ- 
isms, in being very slightly controlled by the central nervous system. 
When not irritated it secretes slowly and regularly; when irritated 
locally the secretion is increased, but irritation of the nerves passing to 
it. such as the vagus, the superior or inferior laryngeal, or the sympa- 
thetic, does not cause any increase as it does in the case of the submaxil- 
lary gland. These nerves, however, can influence it indirectly through 
the circulation, for when they are divided an increased dilatation of the 

-■•Is occurs in the mucous membrane of the trachea, a freer circulation 
of blood occurs, and increased secretion is thus indirectly produced. 
When tlicv arc irritated, however, and anaemia of the trachea produced, 
the secretion is not arrested but continues. 

The circulation in the mucous membrane is readily affected reflexly 
by irritation of other parts of the body. When, for example, a warm 
poultice is laid for five or ten minutes on the belly of an animal, and then 
afterwards replaced by ice, the mucous membrane of the trachea and larynx 
becomes in half a minute deadly pale from contraction of its vessels. 
Though the ice is still allowed to remain on the belly, the tracheal 
mucous membrane quickly changes color, and to the paleness succeeds 



■ft rift der .In li a s- Maximilian- Universltiit zu Wurzburg, Leipzig. 



ACTION OF DRUGS ON RESPIRATION. 225 

first slight redness, then deep red congestion, and in five or ten minutes 
lividity. This lividity shows that the congestion is not arterial but 
venous, and that the circulation instead of being quicker, is really 
slower. Along with the increase of congestion in the mucous membrane, 
the amount of mucus secreted increases. When the ice is removed for 
half an hour, and again replaced by a warm poultice, the bluish red 
color of the mucous membrane almost immediately disappears and gives 
place to a rosy color which is, however, redder than normal. Ice again 
applied will cause a second contraction of the vessels and paleness, 
though much less than before. These experiments show how sensitive 
is the mucous membrane of the trachea to reflex stimulation of other parts 
of the body by heat or cold, and enable us to understand more readily 
how a draught of cold air on some part of the body should cause inflam- 
mation of the respiratory organs. 

Action of Drugs on the Secretion. — Alkalies, such as carbo- 
nate of soda, injected into the blood, lessen, or in large quantity 
completely arrest, the secretion of mucus from the trachea. 

This experimental result is in contradiction to the teaching of clini- 
cal experience, which shows us that alkalies increase the amount of 
secretion, and render it more fluid. The results of clinical observation 
are quite as certain as those of Rossbach's experiments, for we may not 
only remark the greater quantity of expectoration, and its greater fluidity 
in persons taking alkalies, but one may note the alteration which they 
occasion in the amount and nature of the moist rales heard within the 
lungs. This can be observed most readily in persons suffering from 
phthisis, especially round the margin of a cavity. After catching a 
slight cold an extension of consolidation may be remarked, in which 
moist rales readily occur on the administration of dilute alkalies. When 
these are continued until the expectoration has been free for a day or 
two and the rales diminish, acids may be given with advantage so as to 
dry up the expectoration still more. But if the acid is given too soon 
the expectoration diminishes, but the cough increases and becomes trou- 
blesome to the patient. 

In all probability the difference between the results of clinical obser- 
vation and Rossbach's experiments depends upon the difference of dose, 
the quantity usually given to a patient being proportionately much smaller 
than that which he employed. We are able to observe a similar differ- 
ence between the effects of small and large doses in the case of iodide of 
potassium ; a small dose of a grain and a half, taken by a healthy man 
three times a day, will almost certainly cause the nose to run freely, 
while if the dose be increased to ten, twenty, or thirty grains, the exces- 
sive secretion will almost certainly be arrested. 

The local application of a one to two per cent, solution of sodium 
carbonate has very little action. The local application of strong liquor 
ammonise causes both congestion and increased secretion of mucus. Very 
strong solutions cause a croupous exudation from the surface of the mu- 
cous membrane. The local application of dilute acetic acid (three per 
cent, solution) has a similar action to weak solutions of ammonia: the 
mucous membrane becoming redder and secreting more mucus. 
15 



226 PHARMACOLOGY AND THERAPEUTICS. 

"When acetic acid was given internally, Rossbach observed in one case 
that the mucus which was before watery and clear, became gelatinous and 
opalescent. This result agrees with what one finds clinically, that acids 
dry up the secretion and make it harder to expectorate. 

Among astringents Rossbach tried tannin, alum, and nitrate of 
silver ; the first two when locally applied made the mucous membrane 
appear paler by altering the epithelium of the mucous membrane and 
rendering it opaque, so that the vessels underneath could hardly be seen ; 
at the same time they arrested the secretion of mucus almost entirely. 
A four per cent, solution of nitrate of silver also caused opacity of the 
epithelium, arrest of secretion, and dryness of the mucous membrane. 
There appears to be a difference in the action of nitrate of silver on the 
mucous membrane of the nose and on the trachea, as when the inside of 
the nose is touched by it, it causes a profuse secretion, whereas it causes 
dryness in the trachea. 

The vapor of oil of turpentine mixed with air arrests the secretion 
of mucus, while a current of air alone, without admixture with oil of 
turpentine, will act as an irritant to the mucous membrane and increase 
secretion. Here again, however, a marked difference is to be seen in the 
effect of small and large doses, for when a watery solution containing from 
one to two per cent, of oil of turpentine was dropped directly on the mu- 
cous membrane, it became less vascular, but the secretion was at once 
increased, instead of being diminished as it was by the vapor. 

This action of oil of turpentine is of great therapeutical importance, 
inasmuch as in many cases of bronchitis we have profuse secretion with 
vascular congestion, a condition likely to be removed by the vapor of 
oil of turpentine. 

Apomorphine, emetine, and pilocarpine, when given internally, all 
cause a great increase of the secretion of mucus, but they do not alter 
the vascularity of the mucous membrane. The most powerful of all these 
is pilocarpine, and after it come apomorphine and emetine. One would 
therefore expect that pilocarpine would be the best remedy in catarrhal 
conditions, but this is not the case, for its other actions on the salivary 
and sweat glands and on the heart render its administration unpleasant 
for the patient. Sometimes also in children oedema of the lungs has 
followed its use. Apomorphine, on the contrary, has been found by 
Rossbach to be of the greatest service in catarrh of the larynx, trachea, 
and bronchia, both in adults and in children. Ipecacuanha has long 
been recognized as one of the most useful expectorants, but the dose given 
18 often tOO small. 

Rossbach's experiments have shown that the consequence of sudden 
changes of heat and cold applied to a part of the body is congestion of 
the respiratory mucous membrane with diminished circulation and 

/nation of blood in the veins. A similar condition occurs in many 

of chronic bronchitis, and in them we not unfrequently find great 

benefit from vascular tonics such as digitalis, which, in addition to 

Stimulating the vaso-motor centre, increase the activity of the heart, and 

thus tend to maintain the pulmonary circulation. 

In what way cod-liver oil affects the bronchial mucous membrane it 
i- perhaps hard to say, but there is no doubt whatever that it is one of 






ACTION OF DKUGS ON EESPIRATION. 227 

the most efficient expectorants that we possess, and in cases of chronic 
bronchitis it affords more relief than any of the ordinary expectorants. 
It is possible that, being a form of fat which is readily assimilated, it is 
taken up by the young epithelial cells of the respiratory mucous mem- 
brane, and thus enables them to grow and maintain their attachment to 
the mucous membrane, instead of being at once shed in an undeveloped 
form as pus cells in the expectoration. 

Action of Drugs on the Expulsive Mechanism. — The 
expectorants which act by increasing the activity of the expulsive ap- 
paratus may be divided into — 

(1) Those which increase the rapidity of the ciliary motion in 
the tracheal mucous membrane. 

(2) Those which increase the activity of the respiratory centre. 
We have no direct experiments or observations on the rapidity of the 

ciliary motion in the bronchial mucous membrane of the higher animals, 
but ammonia has been found to increase its rapidity in the mucous mem- 
brane of the frog. 

The remedies which increase the activity of the respiratory centre are : 
strychnine, ammonia, emetine, ipecacuanha, belladonna, atropine, senega, 
and saponine. They are used more especially in cases of bronchitis, where 
the expectoration is imperfect. 

The chief expectorants have been divided into depressant and stimu- 
lant. They are as follows : — 

Depressant Expectorants. Stimulating Expectorants. 

Increasing secretion and gen- Generally increasing blood-pres- 

erally tending to lessen blood- sure and diminishing secretion, 
pressure. 

Antimonial preparations. Acids. 

Tartar emetic. Ammonium chloride. 

Alkalies. Ammonia. 

Ipecacuanha. Strychnine. 

Emetine. Nux vomica. 

Lobelia. Senega (saponine). 

Lobeline. Onion. 

Jaborandi. Garlic. 

Pilocarpine. Squill. 

Apomorphine. Tar. 

Quebracho. Benzoin. 

Aspidospermine. Benzoic acid. 

Potassium iodide. Balsam of Tolu. 

Balsam of Peru. 
Wood tar. 
Turpentine. 
Oleum Pini Sylvestris. 
Oleum Pini Pumilionis. 
Sulphur. 

Saccharine substances. 
Liquorice. 



228 PHARMACOLOGY AND THERAPEUTICS. 

Adjuncts. — One of the most powerful adjuncts to expectorants is an 
emetic, which frequently will clear the lungs and save life in cases of 
chronic bronchitis with impending suffocation, when ordinary expectorants 
have completely failed. 

One of the emetics most commonly employed in such cases is ipecac- 
uanha either alone or combined with squill, e. g., half a fluid ounce each 
of ipecacuanha wine and oxymel of squills. When there is great de- 
pression, however, and the circulation is very feeble, carbonate of ammonia 
is to be preferred. 

Another powerful adjunct is warmth and moisture in the room 
in which the patient is living, and this is best secured by means of 
steam brought well into the room from a kettle placed upon the hob. 
The kettle used should either be furnished with a very long spout, as in 
the case of the ordinary "bronchitis kettle, or a long tube made of a 
piece of stout brown paper tied around with a string may be used to con- 
vey steam into the room from the nozzle of an ordinary kettle. 

Respirators are also serviceable, by preventing the entrance of cold 
air into the trachea. Many persons, forgetting that the mouth is part of 
the digestive tract, and that the nose is the proper entrance to the respira- 
tory tract, breathe through their mouth ; the consequence is, that the 
cold air passes down the trachea without being previously warmed. In 
the nose we have a special arrangement for warming the air. The tur- 
binated bones present an enormous warming surface, like some recently- 
invented stoves, and, moreover, a special arrangement is made for allowing 
a free flow of blood through this mucous membrane by its being loosely 
instead of firmly attached to the turbinated bones. Its vessels are there- 
fore capable of great and rapid distension, so as to allow the air to be 
readily warmed in cold weather. 

Most respirators are made simply to go over the mouth, and their 
advantage is that they force people to breathe through their nose, or warm 
the air if they cannot do so, and continue to breathe through the mouth. 
In many persons the same end may be gained by forcing them to wear an 
invisible respirator. An instrument is sold bearing this name, consisting 
of a thin plate of metal ; but what is perhaps quite as good, or better, is 

ivereigD or half sovereign placed between the lips and teeth. Patients 
are thus forced to keep the mouth shut in order to prevent it from falling 
out, and its value makes them careful about losing it. 

It is often forgotten too that passages and disused rooms are nearly 
•Id as the external air, and many delicate people who would never 
dream of going outside in cold weather will, without thinking, walk 
through cold passages and in rooms without fires. Warm clothing', 
especially over the shoulders, neck, and chest, is very useful, and its utility 
i- recognized by the common employment of so-called chest protectors 
made of chamois leather and red flannel. 

Other adjuncts arc friction to the chest with stimulating liniments ; 
mustard Leaves, warm poultices, and the application of plasters; the 
emplastrnm calefaciena (B. P.) or emplastrum picis cum cantharide 
I . 8. P.) is especially useful in chronic bronchitis. 



ACTION OF DRUGS ON CIRCULATION. 229 

CHAPTER XL 

ACTION OF DRUGS ON THE CIRCULATION. 

It has already been mentioned that the cells of which higher organisms 
are composed live in the intercellular fluid or lymph which bathes them. 

This nutritive fluid is continually being renewed by fresh supplies 
exuding from the blood-vessels into the lymph spaces which surround the 
cells, the excess being removed by absorption either by the veins or by 
the lymphatics. Besides this, an interchange of gases (internal respira- 
tion) and of solids takes place by diffusion between the lymph and the 
blood. 

When the circulation stops, internal respiration is arrested, and the 
cells die. But they do not all die at the same time, for some are able to 
live longer without fresh supplies of oxygen than others. The order in 
which they die is (1) the cells of the initiative nerve-centres, as the brain ; 
(2) those of the automatic and reflex centres ; (3) nerve fibres (which are 
modified nerve-cells); (4) unstriated muscles; (5) striated muscles. 

Arteries and Veins. — It is important in this respect to remember 
that it is only so long as blood is in the arteries that it is available for the 
nutrition of cells. Once in the veins it is useless for nutrition ; and were 
it not that it readily passes from the veins into the arteries again, it might 
as well be outside the body for any purposes of nutrition. 

The veins are very capacious, and when dilated to their utmost, they 
can alone hold all the blood the body contains, and more. During life 
they are constantly kept more or less in a state of contraction by the 
action of the nervous system, but when they become completely dilated, 
as after death, all the blood flows into them, leaving the arteries empty. 
It is therefore possible, as Ludwig has well expressed it, to bleed an ani- 
mal into its own veins. Schiff has shown that when the blood-vessels 
relax as they do after section of the medulla oblongata, the whole of the 
blood of another animal as large as the one experimented upon must be 
introduced in addition to its own, in order to raise the pressure within 
the vessels to the normal. Even this is insufficient to keep up the pres- 
sure, for the vessels go on still dilating, and the pressure falls, notwith- 
standing the large quantity of blood which is present in them. It is 
therefore evident that the normal action of the vaso-motor centres is 
more than equivalent, for the purposes of circulation, to as much blood 
again as the animal possesses. Weakened power of these centres is to a 
certain extent equivalent to bleeding, and increased power has a similar 
effect to an increase in the quantity of blood in the vessels. 

Blood-Pressure. — The continuity of the circulation of blood through 
the capillaries is not maintained by the heart alone ; the elastic pressure 
of the arteries on the blood within them plays a most important part, and 
indeed during the cardiac diastole the circulation is maintained entirely 
by this elastic pressure. 

If the arterioles or capillaries through which the arterial system empties 
itself into the veins are much contracted, so that the blood can flow 
only slowly through them, the heart may stop, and yet the blood-pressure 
may remain for many seconds almost unchanged. But if the arterioles 



230 PHAEMACOLOGY AND THERAPEUTICS. 

or capillaries are dilated, the arteries quickly empty themselves into the 
veins, arterial pressure rapidly falls, and circulation soon stops. 

I use the words arterioles and capillaries as synonymous, because it 
is almost certain that the capillaries do contract. In most cases where 
contraction has occurred in the peripheral vessels, it is difficult or im- 
possible to say whether its seat is in the capillaries or arterioles. 




Fig. 57.— Diagram to illustrate the effects of the horizontal and vertical position on the circulation of 
the frog in shock, a, normal circulation in the upright position, b, circulation after dilatation of 
the veins has been produced by a blow on the intestines. The blood does not reach the heart, and 
it beats empty, so that the circulation stops, c shows the circulation in a horizontal position after 
the veins have been dilated, as in b. The veins are still dilated, but the blood reaches the heart, 
and the circulation is carried on. Fig. c is perhaps too diagrammatic, as it appears to show an 
empty space or air in the veins. In reality the veins, being very thin-walled, collapse. Fig. b is 
open to the same objection, but if we suppose ourselves to be looking at the vein from the front 
instead of in section, 6 represents almost exactly what I have myself seen in repeating Goltz's 
experiment. 

The action of the heart is to pump the blood out of the veins into the 
arteries, and this it can only do when the blood reaches it. If the veins 
are much dilated and the animal is in an upright position, no blood, or 
so little blood may reach the heart, that its pulsations are practically use- 
less. This is seen in the frog when dilatation of the large veins has been 
reflexly produced by striking the intestines (Fig. 57). When the animal 
is laid flat, the blood flows into the heart, and then it works normally. 
It is probable that a similar condition occurs in man, as one of the factors 
in shock, and in this condition, as well as in fainting, or failure of the 
heart's action from the effect of drugs, as chloroform or other causes, the 
person should be laid flat, with the limbs raised so that the blood may 
flow out of them into the heart, and with the head low (either perfectly 
level with the body or depressed below it), in order to permit of an in- 
creased supply of blood to the inter-cranial nerve-centres. 

Fainting and Shock. — In fainting- there is sudden unconscious- 
lies-, which appears to be caused by sudden arrest of the supply of blood 
to the brain. This arrest may be due to a rapid fall in blood-pressure, 
either from stoppage of the heart, rapid dilatation of the arterioles, or 
sudden removal of pressure from the larger vessels. It is possible that 
these conditions may be associated with spasmodic contraction not only 
of the vessels of the face and surface generally, but of those supplying the 
brain itself. The effect of sudden change from horizontal to an upright 

are in producing syncope has already been mentioned, p. 187. 
Sudden removal of external pressure from the great vessels acts upon 
both arteries and veins. It removes external support from the arteries, 
and allows them to yield more readily to the influence of the blood- 
pressure, and by their dilatation to lessen it. It allows the large veins 
also to dilate and blood to stagnate in them. Its influence is readily 
seen when fluid is removed too suddenly from the abdomen, and external 

■nre bya bandage not supplied in its place, as in cases of ascites. 



ACTION OF DEUGS ON CIRCULATION. 



231 



It is seen, perhaps, even more strikingly, where the bladder has been 
allowed to become distended and is suddenly emptied. The effect of this 
is shown in Fig. 58. In a the bladder is represented as full, and, the 



Carotid artery (full). 



Aorta tense. 
Veins tense and moderately ) 



full./ 



Bladder (full). 





Carotid artery (empty), 



Aorta lax. 

Veins lax and full. 



Bladder (empty). 



Fig. 



a b 

-Diagram to show the effects on the cerebral circulation of rapidly emptying the bladder. 



pressure within the abdomen being considerable, the veins are prevented 
from dilating, the heart is well supplied with blood, and the circulation in 
the brain is active. In b, the bladder is represented as empty, and the 
abdominal contents being diminished, so that the intra-abdominal pressure 
is lessened, not only do the aorta and other vessels become lax from loss 
of the external pressure but the veins dilate, the heart is imperfectly 
supplied with blood, the cerebral circulation fails, and syncope ensues. 
This occurs more readily just after waking, before the vaso-motor centre 
has recovered its usual tone, so that one of the most favorable conditions for 
its occurrence is when a man jumps suddenly into the upright position 
and empties his bladder immediately on waking. The consequence of 
this sometimes is that he falls down suddenly, quite insensible, during the 
act of micturition. I have seen one case in which the tendency appeared 
to be increased by the practice of opium-eating, probably from the dimin- 
ished excitability of the vaso-motor centre produced by the drug. It is 
evident that the danger will be increased if the intervals between the 
systoles of the heart are prolonged, and it is the combination of the 
natural tendency to syncope, produced by large doses of digitalis, with 
that caused by the sudden assumption of the upright posture, and by the 
rapid emptying of the bladder, which renders micturition in the upright 
posture so excessively dangerous in persons under the action of digitalis, 
and leads so frequently to death. 

It is evident that fainting may be prevented by increasing the blood- 
pressure in the brain locally, or throughout the body generally. To in- 
crease it locally the head of a fainting person should be allowed to lie 
level with the body, or a little below it, and on no account raised even by 
pillows. A fainting fit may indeed often be prevented by sitting with the 
head hanging between the knees. It may also be prevented or removed by 
such conditions as raise the general blood-pressure, e.g.,& draught of cold 
water, which causes contraction of the gastric vessels, or a sniff of am- 
monia or acetic acid, which stimulates the nasal nerves and causes reflex 
contraction of the vessels generally. In some parts of India the natives 



232 



PHARMACOLOGY AND THERAPEUTICS. 



are accustomed to bring persons round from a faint by compressing the 
nostrils and holding the hand over the mouth, so as completely to stop 
respiration. The accumulation of carbonic acid in the blood irritates the 
vaso-motor centre, raises the blood pressure, and thus probably tends to 
bring the person round. 

In shock there is no unconsciousness, but the failure of the circu- 
lation is even more profound than in syncope. Its pathology is not per- 
haps exactly ascertained, but it probably depends to a great extent on a 
paralytic distension of the great veins, as in Goltz's experiments. I have 
found that in shock produced in a similar manner in a rabbit the blood- 
pressure could be raised from two inches up to two and a half by the 
inhalation of ammonia. 

Schema of the Circulation. — In order to understand the action of drugs 
on the circulation it is absolutely necessary to have a clear idea regarding the 
effect of the heart and capillaries in maintaining the blood-pressure. This is 
best obtained by using a schema, which can be easily made from a spray-appa- 
ratus. By removing the glass or metal tube from one of these, and attaching a 
nozzle with a small stopcock to the India-rubber tube in its stead, we obtain a 
very good schema of the circulation ; and, by imitating on it the changes which 
occur in the heart and vessels, we may form a much clearer idea of them than 
we could otherwise do. The India-rubber ball will represent the heart; the 
elastic bag, surrounded by netting, will represent the elastic aorta and larger 




-Hruj.Ie schema of the circulation, consisting of a spray-producer, bladder, and mercurial 
lastic ball represents the heart, the elastic bag covered with netting to prevent 



manometer. 

real distension represents the aorta and arterial system °and the bladder represents the 
j tarn. 



arteries; and the stopcock, which regulates the size of the aperture through 
which the air escapes, will represent the small arteries and capillaries, whose 
contraction or dilatation regulates the flow of blood from the arteries into the 
veins. We may judge of the tension in the arteries by the distension of the 
or still better, we mav connect the tube between it and the stopcock with a 
mercurial manometer, and estimate the tension by the height of the mercurial 
column which it Hi>t;im.^. If we turn the stopcock so as to present some resist- 
ance to the escape of air. and then compress the India-rubber ball, very little air 
will issue from the Btopcock oven while wo are squeezing the ball; the greater 
part of il j'-s to distend the bag; and, when we cease to compress the bail, very 



ACTION OF DRUGS ON CIRCULATION. 233 

little air passes through the stopcock. At the next squeeze the bag becomes a 
little more distended : and a little more air passes through the stopcock, not only 
while we are compressing the ball, but even when we relax our grasp. At each 
squeeze of the ball, the elastic bag becomes tighter, till it is so tense, and con- 
tracts so strongly on the air inside, that it can press all the extra amount of air, 
forced into it when the ball was compressed, through the stopcock during the 
time when the ball is relaxed. When this is the case, every time we squeeze the 
ball we see the bag become a little fuller, and air issue more quickly from the 
nozzle. At each relaxation, while the ball is refilling, the bag gets a little 
slacker, and the air passes out of the nozzle a little more slowly, but never stops 
entirely. During the time the ball is filling, the valves between it and the bag 
and nozzle are closed, and cut it off from any connection with them. All this 
time, then, the stream of air from the nozzle must be entirely independent of the 
ball ; it is produced by the contraction of the elastic bag, and by it alone. The 
bag may be stretched, and the tension of its walls increased in consequence, in 
two ways ; first, by working the ball more quickly, or compressing it more com- 
pletely ; second, by lessening the opening of the nozzle, and thus hindering the 
passage of air through it. One trial will, I think, be enough to show how much 
easier it is to alter the pressure by changing the size of the nozzle, than by any 
alteration in the working of the ball, and to prove that alterations in blood- 
pressure probably depend much more on alterations in the lumen of the small 
arteries than on changes in the action of the heart. 

But our schema, as it at present exists, is not a perfect representation of the 
heart and vessels ; for it draws its air from an inexhaustible reservoir, the atmos- 
phere, and is not obliged each time to use that amount alone which it had pre- 
viously driven through the nozzle ; while the heart can only use the blood which has 
been forced by it through the capillaries, and returned to it by the veins. In order 
to make our schema complete, we must connect its two ends by tying them into 
a bladder or large thin caoutchouc bag (such as is used, after inflation, as a toy 
for children), so that the air shall pass into it from the nozzle, and be sucked 
out of it by the elastic ball. This will represent the veins. If we then repeat 
the experiment just described, we shall find that, when we begin to work the 
ball and stretch the elastic bag representing the arteries, the bladder representing 
the veins, becomes empty and collapsed ; and just in proportion as we fill the 
bag do we empty the bladder. If we now stop, the air will gradually escape 
from the bag to the bladder, till the air in both is of equal tension as at first, 

Circulation in the Living Body.— The phenomena of the cir- 
culation in the heart and vessels are very much the same as in the 
schema. When the heart stands still (as when the vagus is strongly 
galvanized), the blood flows from the arteries into the veins until the 
arteries are nearly empty and the pressure within them falls to zero. If 
the heart now begin to beat, it forces blood into the elastic aorta and 
arteries at each systole, and distends them, just like the elastic bag of 
the schema ; while at the same time it takes blood from the veins, and 
they become empty in proportion as the arteries become full. During 
every diastole of the heart, the distended aorta and other arteries, in 
virtue of their elasticity, contract on the blood they contain, and keep it 
flowing on through the capillaries till another systole occurs ; the heart, 
meanwhile, being completely shut off from the aorta by the sigmoid 
valves (just as the ball of the schema was shut off from the elastic bag). 
In general, the diastole is longer than the systole ; so that for the greater 
part the circulation through the capillaries is carried on by the elasticity 



234 PHARMACOLOGY AND THERAPEUTICS. 

of the arteries, and not directly by the heart. The arteries, which we 
have supposed to be at first empty, gradually become distended by the 
heart, just as the elastic bag was by the ball, and exert more and more 
pressure on the blood in them (so that it would spout higher and higher, 
if one of them were cut), till they are able during the diastole to press 
the same amount of blood through the capillaries into the veins as had 
been pumped into them during the systole. The more tensely they are 
stretched, the greater is the pressure they exert on the blood they con- 
tain ; and the amount of this is termed the arterial tension or blood- 
pressure. These two terms mean the same thing, and we use one or 
other just as the fancy strikes us. At each systole, the fresh supply of 
blood pumped in by the heart stretches them more; that is, the arterial 
tension rises. During each diastole, the blood escapes into the wide and 
dilatable veins, and the arteries become less stretched; that is, the 
arterial tension falls. This alternation of rise and fall constitutes the 
pulse. 

Besides the oscillations which take place in the blood-pressure at 
each beat of the heart, a rise and fall in the form of a long wave occurs 
at each respiration. The wave begins to rise just after inspiration 
has begun, reaches its maximum just after the beginning of expiration, 
and then begins to fall again till a new wave succeeds it. The heart- 
beats are generally quicker during inspiration, and slower during expira- 
tion. 

The blood-pressure thus oscillates up and down at each heart-beat 
and rises and falls with each respiration, and the average between the 
highest and lowest points is called the mean arterial tension or mean 
blood-pressure. 

Besides the oscillations in blood-pressure due to the pulse and to the 
respiration, there are slowly rising and falling waves to which the name 
of Traube's curves is given. These are due to alternate contraction 
and relaxation of the arterioles and capillaries. Rhythmical contraction 
of the arterioles has been observed in almost all parts of the body of 
rabbits, and probably occurs both in the lower animals and in man. 

The blood-pressure is not equal throughout the whole arterial system. 
It is greater in the large and less in the smaller arteries in which it be- 
come- diminished by the friction between the blood and the arterial 
walls. It is also modified by gravity, so that the position of a limb may 
alter the pressure in its arteries. 

Method of ascertaining- the Blood-Pressure. 

The blood-pressure is usually estimated in animals by connecting a large 
artery, such as the carotid or femoral, with a bent tube containing mercury by 
means of a connecting tube, which is filled with a solution of carbonate of soda 
to prevent coagulation. The pressure is estimated by the height at which the 
mercurv Btands in the outer limbof the tube. The height may either be read 
off with the eye, <>r. what is much better, it may be registered on a revolving 
cylinder bj means of b long float which rests upon the surface of the mercury, 
and bears on its upper end a brush or pen. This method, which is important 
both in itself and as being the introduction of the graphic method into physi- 
ology, we owe to 0. Ludwig. The apparatus is known as the kymograph. 



ACTION OF DRUGS ON CIRCULATION. 



235 



Tracings may be taken upon paper with a varying speed ; it is usual to take 
them upon paper travelling rapidly, so that quick and small oscillations due to 
the cardiac beats may not be lost or obscured by fusion. The great disadvantage 
of this is that it is impossible to use the curves directly ; they must be reduced, 
and this is a work requiring much time and labor. When taken on a slowly re- 
volving cylinder we get the general results of the action of a drug on the blood- 
pressure shown us at a glance ; and its effects on the form and rapidity of the 
pulse may by a little arrangement be recorded from time to time on another cyl- 
inder revolving more rapidly. 

This method gives us both the blood-pressure and the oscillations which it 
undergoes on account of the cardiac pulsations and respiration. If we wish to 
get the mean blood-pressure unaffected by these oscillations, it is done by simply 
narrowing at one point the calibre of the tube containing the mercury, either by 
a stopcock, or by reducing the tube to a capillary bore. 

Fallacies of Mercurial Manometers. — The oscillating mercurial 
column does not give the variations in blood-pressure quite truly, because the 
oscillations are compounded of these variations and of the oscillations due to the 
inertia of the mercury itself. In order to obtain the exact form of variation we 
employ Fick's kymograph, or Roy's tonometer, in which the apparatus is made 
very light, and all oscillations due to its own inertia are as far as possible 
avoided. 



Writing-point. 



Piston to lessen oscil- 
lation of point 



Tube filled with gly- 
cerine 




Syringe for altering the 
pressure in the mano- 
meter. 



Flat metal tube forming 
the manometer. 



Tube to connect the ma- 
nometer and artery. 



Fig. 60.— Fick's kymograph. It consists of a flat metal tube, bent into a nearly circular form, filled 
with alcohol, and connected with the artery bv means of a leaden tube, filled with a solution of 
sodium carbonate. When the pressure increases within it, the tube straightens, and when the 
pressure diminishes it bends. These changes are magnified and recorded on a cylinder by a light 
lever. The vibrations of the lever are lessened by a piston, which works in a tube filled with 
glycerine. 

Fallacies from Anaesthetics. — Even if the instrument be free from 
fallacy, we still have difficulty in ascertaining the real action of the drug on the 
circulation, inasmuch as the blood-pressure is much affected by movements, and 
by anaesthetics. If the animal is not anaesthetized we may get untrustworthy 
results from the straining or movements it may make, and if it is anaesthetized, 
the anaesthetic may greatly alter the power of the heart, or the sensibility of the 
nerve centres, either to the direct action of the drugs upon them, or to its reflex 
action through the afferent nerves. In order to get rid of movement, and at 
the same time to prevent the vascular centres from being much depressed, curare 



236 PHARMACOLOGY AND THERAPEUTICS. 

is sometimes used instead of an ansesthetic. Perhaps, almost equally good re- 
sults may be obtained by using ether as the anaesthetic, carefully regulating the 
supply so as to abolish sensation without greatly affecting the medulla. The 
reasons why this is possible are discussed at p. 185. In order to regulate the 
supply of ether, we use a stopcock, by which pure ether, or pure air, or an ad- 
mixture of both in any desired proportion, can be passed into the lungs, Fig. 48, 
p. 191. 

Other fallacies arise from the mode of injecting the drug, and this has 
sometimes led to false results : thus drugs are not unfrequently injected into the 
jugular vein, as it is very conveniently situated for the purpose. In this way, 
however, they are carried directly to the heart, and act much more strongly upon 
it than they would do if absorbed from other parts of the body. In the case 
of irritant salts, for example, time is not afforded for their irritant properties 
becoming lessened by chemical combination with the constituents of the blood. 
If the solution injected contain particles which will not pass through the pulmo- 
nary capillaries, or if it is likely to cause coagulation of the blood, it may plug 
up the pulmonary vessels and give rise to dyspnoea and convulsions. 

Both these objections are avoided when the drug is injected unde£ the skin, 
or into the peritoneal cavity. Absorption from the skin is slower than from the 
peritoneum. In some experiments this is a disadvantage : in others, however, it 
is an advantage. 

Another fallacy sometimes arises from the solution of carbonate of soda used 
to prevent coagulation. In order to prevent the blood from passing too far into 
the tube connecting the artery with the kymograph, it is usual to introduce the 
solution of carbonate of soda into the tube by a syringe (vide Fig. 60) or other- 
wise, under a pressure very little less than the usual blood-pressure of the animal 
experimented on. If the blood-pressure be lowered much by stoppage of the 
heart or dilatation of the vessels, the solution of carbonate, or bicarbonate of 
soda, runs into the arteries, and may cause convulsions and death. Thus stop- 
page of the heart by irritation of the vagus, or by the action of a drug, may 
sometimes appear to be followed by results which are not really due to it, but 
only to the conditions under which the experiment has been made. 

Alterations in Blood-Pressure. 

In speaking of blood pressure, arterial blood-pressure is always meant, 
unless otherwise stated. 

As the blood pressure depends on the difference between the quantity 
pumped into the arterial system by the heart at one end, and the quan- 
tity flowing out through the arterioles into the veins at the other in a 
given time, it is evident that — 

The blood-pressure will remain constant when these quantities 
remain equal to each other. 

It will rise when — 

(a). More blood is purnped in by the heart. 

(b). When less flows out through the arterioles in a given time. 

Ir will Call — 

When less is pumped in by the heart, or: 

More flows out through the arterioles; or to look at it another 

way:— 

II I more active. Blood-pressure rises. 

i Less " - « falls. 

i contracl " " rises. 

i dilate " " falls. 



Arterioles 



ACTION OF DRUGS ON CIRCULATION. 



237 



The heart may throw more blood into the arteries, either by pulsat- 
ing more rapidly, or by pulsating more vigorously and more completely, 
so that at each contraction a larger amount of blood is expelled. But 
increased activity can only affect the blood pressure so long as there is a 
free supply of blood entering the heart. If there exist any obstruction 
to its entrance the increased cardiac action will have no effect. Hence 
obstruction of the pulmonary circulation will also lower the blood- 
pressure. 

The causes of alteration in the blood-pressure may be tabulated as 
follows: — 



Blood-pressure. 



May be raised- 



1. By the heart beating more 
quickly. 

2. By the heart beating more 
vigorously and more completely, 
and sending more blood into the 
aorta at each beat. 

3. By contraction of the arte- 
rioles, retaining the blood in the 
arterial system. 



May be lowered- 



1. By the heart beating more 
slowly. 

2. By the heart beating less 
vigorously and completely, and 
sending less blood into the aorta 
at each beat. 

3. By dilatation of the arte- 
rioles, allowing the blood to flow 
more quickly into the veins. 

4. By deficient supply of blood 
to the left ventricle, as from con- 
traction of the pulmonary vessels, 
or obstruction to the passage of 
blood through them, or from stag- 
nation of blood in the large veins, 



e.g. 



in shock. 



The influences on the pressure exerted by (a) the number of beats, 
and (b) by the amount of blood sent out by the heart at each beat, to a 
certain extent, though by no means completely, counteract each other; 
for, when the heart is beating quickly, it has not time to fill completely, 
and so sends out little blood at each beat ; but, when beating slowly, it 
becomes quite full during each diastole, and sends out a larger quantity 
of blood at each contraction. 

It is evident that the amount of blood which the heart can send into 
the arteries at each beat will depend also upon the completeness with 
which the ventricle relaxes during diastole. If the relaxation be incom- 
plete very little blood will enter the ventricle, and thus a drug which 
increases the contractile power of the heart may, by unnecessarily pro- 
longing the systole, lower the blood-pressure as much as a drug which 
paralyzes the heart and prevents the ventricle from expelling its contents. 



Relation of Pulse-Kate and Arterioles to Blood-Pressure. 

Although we are unable, from the mere fact that the blood-pressure 
rises or falls after the administration of a drug, to say whether the result 
is due to the action of the drug on the heart or on the arterioles, yet we 



238 PHARMACOLOGY A^D THERAPEUTICS. 

can come to some general conclusion regarding its mode of action by 
comparing the alterations which it has produced in the blood-pressure 
with those which occur in the pulse-rate. For in the normal condition 
of an animal, when all the nerves are intact, a rise in the blood-pressure 
renders the pulse slow by increasing the normal tone of the vagus centre 
in the medulla, and a fall of blood-pressure quickens the pulse by dimin- 
ishing the tone. This mechanism tends in the normal animal to keep 
the blood-pressure more or less constant. 

We find, therefore, that when alterations in blood-pressure and pulse- 
rate are depicted graphically, so that a rise in one curve indicates a rise 
in blood-pressure, and a rise in the other indicates quickening of the 
pulse, the two curves run in opposite directions if the alteration in 
blood-pressure is due to the arterioles, but they run parallel when 
the alteration is due to the heart. Thus, if the vagi be cut, we find 
that the pulse-rate rises, and in consequence of this the blood-pressure 
also rises. Here the alteration in pressure is due to the heart, and the 




Fig. 61.— Diagram of a pulse and blood-pressure curve, where the alterations are due at first to the 
action of a drug on the heart, as in the case of atropine. The unbroken line indicates the blood- 
pressure, and the dotted line the pulse. After the injection shown by the vertical line the vagus 
is paralyzed, the pulse becomes very rapid, and the blood-pressure rises. At a the vaso-motor 
centre becomes paralyzed, the arterioles dilate, and the pressure falls. From a to b the action of 
the heart continues nearly uniform, notwithstanding the fall in blood-pressure, but at b the heart 
begins to become paralyzed, and the pulse-rate and blood-pressure both continue to fall steadily 
tilldeath. 

two curves are therefore parallel. If the vagi be irritated the pulse-rate 
falls, and in consequence of this the blood-pressure also falls. Here again 
the alteration is due to the heart, and the two curves are parallel. 

If, on the other hand, the arterioles are made to contract the pressure 
rises, but the increased pressure stimulates the vagus roots in the medulla 
and the pulse-rate falls, so that the curves run in opposite directions. 




fagram of pulse and blood-pressure curves, where the alterations are due at first to the 

anion of a drug on the arterioles, The unbroken line indicates the blood-pressure, thedotted line 

Stea the pulse The upright line indicates the time of injection of the poison. This is followed 

traction of the arterioles and consequent rise of blood-pressure. This rise stimulates the 

roots, and causes slowness of the pulse. At b the vagus becomes paralyzed, the pulse becomes 

quick, and the pr< ill higher between a and H. At iJ the vaso-motor centre becomes 

paralyz.d, tin- arterioles dilate, and the pressure falls, notwithstanding the rapidity of the pulse. 

the heart Itself begins to be paralyzed, its beats become slow, and both pulse and pressure 

fall -leadily till death. 

If the arterioles dilate the pressure falls, and the vagus tone being les- 
I ill- pulse-rate rises; so the curves are again in opposite directions. 



ACTION OF DRUGS ON CIRCULATION. 



239 



An example of this is seen in the accompanying curve (Fig. 63), 
which illustrates the action of erythrophloeum — a substance similar in 
action to digitalis — on the circulation. After the injection of the drug 
the vessels contract, and the blood-pressure consequently rises and pro- 
duces some slowness of the pulse. In a little while the vagus becomes 
paralyzed, the pulse becomes quicker, and the pressure rises still further. 
At a later stage the heart becomes slow, apparently from the action of 
the drug upon it, and the blood-pressure then falls again. At first then, 







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Fig 63.— Curve of the pulse and blood-pressure in a cat after division of the spinal cord at the atlas and 
injection of ervthrophlceum. From a paper by Brunton and Pye, Phil. Dans., vol. 167. 

where the alteration of pressure depends upon the state of the vessels, we 
have the two curves running in opposite directions, but when the alter- 
ations depend upon the condition of the heart we have them running 
parallel. 1 It will be noticed that in the latter part of the curve, although 
the blood-pressure and the pulse sink together, they do not sink quite 
parallel ; the pulse falling very rapidly and the blood-pressure very slowly. 
From this fact we may conclude that the arterioles are still contracted, 
and this affords an illustration of another way in which we judge of the 
effect of drugs upon the arterioles. This conclusion would not be warranted 



1 Although the rise in blood-pressure which accompanies that of the pulse is 
partly due to the heart, it is very probable that the contraction of the arterioles 
which caused the rise at first is not only continuing but increasing. 



240 PHARMACOLOGY AND THERAPEUTICS. 

by the data contained in Fig. 63 alone. For the slow fall of blood- 
pressure in this experiment might possibly be due to the heart beating 
more perfectly, at the same time that it begins to beat more slowly. 
An examination of the original tracings of the blood-pressure shows that 
this is not the case and that the beats of the heart became feeble at the 
same time that they became slow. 

The mutual regulating power of the pulse and blood-pressure only 
exists when the vagi are working normally. If they should be paralyzed 
either by section or by the action of a drug, increased arterial pressure 
will no longer slow the pulse ; it may even quicken it, and therefore the 
pulse-rate and blood-pressure may, in such a condition, run parallel even 
though the increased pressure should be dependent upon alterations in the 
arterioles. 

But if the vagi are not paralyzed, and we find on comparing the 
curves of blood-pressure and pulse-rate that they run parallel, a fall in 
the blood-pressure and slowness of pulse occurring together, or a rise in 
pressure and quickness of pulse accompanying each other, we may con- 
clude that the alterations in such a case are due to changes in the action 
of the heart. 

If, however, we find that the curves run in opposite directions, the 
pressure rising and the pulse falling, it is highly probable that the rise is 
due to contraction of the arterioles, and that the fall of the pulse is 
caused by the rise of pressure acting as a stimulus to the vagus roots. 
This is, however, not quite certain, as it might be due to the action of the 
drug upon the vagus, and the proper method of ascertaining this would 
be that employed by Ludwig, of allowing a quantity of blood to flow out 
into a bladder connected with a blood-vessel, so that the pressure should 
fall. If the pulse still continued slow in spite of the fall of pressure, it 
would be evident that the slowness was due to the action of the drug upon the 
vagus and not to indirect action through the blood-pressure. By employing 
a bladder in this manner the blood can be quickly introduced again into 
the vessels after the effect of its withdrawal has been ascertained. 

We not unfrequently find that owing to the action of a drug the pulse, 
which has become slow during the rise of the blood-pressure, suddenly 
becomes very rapid, notwithstanding that the pressure continues high. 
This is usually due to paralysis of the vag-us-ends in the heart, and 
when this occurs the correctness of the conclusion which we draw from 
the occurrence may be ascertained by stimulating the vagus in the neck 
by a faradaic current, and seeing whether any slowing or stoppage of the 
heart occurs. Frequently we find that after the pulse has become quick 
from paralysis of the vagus, the pressure which the quick pulse had raised 
begins to fall again from paralysis of the arterioles. The pulse may 
continue quick and weak almost till death, and then cease suddenly, or it 
may become gradually slow as well as weak from paralysis of the heart 
itself. 

Effect of the Arterioles on Pulse Curves. — The influence of the 
arterioles upon the blood-pressure in a living animal can be to a great 
extent ascertained from the rapidity or slowness of the fall of the blood- 
pressure during the diastole of the heart. When the heart is beating 
Blowly the diastole may be long enough to show distinctly the curve which 



ACTION OF DKUGS ON CIRCULATION. 241 

the blood-pressure describes during its descent ; but if the heart is beat- 
ing quickly the diastole may be so short that this curve cannot be exactly 
obtained. It is then necessary to prolong the diastole artificially by stim- 
ulation of the vagi. 

The reason why the part which the arterioles play in maintaining the 
blood-pressure can be ascertained by the way in which it falls during 
cardiac diastole, natural or artificial, is that in the healthy heart the aortic 
valves close during the diastole so as to separate the aorta completely 
from the ventricle. 

In considering the blood-pressure during the diastole, we may there- 
fore disregard the heart entirely, and look upon the aorta and its branches 
as an elongated elastic bag closed at its cardiac end, but open at its 
capillary end. This bag is distended with blood, which in consequence 
of the elastic pressure exerted upon it by the arterial walls tends to flow 
out into the veins. The rate at which it does this will depend — 

1st, on the elastic pressure or arterial tension, and, 

2ndly, on the size or degree of contraction of the arterioles or 
capillaries. 

If we connect a manometer with this elongated bag, as in Fig. 64, 
and place on the mercurial column a float by which its height can be re- 
corded on a revolving cylinder, it is evident that the pressure curve will 




Fig. 64. — Diagram of the circulation, a, the heart, completely shut off' by the valves during diastole 
from b, the arteries, c, the capillaries, d, the veins, e, mercurial manometer. /, a float, g, a 
recording cylinder. 

fall more quickly to zero when the capillaries are dilated, and more slowly 
when they are contracted. 

With capillaries of the same size, the rate of flow will vary with the 
arterial pressure. If the pressure be high the curve will fall more rap- 
idly than when it is low, for the greater blood-pressure will drive the 
blood more rapidly through the open arterioles. If we find that with a 
normal pressure the pressure curve falls more slowly than usual during 
the diastole, we may conclude that the arterioles are contracted ; and if 
we find that the fall is slower, notwithstanding that the pressure is 
higher than usual, the proof that the arterioles are contracted is so much 
the stronger. • 

This is what Meyer and I 1 observed in the case of digitalis, 
where we found as in the accompanying figure that the fall of the 



1 Brunton and Meyer, Journal of Anatomy and Physiology, vol. vii., 1872, p. 134. 
The experiments described in the paper were performed in 1868. 
16 



242 PHARMACOLOGY AND THERAPEUTICS. 

blood-pressure during the cardiac diastole in a dog is much slower 
after than before the injection of digitalis into the circulation. 



vsmmmmwiamm 

MiflLiavai 

iiiwuimir/ftMK 

imm IKHB9 

¥9 



Fig. t)5.— Tracing showing the blood-pressure and form of the pulse-wave before and after the 
injection of digitalis in the dog. The thin line shows the blood-pressure before, and the thick 
one after, the injection. The curve sinks more slowly after the injection, notwithstanding the 
greater pressure in the vessels. 

In observations of this sort it must always be borne in mind that a 
great difference exists between the vessels of the intestines on the one 
hand, and those of the muscles on the other. The former are readily 
controlled by the vaso-motor centre, and when this is stimulated they 
contract greatly. Those of the muscles appear to be but slightly influ- 
enced by the vaso-motor centre, so that when it is stimulated they hardly 
contract at all, and indeed the flow of blood through them becomes 
accelerated on account of the contraction of the vessels elsewhere. When 
the vaso-motor centre is stimulated at the same time that the vagus is 
irritated, the blood-pressure appears to fall nearly as quickly as when the 
vagus alone is irritated. It seems possible, however, that this result 
may be really due to some extent to actual dilatation of the vessels in 
the muscles, for stimulation of the motor nerves of muscle appears to 
produce a vaso-dilating effect on their blood-vessels (Gaskell and others). 

The want of power of the vaso-motor centre over the vessels of the 
muscles is probably of considerable pathological importance. John 
Hunter 1 noticed, when he was bleeding a lady from a vein in the arm, 
that the blood, which previously had been dark and venous, became 
bright scarlet like arterial blood when she fainted, and remained so 
during the continuance of the faint. This seems to indicate that during 
syncope, although the superficial vessels are empty and contracted, the 
arterioles of the muscles are dilated like those of an actively secreting 
salivary gland. 

[f we find then that after the injection of a drug the blood-pressure 
remains constantly high, during stoppage of the heart, we may conclude 
thai the vessels of the muscles are contracted as well as those of the 
Intestine. Such a condition occurs after the injection both of digitalin 
and of erythrophlceum, in which the pressure sometimes remains high 
for many seconds, or even for a minute or more, after the heart has 
finally to beat | Fig. 63). 



.John Hunter' 



works, edited by Palmer, 1837, vol. iii., p. 91. 



ACTION OF DRUGS ON CIRCULATION. 243 

Investigation of the Action of Drugs on the Arterioles. 

The arterioles become contracted by the action of the involuntary 
muscular fibre contained in their walls ; they dilate partly by their own 
elasticity and partly by the pressure of fluid within them. 

The capillaries also appear to have the power of contraction. Both 
arterioles and capillaries are induced to contract by the effect upon them 
of the nerves which pass to them from vaso-motor centres. The blood- 
vessels may also dilate actively from irritation of vaso-inhibitory nerves. 
The exact mode ofTf action of these nerves is not ascertained; they are 
generally looked upon as entirely separate from vaso-motor, but it seems 
not improbable that here also the difference between vaso-motor and 
vaso-inhibitory nerves is a mere question of relation, and some nerves 
produce contraction and dilatation according to the point where they are 
stimulated. Thus Dastre and Morat have found that the servical sympa- 
thetic which produces contraction of the vessels in the rabbit's ear, when 
irritated between the ear and the first thoracic ganglion, causes dilatation 
instead of constriction when it is irritated at a point below the ganglion, 
in which case the stimulus has to pass through the ganglion before it 
reaches the ear. 

In considering the action of drugs on the vessels we have, therefore^ 
to examine : — 

1. Their direct effect upon — 

A. The contractile walls of the vessels themselves with their 

a, muscular fibres, 

b, motor ganglia; 

b. Nerve fibres 

a, vaso-motor, 

b, vaso-dilating ; 

c. Nerve centres 

a, vaso-motor, 

b, vaso-dilating. 

2. Their reflex action on the nerve centres just mentioned. 

There are two modes of estimating- the contraction of the 
arterioles ; 1st, by direct observation and measurement under the micro- 
scope ; 2d, by ascertaining the quantity of blood or other fluid which will 
pass through them in a given time. 

Each of these methods may be used in several ways, according as we 
wish to ascertain the action of a drug ; first, on the contractile walls of 
the vessels alone ; 2d, on the walls together with the vascular nerves, but 
without the nerve-centres ; and 3d, on the vessels in connection with the 
nerve-centres. 

The method of direct observation of the arterioles may be 
practised in either frogs or mammals. 

The part of the frog usually selected is the web, the mesentery, 
the mylohyoid muscle, the tongue, or the lung. The parts usually ob- 
served in mammals are the wing of the bat and the ear of the rabbit. 1 



1 For observing the vessels of the rabbit's ear one of Briicke's lenses is very con- 
venient. It resembles a telescope in its construction, but has a very short focus. 



244 



PHARMACOLOGY AND THERAPEUTICS. 



In observing the effect of various conditions on the lung, it is neces- 
sary to innate it. This is easily done by means of a small cannula with 
a bulging end which is tied into the larynx. Over the other end is slipped 
a small piece of India-rubber tubing, and by clamping this after the lung 
has been inflated, the escape of air is prevented. 







pparatua lor ascertaining the effect of heat and cold on the vessels of the frog's lung, a, a 
piece oj cork to which the frog is fastened, is laid on b, the stage of a microscope, and attached by 
an indlfl-rnbDer strap, 0. D la a .small ring of cork covered with a thin circle of glass. E is the 
inflated [rog i lung, i is a tube by which a current of air can be directed on the frog's lung. Itis 
new in position by a piece Of wire, <,, which can be bent to any position. lis a flask containing ice 
m a Bask containing hot water. K is a three-way stopcock, by which a current of air 
• rom i be ipray-produoer, L and m, through either i or n at will, and thus cold or hot 
air may be applied alternately to the lung. 

An apparatus for this purpose is described by Holmgren. 1 The ac- 
panying engraving (Fig. 66) shows one which I used in 1870 for the 
urpose of investigating the action of heat and cold upon the lung 2 . 

1 Ludwig's Festgdbe. 

British Medical Journal, Feb. 13th, 1875, p. 204. 



com 



ACTION OF DRUGS ON CIRCULATION. 245 

By means of the Inclia-rubber ball I directed upon the lung a stream 
of air which was previously passed either through hot water or through iced 
water. The pulmonary capillaries, when treated in this way, contract 
under the influence of cold by one-third of their diameter. McKendrick, 
Coats, and Newman, in an investigation on the action of anaesthetics on 
the pulmonary circulation, found that chloroform, ethidene, and ether, all 
stop the pulmonary circulation^ the action of chloroform being greatest 
and that of ether least. 1 

In observing the effects of drugs on the vessels alone, it is necessary 
to destroy the influence of the nerve-centres over them. This is usually 
done in a frog, by destroying the brain and spinal cord. In the rabbit's 
ear it is done by dividing as far as possible all the nerves going to one 
ear, then injecting the drug into the general circulation and comparing 
its effect upon the two ears. It is evident, however, that such experi- 
ments are not free from fallacy, because in them the circulation is de- 
pendent on the condition of the heart as well as that of the vessels ; and 
both of these may be affected by the drug. 

A better plan, therefore, is to obviate this fallacy by keeping up the 
circulation artificially, either in the body of the frog, or in the ear of the 
rabbit. 

A method for maintaining- artificial circulation in the rabbit's 
ear while the calibre of the vessels is being measured was invented by 
Ludwig, and described by me in the British Medical Journal, 1871. 

In the frog artificial circulation is kept up by putting a cannula into 
the aorta, and another into the vena cava or abdominal vein after destruc- 
tion of the brain and spinal cord. The aortic cannula is connected with 
two funnels or bottles, such as are used for artificial circulation through 
the intestine. These contain either a saline solution or a mixture 
of saline solution with blood. To one of them the drug is added. 
The circulation can be rendered quicker or slower at will, by increasing 
the pressure under which the fluid flows into the aorta. A suitable part 
of the frog is then put under the microscope, and the vessels measured 
while unpoisoned blood flows through them. The poisoned blood is then 
allowed to circulate under exactly the same conditions of pressure and 
the vessels are measured again. By this method of observation Graskell 
ascertained that very dilute alkalies cause great contraction of the vessels, 
so as sometimes almost entirely to occlude them and arrest any flow of 
blood through them. Dilute acids counteract this effect and cause the 
vessels again to dilate. 

Cash and I have observed that in addition to this action, dilute acids 
have a tendency to increase the exudation of fluid from the vessels and 
produce oedema of surrounding tissues. 

In many experiments which have been made on the action of drugs 
on the blood-vessels by direct microscopic measurement of their size, be- 
fore and after the application of the drug, no account has been taken of 
the effect which the application of the drug may produce by its local irri- 
tating action on the nerves or tissues of the part to which it is applied, 



Ibid., Dec. 18,1880. 



246 PHARMACOLOGY AND THERAPEUTICS. 

and by its reflex action through the nerves, quite independently of any 
special action which it may have on the vessels. Thus, irritation by the 
application of alcohol, either alone or as a solvent in tinctures, or by a 
strong saline solution, has an effect similar to that of simple irritation by 
pressure or scratching, and usually causes temporary contraction, followed 
by dilatation of the capillaries. This contraction may be more or less 
prolonged, according to the strength of the irritant which is applied. 
Unless these conditions are taken into account, observations on the effect 
of drugs applied locally to the web, mesentery, or tongue, are very un- 
satisfactory and generally worthless. 

Perhaps a somewhat better result may be obtained by injecting the 
drug into the lymph-sac of a frog, and then observing the web. But 
here also we have the same difficulty, because the sensory nerves of the 
lymph-sac being irritated, reflex stimulation of the vaso-motor centre and 
consequent contraction of the vessels may be induced. 

Method of Measurement by Kate of Flow. — Another method 
of ascertaining the effect of drugs on the vessels is to measure the amount 
which flows out of them in a given time. This method may be employed 
either in the frog or in the higher animals. The method of employing 
it in the frog is to destroy the brain and spinal cord, and tie one cannula 
into the heart or aortic bulb, and another into the inferior vena cava. 
The aortic cannula is connected with a reservoir containing saline solu- 
tion, or defibrinated blood, which can be made to pass into the aorta and 
circulate through the vessels at any desired pressure by simply raising 
or lowering the reservoir ; the fluid flows out through the cannula in the 
vena cava, and the quantity is registered upon a revolving cylinder. 

By this method Cash and I have found that potassium chloride, contrary 
to our expectation, causes great contraction of the vessels: that barium 
and calcium and strontium do so also, but to a less extent. The instru- 
ment used for this purpose consists of a light lever, one end of which is 
depressed each time that a drop falls upon it. An electric circuit is thus 
broken, and the fall of each drop is readily recorded by means of an 
electro-magnetic marker, at the same time the pressure under which the 
circulation is going on is also recorded by means of a manometer. Slow- 
ing of the flow indicates of course contraction of the vessels, and acceler- 
ation indicates dilatation of the vessels. 

The general results of our experiments with several metallic salts are 
shown in the accompanying table. Most of the drugs experimented on 
cause contraction of the blood-vessels, but we are unable at present to 
arrange them in the exact order of their strength of action. 

Lithium causes slight contraction. Iron causes slow contraction. 

Potassium (very dilate solutions) causes Copper " powerful do. 

dilatation. Zinc " powerful do. 

Ditto (solutions of T ,,'o.,,) causes con- Tin " powerful do. 

traction. Cadmium" slight do. 

Barium causes rapid contraction. Nickel " slight do. 

Calcium gradual do. Cobalt " slight do. 

Strontium " gradual do. Platinum" powerful do., but none is 

Magnesium slighl do, produced by solutions weaker than B oW- 
a in in in i urn (much diluted), lias do effect. 

1 per cent, needed to produce any 

effect 



ACTION OF DRUGS ON CIRCULATION. 247 

In experiments made by such methods as that just described we re- 
duce the problem of the action of drugs on the blood-vessels to a very 
simple form, although we have still to distinguish whether the drug 
acts directly on the contractile walls of the blood-vessel or on the nervous 
elements contained in its wall. There is at present no means of abso- 
lutely separating those two factors, but it is probable that the nerves die 
sooner than the muscular fibres, and that if the experiments are carried 
on for some time the effect of the drug is chiefly, if not entirely, exerted 
upon the muscular fibres. This is probably the explanation of the differ- 
ent effects of chloral on the vessels of the kidney observed by Ludwig and 
Mosso. 

In experiments on the flow of blood through the vessels of warm- 
blooded animals, the circulation is kept up in much the same way as in 
the frog. The blood may be used cold, or may be kept at the tempera- 
ture of the body. The cannula is usually inserted either into the artery 
supplying an organ such as the kidney, or supplying a single muscle, or 
it may be put into the descending aorta, so that the blood passes through 
the whole of both lower extremities. The flow is measured by the rate 
at which the blood issues from the corresponding vein. 

This method we owe to Ludwig, who, along with his pupil Mosso, 
made a number of experiments on the circulation through the kidney. 
The conclusions arrived at were : — that venous blood causes contraction, 
and oxygenated blood, dilatation of the vessels ; but the dilatation which 
richly oxygenated blood, circulating after venous blood, causes in the 
vessels is only temporary, and they soon return to their normal calibre. 
Mosso's experiments have been repeated by Severini, who used the lung 
instead of the kidneys. He finds that the alternate circulation of oxy- 
genated and of venous blood acts in the manner described by Mosso, 
but that when oxygenated blood is passed through steadily the vessels 
contract and the flow through them is diminished ; venous blood, on the 
contrary, when circulated for a length of time, causes the vessels to 
dilate and the flow through them to increase. The action of venous 
blood upon the arterioles appears indeed to be similar to its action upon 
other tissues. A small or moderate quantity of carbonic acid acts as a 
stimulus and causes contraction, but great interference with the natural 
process of oxidation produces paralysis. 

Nicotine, in the proportion of 1 in 10,000, causes contraction of the 
vessels ; but this is also temporary. One per cent., on the contrary, 
immediately causes dilatation. 

Atropine has a very powerful action ; but this differs completely 
according to the dose. One part in 100,000 causes temporary contrac- 
tion of the vessels, which soon passes off. One in 10,000 causes con- 
traction, which, instead of returning simply to the normal, passes into 
dilatation, and then returns to the normal. One in 5,000 has a similar 
action, but instead of the dilatation passing away, and the vessels return- 
ing to their normal size, the dilatation persists, and the kidney soon 
dies. 

Chloral causes the vessels to contract and then to dilate ; but besides 
this it has a peculiar action, either increasing rhythmical contraction 
and dilatation of the vessels, when such movements are already present, 



248 PHARMACOLOGY AND THERAPEUTICS. 

or inducing them when they are absent. It only acts upon the vessels 
when the blood contains oxygen ; and when the blood is saturated with 
carbonic acid, it has no action on them at all. Its action is also altered 
by the condition of the kidney. When this organ has been kept for 
twenty-four hours in a cool place, its vessels still retain their irritability ; 
but small doses of chloral, instead of causing contraction followed by 
dilatation, only produce contraction, and a much larger dose is required 
to produce dilatation. This alteration is due to a change in the vessels — 
either in their muscular walls, or more probably in the ends of the vaso- 
motor nerves — and not to any change in the blood ; for it occurs when 
serum instead of blood is passed through the kidneys. When the kid- 
ney is dead, chloral mixed with the blood, instead of increasing the 
rapidity of the current as in the living organ, or leaving it unaltered, as 
one would expect, greatly diminishes it. Chloral also alters the effect of 
artificial stimulation of the kidney. Faradaic currents or induction- 
shocks do not seem to affect the normal vessels, but constant currents 
cause dilatation, which continues while the currents are passing and 
diminishes after they cease. When chloral is added to the circulating 
blood, however, the vessels contract during the passage of the current 
instead of dilating, and dilate slightly after the current has ceased. 
When the chloral has acted so far upon the vessels as to dilate them 
greatly, the constant current causes no alteration while it is passing, but, 
after it ceases, dilatation increases still further. 

Action of Drugs on Vaso-motor and Vaso- dilating- Nerves. 

The effect which irritation of. the vascular nerves produces in the 
living body is also altered by the action of drugs. This effect is of two 
kinds — vaso-motor or vaso-contracting, and vaso-dilating. Fibres, having 
these two different actions on the vessels of a part, appear frequently 
to run together in the same nerve-trunk, so that sometimes we get dilata- 
tion, at other times contraction of the vessels on irritation of a nerve, 
and not unfrequently we get contraction followed by dilatation. Such 
fibres, however, are not contained -in equal proportions in different nerve- 
trunks. The splanchnics, for example, chiefly contain vaso-motor fibres, 
bo that irritation of these nerves causes great contraction of the vessels 
in the intestine, and a rise of blood-pressure. The motor nerves of 
muscles, on the contrary, appear to contain chiefly vaso-inhibitory fibres, 
BO that stimulation of the nerve causes dilatation of the vessels in the 
muscle to which it is distributed. Similarly, irritation of nerves distrib- 
uted to glands usually causes dilatation of the vessels in them. The 
chorda tympani affords a marked example of this, though the same thing 
is DOticed also in the ease of the sweat-glands in the foot on irritation of 
the sciatic nerve. 

Most of these vaso-motor or vaso-inhibitory nerves can be stimulated 
reflexly by irritation of a sensory nerve, as well as directly by irritants 
applied to the nerves themselves. 

We are not acquainted with many drugs which have the power of 
paralyzing the ends of the vaso-motor nerves in the vessels apart from 
an action upon the contractile walls of the vessels, or the central nervous 



ACTION OF DRUGS ON CIRCULATION. 249 

system. Arsenic, however, appears to be a drug of this kind, and in 
acute poisoning by arsenic Bohm has observed that neither irritation of 
the splanchnic nerves nor of the medulla raises the pressure in the way 
it usually does. From this effect Bohm concludes that the vaso-motor 
nerves contained in the splanchnics are paralyzed, but some other ob- 
servers have not obtained similar results. Hay has found that potash 
has a similar action. The method is not free from fallacy, for it is 
obvious that if the vessels in the intestine should happen to be already 
contracted either from the effect of a drug upon them or from any other 
cause, neither stimulation of the splanchnics nor of the medulla can have 
any further effect upon them or on the blood-pressure through them. 
For when the vessels of the intestine are contracted the blood pours into 
the veins from the aortic system, through the arterioles and capillaries 
of the voluntary muscles, and these are only to a very slight extent under 
the control of the vaso-motor centre in the medulla. Irritation of it 
will therefore have little effect on the general blood-pressure when the 
arterioles of the intestine are already contracted, and irritation of the 
splanchnics is also prevented from having much effect. 

It seems probable that curare and poisons which, like it, not only 
paralyze the ends of the motor nerves, but also the ends of the vagus in 
the heart, also paralyze vaso-motor nerves, though larger doses are 
required for this purpose. 

Vaso- dilating fibres appear also to be paralyzed by curare, for irrita- 
tion of the motor nerve of a muscle does not cause dilatation 1 of the ves- 
sels in a muscle of an animal deeply poisoned by curare. Stimulation of 
the spinal cord produces contraction of the vessels of the penis instead of 
erection in an animal poisoned by curare, 2 and stimulation of the chorda 
tympani does not cause the same amount of dilatation in a poisoned as in 
a non-poisoned animal, even when the dose of curare is small. 3 Small 
doses of curare, however, and even large doses of opium, do not appear 
to paralyze the vaso-dilating nerves of muscles. 

In some experiments which I made on the chorda tympani, I got a 
different result from the usual one in an animal thoroughly under the 
influence of opium. The vessels appeared to contract instead of dilating 
on irritation of the chorda tympani, so that instead of the blood gushing 
out of the vein, it flowed slowly, drop by drop. 

Action of other parts on the Blood-Pressure. — It has 
already been mentioned that the blood-pressure rises during muscular 
exertion, as for example during the struggles of an animal. The cause 
of this has not been definitely ascertained, but it is probably, to a great 
extent, due to the flow of blood through the muscles being mechanically 
obstructed by the contraction of the muscular fibres and to a more rapid 
action of the heart. 

The flow of blood through those organs which consist of involuntary 
muscles, e.g., the intestine, may also be obstructed. 



1 Gaskell, Journ. of Physiol, 1878-9, vol. i., p. 273. 

2 Eckhard, Beitrcige, vol. vii., p. 67. 

3 V. Frey, Ludwig's Arbeiten, 1876, p. 98. 



250 PHARMACOLOGY AND THERAPEUTICS. 

When physostigraa is given to an animal, the blood-pressure is some- 
times noticed to rise considerably, and this rise of pressure was at first 
attributed to contraction of the arterioles. According to Von Bezold 
and Grotz, however, this is due, to a great extent, not to the contraction 
of the arterioles themselves, but to mechanical obstruction of the intes- 
tinal vessels by the tetanic contraction of the muscular walls of the 
intestine. 1 

Keflex Contraction of Vessels. — Experiments on the outflow of 
blood from divided vessels, while the nervous system is intact, are some- 
times made on frogs for the purpose of ascertaining the direct effect of 
drugs on the arterioles themselves, but this method is faulty, for the 
alterations consequent on the injection of the drug may be simply due 
to its local irritant action producing reflex contraction. 

Such experiments are usually made by snipping off the toe of a frog, 
then injecting the drug into the lymph-sac and observing how many 
drops of blood exude in a given time from the toe before and after the 
injection. 

It is obvious that if no change occur in the heart, and the openings 
of the divided vessels do not become obstructed by clots or otherwise, 
these experiments may give some indication regarding the contraction of 
the vessels : but the results are not trustworthy unless we can ascertain 
the condition of the heart. A modification of this experiment enables 
lis to some extent to do this. The end of a toe on each foot having been 
snipped off, the nerve in one leg is divided and then the drug is injected 
into the lymph-sac. If it be then found that the flow of blood from the 
foot, whose vaso-motor supply has been destroyed by division of the 
nerve, continues unchanged or is even increased after the injection of 
the drug, while that from the other foot is diminished, we may conclude 
that the diminution is due to contraction of the vessels caused by the 
injection of the drug. 

But it is incorrect to assume, as has sometimes been done, that this 
contraction is due to any specific action of the drug, either upon the 
muscular walls of the blood-vessels or upon the vaso-motor centre. There 
is here a fallacy similar to that already mentioned in respect to direct 
observation of the size of blood-vessels. Any irritation of a sensory nerve 
by pinching, scratching, heat, &c, may cause reflex stimulation of the 
vaso-motor centre and produce contraction of the vessels, and injection 
of strong saline solutions into the lymph-sac, having a local irritant action, 
will produce a similar effect. 

A.S an example of this fallacy we may mention certain experiments 
with bromide of potassium. In such experiments it was found that 
injections into the lymph-sac were followed by contraction of the vessels 
of the toes, so that much less blood flowed after the injection. When 
the sciatic nerve was divided on one side the flow was not lessened but 
rather increased in the corresponding foot, at the same time that it was 
much diminished on the other side where the nerve was intact. This 
resull clearly shows that after the injection the vessels in one foot 



OentraZblatt d. med. H7.«., April 6, 1867, p. 234. 



ACTION OF DRUGS ON CIRCULATION. 251 

contracted, and that this contraction was due to the effect of the injection 
on the vaso-motor centre, inasmuch as it did not occur in the foot whose 
vessels had been withdrawn from the influence of this centre by division 
of the nerves. From this fact the conclusion has been drawn that bro- 
mide of potassium has a special power of contracting blood-vessels gen- 
erally, and on this conclusion theories of its action upon the nervous 
system have been based. Such theories, however, rest on a very untrust- 
worthy foundation; for although contraction of the vessels no doubt 
followed the injection of a strong solution of bromide into the lymph-sac, 
this contraction was probably not at all due to any specific action of the 
bromide, but only to the reflex stimulation of the vaso-motor centre 
caused by its local irritant action at the place of application. If intro- 
duced in a dilute solution into the mouth instead of in a concentrated 
form into the lymph-sac, this local irritant action would be absent and 
probably no contraction of the blood-vessels would be produced. 

Action of Driig-s on Reflex Contraction of Vessels. — 
Irritation of a sensory nerve usually produces reflex stimulation of the 
vaso-motor centre and consequent contraction of the vessels and rise in the 
blood-pressure both in the frog and higher animals. The chief vaso-motor 
centre is situated in the medulla oblongata, but it is probable that there 
are many subsidiary centres throughout the body. It is probable also 
that these vary in strength and in the amount of independent action they 
possess in different animals. When the influence of the chief vaso- 
motor centre upon the body is destroyed by section of the spinal cord 
just below the medulla, the vessels dilate and the blood-pressure falls 
greatly. This is, however, not always the case, for in some dogs I have 
noticed that after section of the medulla, the blood-pressure remained so 
high that I was under the impression that the cord had been imperfectly 
divided, yet after death examination of the cord showed that section was 
complete. 

The vaso-motor centre is paralyzed by numerous drugs, especially in 
the final stages of their action, so that its ordinary tonic action is destroyed 
and the blood-pressure falls greatly. Its power of responding to a reflex 
stimulation is also abolished, and irritation of a sensory nerve no longer 
raises the pressure. The tonic and reflex action of the centre do not 
always appear to be effected pari passu, — chloral, for example, appearing 
to have a greater power to diminish its reflex action than its tone, so that 
stimulation of a sensory nerve has little or no effect even when the blood- 
pressure has not as yet fallen very low. Sometimes indeed an opposite 
effect to the usual one may be produced and the blood-pressure be lowered 
still further instead of raised by the stimulation. Alcohol also paralyzes 
very markedly both the reflex power and the direct excitability of the 
vaso-motor centre, so that neither stimulation of a sensory nerve, nor even 
stimulation of the centre by suffocation will raise the blood-pressure. 1 
Both the normal tone and the reflex excitability of the vaso-motor centre 
are greatly increased by strychnine. The general blood-pressure greatly 
rises after the injection of this drug, and the effect of irritation of a 



Dogiel, Pfliige^s Archiv, 1874, Bd. viii. 



252 PHARMACOLOGY AND THERAPEUTICS. 

sensory nerve upon it is increased. It has already been mention that in 
ordinary circumstances the subsidiary vaso-motor centres in the cord 
when separated from the medulla cannot of themselves maintain the 
blood-pressure. After the injection of strychnine, however, their action 
is so much increased that they may keep the blood-pressure at a high 
average and may also cause it to rise on irritation of a sensory nerve. 

Comparative effect of Heart and Vessels on Blood- 
Pressure in different Animals. — The influence of these two 
factors — the heart and the vessels — on the blood-pressure varies in differ- 
ent animals, and under different conditions ; and a number of the discrep- 
ancies observed by various observers are probably due to this circumstance. 
Thus, in dogs the effect of the heart is very considerable, and when its 
beats are quickened by division of the vagi the pressure rises ; in rabbits, 
on the other hand, the heart instead of working well under its power, as 
in the dog, beats very rapidly in the normal condition, and when the vagi 
are divided the pressure does not rise much, although when they are 
stimulated the pressure falls both in - the dog and in the rabbit. This 
different action of the vagus in the dog and rabbit is well seen when these 
animals are poisoned by atropia. This drug completely destroys the 
inhibitory action of the vagus on the heart ; and when the inhibitory 
power is completely removed we find that only a slight increase in the 
number of beats takes place in the rabbit, the pulse-rate rising one- 
quarter : for example, perhaps from 100 to 125. In the dog, on the 
contrary, the pulse-rate will rise to three times, or even four times, what 
it was before. 

In man the effect of the vagus on the heart is intermediate between 
that of the rabbit and dog : so that if the normal pulse is between 70 
and 80 in the minute, it rises to between 140 and 180 Avhen the vagus is 
paralyzed by atropia (Yon Bezold). 

This difference between the effect of the vagus on the heart alters the 
effect of drugs on the blood-pressure in different animals. 

The difference in the action of drugs on the dog and rabbit is well shown 
in the case of nitrite of amyl. If this be given by inhalation to a rabbit, 
the blood-pressure falls immediately and rapidly. If given to a dog, the 
fall may be very slight, at least if a small quantity only is used. On 
counting the pulse in the dog we discover at once the cause of the appa- 
rent difference in the action of the drug on the two animals. Before 
inhalation the pulse of the dog was slow, but after inhalation its pulse 
becomes almost as quick as that of the rabbit. In both animals the 
nitrite causes dilatation of the vessels, but in the dog the heart begins to 
beal 90 much more rapidly than usual that it maintains the blood-pressure 
nearly at the normal, notwithstanding this dilatation ; while the heart of 
the rabbit beats so quickly, normally, that it cannot maintain the pressure 
by increased rate of pulsation. If the vagi be cut in the dog, so that the 
heart beats rapidly like that of the rabbit before inhalation, the nitrite 
causes as sudden a fall as in the rabbit. 1 

The Dumerous factors which have to be taken into consideration in 
rd to the blood-pressure, the action and the interaction of different 



Lander Brtmton, Journ, of Anat and Physiol, Nov., 1870, p. 95. 






ACTION OF DRUGS ON CIRCULATION. 253 

parts of the body upon one another, render it by no means easy to under- 
stand the action of drugs on the circulation. The differences which we 
find in the action of drugs on different animals seem at first to make 
matters still worse : but it is through these differences of action that we 
learn the exact mode in which the various factors of the circulation are 
affected by the drug. 

There are at least two other factors which must be borne in mind in 
relation to the difference between rabbits and dogs: these are (1) the 
much greater sensitiveness of the inhibitory nerves of the heart, to reflex 
stimulation from the nose as well as to stimulation by venous blood, in 
the rabbit than in the dog ; and (2) the proportionately much greater 
length of the intestinal tube in the rabbit, which causes the vessels of the 
intestines, on account of their number, to exercise a greater action on the 
blood-pressure in it than in the dog. Thus, in the rabbit, a slightly irri- 
tating vapor will cause the animal to close its nostrils; and almost 
immediately the vagus will be excited and the heart will stop. This 
stoppage is probably chiefly due to reflex action on the heart through the 
nasal nerves, though it may be partly due to accumulation of carbonic 
acid in the blood. When the spinal cord is divided in the rabbit just 
below the medulla, the pressure sinks enormously : in the dog it also 
sinks, but not to the same extent ; and in some cases it sinks so little 
that it is almost impossible to believe that the cord has been divided, until 
examination after death shows that the section has really been completed. 
This effect may be partially due to the less power which the dilatation of 
the intestinal vessels, consequent upon the section, has in the dog. It 
may also, however, be partly due to greater development of extra-cranial 
vaso-motor centres in the spinal cord and elsewhere, than in the rabbit. 

Influence of Nerves on Blood-Pressure. — Both the quickness 
of the heart's beat and the contraction of the arteries are regulated by the 
nervous system ; and it is generally by their action on it that drugs 
alter the blood-pressure, though it must be constantly borne in mind that 
they may also do so by acting directly on the muscular walls of the 
heart and arteries themselves. The parts of the nervous system chiefly 
concerned in regulating the circulation are: 

I. The motor cardiac ganglia which lie in the walls of the heart, 
and are under ordinary circumstances the cause of its rhythmical action. 

II. Inhibitory nerves, which render the heart's action slow, and, 
if irritated very strongly, may stop its beating altogether, and produce 
quiescence in diastole. The inhibitory fibres have their origin or roots 
in the medulla, and proceed in the vagi to the heart. In probably all 
the higher animals they are normally in more or less constant action. In 
men and dogs they maintain a well-marked action ; and, after they are 
cut or paralyzed, the heart beats in the dog three or four times as quickly, 
and in man twice as quickly, as before. In rabbits and cats they act 
less, and their division only makes the heart go one-half or one-fourth 
faster. 

A drug may irritate them, and render the heart's action slow — 
1. By acting directly on (a) their roots in the medulla, (b) their 
ends in the heart ; 



254 PHARMACOLOGY AND THERAPEUTICS. 

2. Indirectly, through its action on other parts, producing (a) in- 
creased blood-pressure, or (b) accumulation of carbonic acid in the blood, 
both of which act as irritants to the vagus roots ; 

3. Reflexly, through irritation of sensory nerves, e.g., irritation of 
the intestines; of the sympathetic nerve ; of the depressor ; or of certain 
afferent fibres in the vagus. Reflex irritation is only likely to be caused 
by drugs having a powerful local action. 

Drugs may also paralyze the inhibitory or the ends of inhibitory 
nerves in the heart and thus quicken the heart. 

Inhibitory ganglia have been supposed to exist in the heart, and 
certain drugs, such as muscarine, are supposed to slow its pulsations by 
their action on these ganglia. They have been supposed to be distinct 
from the ends of the vagus, although generally when the ends of 
inhibitory nerves in the heart are spoken of, the inhibitory ganglia are 
included in the term. 

III. Quickening" Nerves. — These belong to the sympathetic sys- 
tem. They have their origin in the brain or medulla, pass down through 
the cervical part of the spinal cord to the last cervical and first dorsal 
ganglion (which in many animals are united), and thence through the 
third branch of the ganglion to the heart. Quickening fibres are said 
by some to run also in the cervical part of the sympathetic cord. Unlike 
the inhibitory nerves, the quickening nerves are not normally in constant 
action. The accelerating centres may be stimulated — 

1. By the direct action of drugs upon them. 

2. Indirectly by the drugs producing a diminution in the blood- 
pressure. Such a diminution acts as a stimulus to them. 

It is probable that accelerating fibres also pass to the cardiac 
ganglia from the endocardium, for irritation of the interior of the heart, 
either mechanically or by the injection of irritating drugs into it, causes 
acceleration. The supposed relationship of the various accelerating 
fibres to the cardiac ganglia is shown in the accompanying figure. 



W)" 



i to show the supposed relation of motor ganglia in the heart to accelerating libres . 

Inj fibres proceeding from the cerebrospinal or sympathetic nervous systems to the 

motor ganglia of the heart. G, motor ganglion, a, accelerating fibres passing from the endocar- 

dium to the motor ganglion, m, motor fibres to the cardiac muscle. H, the cardiac muscle. [For 

Ice of rimplicfty in thi> diagram all hypotheses regarding separate motor and accelerating 

glia have been disregarded.] 

I\ . Vaso-motor Nerves, which cause the smaller arteries, and 
probably also the capillaries, to contract. These belong to the sym- 
pathetic system; and the most important of them are contained in the 
splanchnics, which when stimulated produce contraction of the intestinal 






ACTION OF DRUGS ON CIRCULATION. 255 

vessels. As these vessels can, under certain circumstances, hold all the 
blood in the body, the influence of the splanchnics over the blood- 
pressure is very great ; and division of them can lower it, or stimulation 
of them increase it, very much. The intestine being much longer in 
herbivora than carnivora, the splanchnics have a greater influence over 
the blood-pressure in the former. The chief centre of the whole vaso- 
motor system seems to be in the medulla oblongata ; and it is generally 
in constant action, keeping up a certain amount of contraction or tone 
in the vessels. There are also, however, subsidiary centres in the spinal 
cord, and possibly also in the ganglia of the sympathetic system. 

The activity of the vaso-motor centres may be increased, and 
the vessels made to contract — 

1. By direct irritation of these centres. 

2. By reflex irritation through (a) the cervical sympathetic, (5) the 
vagus, when the brain is intact, and the animal not narcotized, (c) sen- 
sory nerves, including the splanchnics themselves. When the medulla 
is separated from the rest of the body by dividing the spinal cord at the 
atlas, it can, of course, no longer exert any influence over the vessels ; 
they consequently become dilated throughout the whole body, and the 
blood-pressure usually sinks very low. If the lower end of the divided 
cord be then irritated, the vaso-motor nerves which pass through it from 
the medulla to the body are stimulated, and the blood-pressure rises. 

It is probable that the peripheral ends of the vaso-motor nerves 
in the vessels themselves may be either stimulated or paralyzed by the 
action of drugs conveyed to them by the general circulation. 

V. Depressor nerves. — Irritation of these nerves is conducted 
to the vaso-motor centres, and acts on them in such a way as to cause a 
reflex dilatation of the small vessels, either (1) generally throughout 
the whole body, or (2) locally in one particular part of it. 

1. The chief nerve which causes dilatation, especially affecting the 
intestinal vessels, is one which runs froin the heart to the medulla, and 
is called, from its power of diminishing blood-pressure, the depressor 
nerve. Its fibres seem to be included in the vagus in the dog ; but in 
the rabbit it generally runs separate from the heart to the level of the 
thyroid cartilage ; here it divides into two so-called roots, one root going 
to the superior laryngeal, and the other to the vagus nerve. These are 
generally called roots, though, as the nerve conveys impressions from 
the heart to the brain, they are, physiologically, really branches. 
There seem to be also depressor fibres in the vagus itself; but the vagus 
contains fibres of many kinds, and, among others, some which cause 
reflex contraction of the vessels and ris6 of blood-pressure — hence called 
pressor-fibres. The depressor-fibres of the vagus seem to act on the 
vaso-motor system through the medulla itself, while the pressor-fibres 
affect it through a centre in the brain, so that, when the brain is perfect, 
irritation of the central end of the vagus causes increased contraction of 
the vessels and raised blood-pressure ; but, when the brain is removed or 
its functions abolished by opium, it causes dilatation of vessels and di- 
minished pressure. 

2. When a sensory nerve is irritated, the action of the vaso-motor 
centre is suspended in the part supplied by the nerve, and in those 



256 PHARMACOLOGY AND THERAPEUTICS. 

which immediately adjoin it, so that their vessels become dilated, while 
at the same time contraction of the vessels in other parts of the body is 
produced. The blood-pressure is thus increased generally, and produces 
in the locally dilated vessels a very rapid stream of blood. This fact 
was first discovered, and its therapeutics indicated, by Ludwig and 
Loven. 

The causes of alteration in blood-pressure as well as in the pulse- 
rate, will perhaps be more easily seen from the following table : — 



ACTION OF DRUGS ON CIRCULATION. 



257 




•paqsiuiimp oq Aum oinssaid-pooftj 

17' 



pas^aioui aq ^m amssaid-pooia 



258 PHARMACOLOGY AND THERAPEUTICS. 

Action of the Heart on Blood-Pressure. — I have already 
mentioned that we can to a certain extent ascertain whether a rise or fall 
in blood-pressure is due to the heart or arterioles, by comparing the 
pressure curve with the pulse curve. If they run parallel the effect may 
be attributed in great measure to the heart. 

But the effect of the heart on the blood-pressure is not so simple as 
that of the arterioles. In the case of the arterioles we have to consider 
only the rate at which the blood will flow through them when they are 
more or less contracted ; but in the case of the heart we have to consider 
not only the rapidity of its pulsations, but the amount of blood which is 
sent into the arterial system at each beat. We judge of the amount of 
blood chiefly by the extent to which the blood-pressure oscillates with each 
pulsation. A large quantity of blood will as a rule cause an extensive, 
and a small quantity only a slight oscillation. When the heart is beating 
slowly, so that it has time to fill completely during each diastole, the os- 
cillations are large, and when it is beating quickly the oscillations are 
small. 

It is evident that although quick pulsations tend to raise the blood-pressure, 
they only do so up to a certain point, as beyond that the heart does not get 
properly filled, and so sends but little blood into the aorta at each beat. But the 
heart may sometimes be imperfectly filled, even when it is beating slowly ; this 
has been shown to occur in the case of the frog, by Goltz. When a blow or two 
is struck on the intestines the veins dilate and the blood accumulates in them, 
BO that the heart, which is also stopped at first, receives no blood when it does 
begin to beat again. It can therefore send none into the aorta, and the circula- 
tion remains completely arrested, although the heart is beating. 




Fig. 68.— For description vide p. 230. 

If the pulmonary capillaries also are contracted the left ventricle will receive 
little blood, and bo will send little blood into the arteries, although the right ven- 
tricle may be much distended. This appears to occur during poisoning with 
muscarine, which causes the lungs to become blanched, 1 the right ventricle dis- 
tended, and the left ventricle and the arterial system empty: so that little blood 
flows from a wound. 2 

It is difficult, however, to estimate precisely the quantity of blood sent into 
rteries at each beat, and its relation to the rapidity of the pulse, so as to 

rtain directly how much the rise or fall of blood-pressure is due to the heart; 
ami therefore tin- is sometimes estimated indirectly by ascertaining first how 
much of tie- effect of the drug on the blood-pressure is due to the arterioles, and 
then attributing to tie- heart what is not accounted for by their action. 

Sometimes also we may gel DsefbJ information by compressing the abdominal 
':'-.-ir th<- diaphragm as possible before and after injection. We thus 



1 Lander Bnmton, Brit. Med. Journ., Nov. 14th, 1874. 
1 Schmiedeberg and Koppe. Das 3fuscarin, p. 57. 



ACTION OF DKUGS ON CIRCULATION. 259 

diminish so greatly the number of capillary outlets by which the blood may flow 
from the arteries into the veins that we greatly lessen though we do not quite 
destroy the effect of the arterioles on the blood-pressure. We can thus estimate 
more precisely the action of the heart upon it. 

Section of the spinal cord below the medulla oblongata by destroying the 
effect of the vaso-motor centre upon the vessels, also aids us in estimating the 
action of the heart. 

Another method of ascertaining what share in alterations of the circulation 
locally is due to the heart and arterioles respectively, consists in the combined 
use of the manometer and Ludwig's stromuhr or Marey's haemodromometer,, The 
manometer shows the general blood-pressure, while the haBmodromometer shows 
the rate of circulation in the particular artery experimented upon. If the rate 
of flow increases while the blood-pressure remains constant or sinks, it is evident 
that the arterioles of the particular vascular district to which the artery is dis- 
tributed have become dilated. If, on the other hand, the rate of circulation 
diminishes while the pressure remains constant or rises, it is clear that the 
arterioles have become contracted. 

This method is only capable of being applied to large arteries, such as the 
carotid or femoral. By placing the stromuhr in the femoral artery, Dogiel and 
Kowalewsky found that during suffocation the rapidity of the blood-flow dimin- 
ished while the pressure rose, showing that the peripheral vessels were contracted. 1 

By the use of the stromuhr, Dogiel 2 has found that the rapidity of the flow 
of blood in the carotid is first increased and then diminished by alcohol, the 
greatest diminution occurring during complete narcosis. 

Effect of Drugs on the Pulse-Rate. — The pulse-rate, i.e., the 
rapidity of the heart's beats, is chiefly regulated by the inhibitory fibres 
of the vagus, although it is affected also by accelerating fibres. In the 
frog the latter, excepting those which pass to the motor ganglia of the 
heart from the endocardium, also run mainly in the vagus, which is 
really the vago-sympathetic (Gaskell). In the higher animals they run 
chiefly through sympathetic channels, though to a slight extent also in 
the vagus. 

If we find that the administration of a drug quickens the pulse, we 
next try to discover the mode in which it has done so. A glance at the 
table will show that there are several ways in which acceleration may 
occur, though the most important is either paralysis of the vagus or, at 
least, cessation of its action. The usual stimulus to the vagus roots in 
the medulla which calls the nerve into action is the pressure of blood 
within the medulla ; when this is high the vagus roots are stimulated, 
and the pulse becomes slow ; when the pressure is low, the stimulus is 
removed, and the pulse again becomes quick. Alterations in the blood- 
pressure will therefore alter the pulse, and drugs which affect the arte- 
rioles may quicken or slow the pulse-rate without any marked action of 
their own on the heart or vagus. This has already been mentioned when 
speaking of nitrite of amyl, which, by lowering the blood-pressure, and 
thus lessening the normal stimulus to the vagus roots, greatly quickens 
the heart in the dog. 



1 Pfluger's Archiv, 1870, p. 489. 

2 Ibid., 1874, vol. viii., parts 11 and 12. 



260 PHARMACOLOGY AND THERAPEUTICS. 

In order to ascertain whether irritation of the vagus has been caused 
reflexly or not, we may divide the nerves through which we may expect 
the reflex to have occurred, or we may abolish their action on the 
medulla to a great extent by the use of large doses of chloral. 

Action of Drugs on the Car dio -inhibitory Functions of the Vagus. 

When speaking in the following pages of the inhibitory action of the 
vagus on the heart, I mean its power to affect the rhythm of the heart 
so as to render its pulsations slow or stop them entirely, and I do not 
include under the term inhibition the power which the vagus also 
possesses of enfeebling the cardiac contractions unless when this is 
expressly stated. 

We distinguish between (a) stimulation of the vagus roots by any 
cause whatever, and (6) stimulation of its ends in the heart 1 by dividing 
both vagi. Sometimes we inject the drug first, and see whether any 
slowing of the heart which it has produced disappears on section, or we 
may divide them before injecting the drug, and see whether any change 
either in the way of slowing or acceleration, occurs after the injection. 
If the effect of a drug in slowing the heart is removed by dividing the 
vagi, we conclude that its action has been exerted on the vagus roots ; if 
it should still persist, after their division, we conclude that it lias acted 
on the vagus ends in the heart, or on the heart itself. 

Thus aconitine, 2 veratrine, 3 erythrophloeum, 4 and probably all 
members of the digitalis 5 group, stimulate the vagus roots, so that the 
slowing of the pulse they produce is much lessened or completely abol- 
ished by section of the vagi, and takes place to a much less extent when 
the vagi are divided before the injection. That the slowing does not 
always completely disappear after the section of the vagi, or is not 
always completely prevented by their previous section, is due to the fact 
that most of these drugs have also an action either on the ends of the 
tragus in the heart, or on the nervous mechanism or muscular fibre of 
the heart itself. Nicotine resembles the substances already mentioned, 
in so far that the slowing which it would otherwise produce is somewhat 
lessened by section of the vagi, but only to a slight extent, its action 
being chiefly exerted on the peripheral cardio-inhibitory system. 6 Phy- 
gmine chiefly affects the heart itself, and so the slowing of the pulse 
it causes is not abolished by section of the vagi. 7 



1 We use the term ragns ends here for the sake of convenient distinction between 
the central cardio-inhibitory systems in the medulla oblongata and the peripheral 
one in the heart A fuller explanation of the peripheral cardio-inhibitory apparatus 
will be gh en further on. 

? Vide Dim rtation on Aconitine under B'ohm's direction, by C. Ewers, Dorpat, 1873. 

; Von Bezoldand Hirt, \Y urzhurycr Physiol. Untersuch., i., p. 103. 

'■ Brnnton and Pye, /'hi/. Trans., 1877, p. 627. 

Tranbe and other-. 
' Traiii..-. Med. OnUrabstg.! 1862 and 1803, No. 9: Centralblatt d. med, Wiss., 1863, 
].].. Ill .-md 169; Rosenthal, Centralblatt d.m. Wiss., 1863, p. 737. 

• i. Trans, of Roy 8oe. of Edinburgh, 1867, Reprint, p. 39; for other literature 

llarnack, Anh.f. exp. Path. /'. P/uinn., Bd. v., p. 446. 



ACTION OF DRUGS ON CIRCULATION. 261 

Keflex Stimulation of the Vagus. — The vagus centre may be 
also stimulated reflexly, and slowing or stoppage of the heart produced 
by irritation of sensory nerves. This stimulation occurs most readily 
through the nasal, dental, or other branches of the fifth nerve, the nucleus 
of which is closely connected with that of the vagus or through the sensory 
branches of the vagus itself, but it may also be induced through almost 
any sensory, and some sympathetic nerves, if the stimulus be strong. 

The vagus centre in rabbits appears to be very readily stimulated 
through the nasal nerves, for the application of any strong vapor such as 
ammonia or chloroform to the nose not only induces closure of the nostrils 
and stoppage of respiration, but also complete arrest of the heart's pulsa- 
tions. It appears also to be very sensitive to venous blood. Stoppage 
of the heart may occur in man from irritation of a sensory nerve, even 
under chloroform anaesthesia, and indeed I believe that in excision of the 
eyeball the heart usually misses one beat at the moment the nerves are 
divided. 

In dogs, stoppage of the heart and death may occur from irritation 
of the stomach, even when complete anaesthesia has been produced by 
chloroform. Some years ago, when making a gastric fistula in a dog, 
the animal, which was in a state of profound anaesthesia from chloroform, 
suddenly died when the stomach was laid hold of with the forceps. This 
occurred in a second case just as the cannula was being introduced. On 
mentioning the subject to Professor Schiff, he informed me that he had 
had several cases of a similar sort when using chloroform as an anaesthetic, 
but had none after he began to use ether instead. I found also on using 
ether that no further death occurred. 

Causes of Quickened Pulse. — If, instead of causing a slowness 
of the pulse, the drug produces quickening-, it may be due to paralysis 
of the vagi, to stimulation of the accelerating nerves, or to direct action 
on the heart itself. We ascertain whether the drug has paralyzed the 
ends of the vagus in the heart by injecting it, and then irritating the 
vagi in the neck by a faradaic current. If we find that we are no longer 
able to slow or stop the heart by stimulation of the vagi, we conclude that 
the drug has paralyzed these nerves. This action is well marked in the 
case of atropine. 

Action of Drugs on Vagus Roots. — We may wish to know, however, 
what the action of the drug has been on the vagus roots, and it is evident that 
if the ends in the heart are paralyzed, no action on the vagus centre could alter 
the pulsations of the heart any more than nervous stimuli proceeding from the 
cord could move the legs of an animal poisoned by curare. Nor can we separate 
the vagus centre from the heart by ligature of the vessels so readily as one isolates 
the frog's leg. It can be done no doubt by tying the carotid and vertebral 
arteries and keeping up an artificial stream of blood through the head. Instead 
of this, however, the simpler method is generally adopted of injecting the drug 
to be tested into the carotid artery, so that it will reach the vagus centre before 
it gets to the heart instead of injecting it as usual into the subcutaneous tissue 
or veins, whence it will be carried to the heart before it can reach the vagus 
centre. 

By experimenting in this way it is shown that atropine stimulates the vagus 
roots so that when injected into the carotid it causes slowing of the heart's action. 



262 PHARMACOLOGY AND THERAPEUTICS. 

When it has passed through the cerebral vessels, and returns with the blood to 
the heart it paralyzes the ends of the vagus in the heart, and therefore the pulse 
again becomes very rapid, notwithstanding the continued stimulation of the vagus 
roots. 

We cannot always conclude with certainty that a drug has excited the vagus 
roots merely because it has caused the pulse to become slower and has had no 
action after the vagi have been divided, for it is possible that the terminations of 
the vagus in the heart may be rendered more sensitive than usual by a drug, so 
that they may respond to a slighter stimulus than usual or with greater energy to 
a normal stimulus. Such an action appears to be exerted by physostigmine, 
which in a certain stage of poisoning renders the vagus more excitable, so that 
when irritated in the neck by a faradaic current a slighter stimulus suffices to 
stop the heart after the administration of the drug than before. 

Action on Accelerating- Nerves. — We ascertain whether a drug has a 
stimulating action on the accelerating nerves of the heart by cutting both vagi 
and then injecting the drug. If it quickens the heart still further, we assume 
that it does so by stimulation of the accelerating nerves. This experiment, 
however, does not enable us to decide whether the stimulation has affected the 
accelerating nerves passing to the cardiac ganglia from the central nervous system 
or those passing from the endocardium. 

Stimulating- Effect of Asphyxial Blood on the Medulla. — In order 
to prevent fallacies arising from stimulation of the vagus roots by an asphyxial 
condition of the blood due to the action of the drug upon respiration, it is usual 
to maintain artificial respiration through a cannula placed in the trachea. This 
acts perfectly well in some cases, but if the drug should cause violent convulsive 
actions it may prevent the movements of the thorax occurring regularly, and there- 
fore it is sometimes necessary to paralyze them by means of curare. 

Moreover, it must be remembered that prolonged stoppage of the heart itself 
will allow the blood in the medulla to become venous and will thus irritate the 
vagus roots. Prolonged arrest of the heart, therefore, tends by this action to 
prolong it still further, and functional inactivity tends to pass into death. This 
mechanism would render every intermission of the pulse very dangerous were it 
not that the same venous condition of the blood which stimulates the vagus roots 
stimulates also the vaso-motor centre and the respiratory centre. The vaso-motor 
centre by contracting the arterioles maintains the blood-pressure during the pro- 
longed diastole, and excitation of the respiratory centre tends to restore the arterial 
character of the blood. The venous condition of the blood also stimulates accel- 
erating centres in the medulla (Dastre and Morat). 

Stimulation of the Heart by increased Blood-Pressure. — 

It has already been mentioned that increased blood-pressure usually 
renders the beats of the heart slower by the stimulating action it exerts 
on the vagus loots. When the vagi are divided, however, its effect is 
usually quite different, and a rise in blood-pressure after division of the 
vagi renders the pulse quicker instead of slower, at least generally. An 
opposite result has been found by Marey in the heart of the tortoise, 
where increased pressure rendered the beats slower. The reason of the 
difference observed between the mammalian heart and that of the tortoise 
i< probably due to the different development of the nervous and muscular 
Structures. The tortoise heart acts more like a single simple muscle, and 
the more resistance it has t«» overcome the more slowly does it work. 

In the mammalian hearl the increased pressure appears to stimulate 
the nerves, 80 thai the more resistance it has to overcome the more 



ACTION OF DEUGS ON CIKCULATION. 263 

quickly does it work — that is, if the vagi have been cut. The sensibility 
of the nervous system in the heart to increased pressure appears to be 
diminished by atropine, for Schiff 1 has found that a quantity of this poison 
slightly larger than will dilate the pupil lessens the sensibility of the 
heart to changes in blood-pressure so much that the pressure may be first 
increased to three times the normal and then diminished to one-half, or 
even one-third, without any change in the pulse-rate being produced. 
Such an observation suggests that atropine would be useful in lessening 
pain or palpitation of the heart in persons with high blood-pressure or 
suffering from the effects of cardiac strain consequent on violent muscular 
exertion. I have tried it in such cases sometimes with apparently great 
benefit, at other times with little result. The cases of failure may, how- 
ever, have been due to the remedy not being pushed far enough, as in 
them the pupil was not markedly dilated. 

Palpitation. — In what I have just said regarding the effect of 
blood-pressure on the heart I have spoken of the total work, including 
in it both the rapidity of pulsation and the amount of work done by each 
beat. This is, perhaps, fair enough ; but at the same time we must not 
forget that there is a distinction between the total amount of work done 
and the nature of the individual contraction, either in the heart of tor- 
toises or mammals, or in voluntary muscles. Both voluntary muscles 
and the heart tend to contract rapidly if they have little resistance to 
overcome. In patients suffering from anaemia and debility where the 
blood-pressure is low and the resistance to the ventricular contractions is 
consequently small, they are apt to take place with great quickness, giv- 
ing rise to a short flapping first sound and a sharp but unsustained apex 
beat, while the patient complains of much palpitation. In such cases 
increased blood-pressure will tend to lessen the palpitation, and digitalis, 
which contracts the vessels, will be useful; iron also is serviceable by 
increasing the nutrition of the circulatory apparatus of the body gener- 
ally. The low blood-pressure, however, while it increases the tendency 
to palpitation, is not the only factor, and is usually accompanied by a 
tendency to disturbance of the cardiac innervation which is to be met by 
sedatives such as the bromides, or by remedies directed to the stomach or 
other organs from which the disturbing stimulus may proceed. 

The Heart of the Frog. 

This is a very convenient object on which to study the action of drugs. 
Their effects upon it are somewhat, though not absolutely, the same as their effects 
on the mammalian heart; and the frog's heart being simpler in its construction 
it is easier to analyze the exact mode in which drugs act upon it. The frog's 
heart consists of three chambers, one ventricle and two auricles. But in addi- 
tion to these, there is what might almost be called a fourth chamber, the venous 
sinus or sac into which the venae cavae open. 

There are three venae cavae, two superior and one inferior, which open into 
the venous sinus. 

The venous sinus itself opens into the right auricle, the opening being covered 
during the auricular systole by a small fold which acts as a valve. 



1 La Nazione, 1872, No. 235. 



264 



PHARMACOLOGY AXD THEEAPEUTICS. 



The left auricle receives the pulmonary veins and discharges into the single 
ventricle the arterial blood which enters it from them, while the right auricle 
does the same with the venous blood it receives from the sinus. 



Left auricle and pulmonary veins. 



Aortic bulb. 



5* 

Bidder's ganglia. Y *i] \ 

Fig. 69.— Diagram of the frog's heart 



Superior venae cavae and vagi nerves. 
Venous sinus and Remak's ganglion. 

Inferior vena cava. 

Ventricle. 



The septum between the auricles ends inferiorly in two triangular flaps which 
act as valves between the auricles and ventricle. 

From the ventricle issues the common aorta, or aortic bulb, which has at its 
origin from the ventricle a spiral valve to prevent the return of the blood. The 




E.t£BMQBC*M.sc 



FlG. 70.— View of the auricular septum in the frog (seen from the left side). The nerves are stained 
with osmic acid, n is the posterior, and n' the anterior cardiac nerve; t is a horizontal portion of 
the latter nerve ; 6 is the posterior, and b' the anterior auriculo-ventricular ganglion ; m is a pro- 
jecting muscular fold. [This figure is taken by the kind permission of my friend, M. Ranvier, from 
lis Lemons d'Anatomie Genbrale, Ann6e 1877-8, " Appareils nerveux terminaux," t. 6., p. 79.] 



tii 



two auricles beat together, and the aortic bulb and ventricle usually beat together, 
though the bulb is capable of independent pulsation. 

The usual rhythm is the following: first the venous sinus, next the auricles, 
then the ventricle and bulb. 

The pulsations of the venous sinus and ventricle alternate with those of the 
auricle. The heart continues to pulsate rhythmically after it has been com- 
pletely removed from the body, so that the motor power of rhythmical contrac- 
tion i- evidently contained within itself. Its rhythm is, however, regulated by 
the vagi nerve-. These pass along behind the two superior cavae to the junction 
of the venous sinus with the auricle. At this spot, or just over the auricles, 
between the superior cavae and the pulmonary veins, they anastomose to form 
a single <t double ganglion, or a plexus containing ganglionic cells sometimes 
known as Remak's ganglion. From hence two nerves pass down in the auri- 
cular septum, to the base of the ventricle, where they end in two ganglia, known 
Bid li : - ganglia. These are situated at the junction of the wall of the ventricle 



ACTION OF DRUGS ON CIRCULATION. 265 

with the two valvular flaps in which the septum ends. They are connected 
with one another by fibres which run transversely, nearly in a line with the 
auriculo-ventricular groove. 

The posterior or dorsal nerve comes chiefly from the left vagus ; and the 
anterior or ventral from the right vagus. 

Both of these nerves grow thicker as they pass down towards Bidder's 
ganglia from the presence in them of numerous ganglionic cells ; they also send 
off several branches to the auricle. 

The ventricle itself has not been shown to contain either nerve fibres or 
ganglionic cehs, excepting just at its base, where Bidder's ganglia, already 
mentioned, are situated, and where branches from them proceed to the ventricle. 

Action of Drugs on the Heart of the Frog". 

The effect of drugs may be observed by simply destroying the brain, 
exposing the heart, and either injecting the drug subcutaneously, or into the 




Fig. 71. — Instrument for showing the action of heat and cold and of poisons on the frog's heart. It 
consists of a piece of tin plate or glass three or four inches long, and two or three wide, at one end 
of which an ordinary cork cut square is fastened with sealing-wax in such a mannerjthat it projects 
half an inch or more beyond the edge of the plate. This serves as a support to a little wooden 
lever about three inches" long, a quarter of an inch broad, and one-eighth of an inch thick. A 
pin is passed through a hole in the centre of this lever, and :uns into the cork, so that the lever 
swings freely about upon it as on a pivot. The easiest way of making a hole of the proper size is 
simply to heat the pin red hot, and then to burn a hole in" the lever with it. To prevent the lever 
from sliding along the pin, a minute piece of cardboard is put at each side of it, and oiled to pre- 
vent friction. A long fine bonnet straw, or section of one, is then fastened by sealing-wax to one 
end of the lever, and to the other end of the straw aroundpiece of white paper cut to the size of a 
shilling or half-crown, according to convenience, is also fixed by a drop of sealing-wax. The pin, 
which acts as a pivot, should be just sufficiently beyond the edge of the plate to allow the lever to 
move freely, and the lever itself should lie flat upon the plate. Its weight too, increased as"it is by 
the straw and paper flag, would now be too great for the heart to lift, and so it must be counter- 
poised. This is readily done by clasping a pair of bulldog forceps on the other end. By altering 
the position of the forceps the weight of the lever can be regulated with great nicety. If the for- 
ceps are drawn back as at c, the flag is more than counterbalanced, and does not rest on the heart 
at all, while the position a brings the centre of gravity of the forceps in front of the pivot, and in- 
creases the pressure of the lever on the heart. The' isolated frog's heart is laid under the lever 
near the pivot, and as it beats the lever oscillates upwards and downwards. When used for demon- 
strating the action of poisons the wooden lever should be covered with sealing-wax, so as to allow 
every particle of the poison to be washed off it, and thus prevent any portion from being left be- 
hind and interfering with a future experiment. By attaching a small point to the end of the straw 
in place of the paper flag tracings may be taken upon smoked paper fixed on a revolving cylinder. 

dorsal lymph sac or even laying it upon the heart itself. Changes in the rate 
of the pulse and in the mode of contraction of the different cavities of the 
heart are thus readily observed. By exposure and irritation of the vagi the 
effect of drugs upon their action can also be observed. Even when completely 
excised the heart of the frog continues to pulsate for a length of time, and the 
action of heat, cold, and poisons upon it can be readily demonstrated. A sim- 
ple apparatus for this purpose is shown in Fig. 71. 

The fact that heat accelerates and cold retards the pulsations of the 
heart is one of fundamental importance, both in regard to a right under- 
standing of the quick pulse, w T hich is one of the most prominent symp- 
toms of fever, and to a correct knowledge of the proper treatment to 
apply when the heart's action is failing. 



266 



PHARMACOLOGY AND THERAPEUTICS. 



It may be shown with the apparatus just described by placing a piece 
of ice under the tin plate. The pulsations will become slower and slower, 
and if the room be not too warm the heart may stand completely still in 
diastole. On removing the plate from the ice the pulsations of the heart 
become quicker. If a spirit-lamp be now held at some distance below 
it the heart beats quicker and quicker as the heat increases, until at last 




Ik.. 72*— Ludwlg and I oats' frog-hear! apparatus, a is a reservoir Cor serum, it, a stopcock to regu- 
late the supply to the heart o, a piece of caoutchouc tubing connecting a and d. d, a glass can- 
nula In the vena cava inferior, r/, another in the aorta, k, a manometer, f, a piece of tubing 
i by a clip, to allow of the escape of serum, o, a fine pen, floating on tbe mercury in e, 
ii. the frog's heart .1, a sealed glass tube passed through the oesophagus, k, and firnilv held by a 
holder Bcond bolder to support a. p, a stand with upright rocl. s, a flap of skin to cover 

the hear! and prevenl drying, The vagus oerve Is seen passing to the heart 



ACTION OF DRUGS ON CIRCULATION. 



267 



it stands still in heat-tetanus. On again cooling it by the ice, its pulsa- 
tions recommence. At first they are quick, but they gradually become 
slower and slower. On again applying the spirit-lamp they become 
quicker, and by raising the temperature sufficiently the heat-tetanus is 
converted into heat-rigor. In this condition no application of cold has 
the slightest effect in restoring pulsation. 

Not only the effects of heat and cold, but the effect of separating the 
venous sinus or the auricles from the ventricle can readily be shown 
with this apparatus, as well as the action of various poisons. The best 
for the purpose of class demonstration is muscarine. A drop of saline 
solution containing a little of the alkaloid being placed on the heart, it 
ceases to beat entirely. If a drop of atropine solution be now added the 
beats recommence. I have seen them do so on one occasion after they 
had entirely ceased for four hours. 

For the purpose of observing alterations in the strength of the cardiac pulsa- 
tions as well as their rhythm, a convenient piece of apparatus is the one devised 
by Ludwig and used under his directions by Coats (Fig. 72). 

One objection to this apparatus as shown in the engraving is, that the blood 
does not circulate freely through the heart, but this can be overcome by closing 
the tube at f only partially instead of completely, and according to the amount 
of closure the pressure under which the heart works may be regulated. Or the 
tube F may be lengthened and made to empty itself into the reservoir A. The 
pressure under which the heart works may be regulated by the height at which 
the tube is allowed to discharge. 

Another apparatus is that used by Williams in his researches on digitalin. 1 
It consists of a Y-shaped cannula whose stem is divided by a longitudinal sep- 
tum into two halves, each of which is continuous with the fork on its own side. 
The stem is inserted through the aorta into the ventricle of the heart, which is 
kept moist by being dipped in a vessel containing serum or a dilute saline solu- 
tion. One fork of the Y is connected with a flask containing blood serum or 
other nutritive fluid, and the other with a manometer. By means of valves 
these fluids are made to flow only in one direction. These valves consist of a 
piece of glass tubing with a slit on one side ; over this slit is loosely tied 
a piece of thin membrane (gold-beater's skin) which covers about three- 
quarters of the circumference of the tube. This membrane allows fluid to pass 
readily out of the tube from within outwards, but not from without inwards, 
any external pressure causing the membrane to become tightly applied to the 
slit and to close it. 



Flask containing 
nutrient fluid. 



Valve opening \ _. 
towards heart. 

Heart 

Valve opening \ 

from heart. 




Valve with slit. 



Recording cylinder. 



.Manometer. 



Fig. 73.— Diagram of Williams' apparatus for investigating the action of drugs 
on the heart of the frog. 



Arch.f. exp. Path. u. Pharm.,~Bd. xiii., p. 1. 



268 PHARMACOLOGY AND THERAPEUTICS. 

A very useful form of apparatus for investigating the action of drugs on the 
frog's heart and on the effect of the vagus upon it is made by combining the 
valves in Williams' apparatus with the apparatus of Ludwig and Coats. 1 

The apex (as the lower two-thirds of the ventricle is commonly 
called), contains, as has been mentioned, no nerves, and when separated 
from the rest, either by cutting or by a tight ligature, usually lies per- 
fectly quiet without contracting. When irritated by a single induced 
shock, it answers by a single contraction, just like any other muscular 
fibre. 

But though the muscular fibres contained in the apex cease to contract 
rhythmically, when the nervous stimulus usually supplied by Bidder's 
ganglia is removed, they still retain a tendency to rhythmical contrac- 
tion; and when subjected to a constant stimulus of another kind they 
again commence to pulsate. This is seen when the apex is stimulated 
by supplying it with oxygenated blood through a cannula under pressure 
(the pressure supplying the necessary stimulus), or by passing through it 
a constant or interrupted current, or by adding a trace of delphinine to 
the nutritive fluid with which it is supplied. This phenomenon is similar 
to that which occurs in the bells of medusae already described (p. 110), 
which cease to contract rhythmically when their marginal ganglia are 
removed, but recommence when an additional stimulus is applied to the 
bell itself, by putting it into acidulated water. 

A curious point has been made out by Bowditch regarding the exci- 
tability of the heart-apex. It has already been mentioned that the amount 
of contraction of voluntary muscle varies with the intensity of the stimu- 
lus, and that this is also the case with the reflex contraction produced by 
irritation of sensory nerves. The apex when fed with serum usually stands 
still for a long time before it begins to beat, but when in this condition 
may be made to contract by the application of an induction shock. The 
difference between the reaction of an ordinary striated muscle and of the 
apex to such a shock is, that the heart, instead of responding by a strong 
or weak contraction to a strong or weak stimulus, either does not contract 
at all or contracts with as much force as it can exert. The weakest stim- 
ulus which will act at all and the strongest have thus exactly the same 
action, or, in other words, a minimum is also a maximum stimulus. This 
condition does not correspond to that which obtains in the normal striated 
muscle when stimulated either directly or reflexly. We find, however, a 
corresponding condition in the reflex contraction of the muscle produced 
by stimulation of sensory nerves in an animal poisoned by strychnine (p. 
166). We noted, however, in discussing the action of strychnine on the 
spinal cord, that, just after exhaustion had occurred from a spasm, strong 
and weak stimuli produced strong and weak contractions in the muscle. 
\ somewhal similar condition appears to occur in the heart, for Mays 
has noticed that, when the apex Is supplied with old blood which has 
stood throe or four days instead of with fresh blood, strong and weak 
stimuli produce Strong and weak contractions. 2 



K.uiKick and Hoffmann, Arch.f. exp. Path. u. Pharm., BcL xvii., p. 159. 
Separat-Abdk a. d. Verhandl <l. phyaiol gesellsch. zu Berlin, Jan. 12, 1883. 



ACTION OF DRUGS ON CIRCULATION. 



269 



It is obvious that, although the contractions of voluntary muscle on 
reflex stimulation may be analogous to the contractions of the apex, yet, 
in the former case, the alterations occur in the nervous centres, while in 
the apex the changes occur in the muscular substance. 

Action of Drug's on the Muscular Substance of the Heart. 

As the lower two-thirds of the ventricle or apex, as it is usually 
termed, contains no nerves, it forms a convenient object for ascertaining 
the action of drugs upon the muscular substance of the heart itself, and 
has been much used for this purpose. 



Tube for allow- 
ing escape of 
fluid from the 
heart 



Tube for the 
introduction 
of fluid 




._Tube for con- 
necting with 
manometer. 



-End for intro- 
duction into 
the heart. 



Fig. 74.— Perfusion cannula, with the anterior part removed so as to show the septum. 

The apparatus usually employed consists of a small cannula introduced into 
the ventricle, which is attached to it by a ligature tightly tied round it at the 
junction of its upper with its lower two-thirds. The interior of the cannula is 
divided into two by a septum which runs longitudinally, and the one-half is 
connected with a flask containing the nutritive fluid with which it is to be sup- 
plied ; and the other with a small mercurial manometer provided with a float to 
register its oscillations upon a revolving cylinder. 






Fig. 75.— After Ringer. TraciDgs showing the effect of simple NaCl solution in weakening the pulsa- 
tions of the apex of the frog's heart. The tracing a was taken soon after the blood was replaced by 
NaCl solution; b, after a longer period ; and c after a still longer time. 

At first the nutritive fluid is supplied pure to the apex, and after a 
normal tracing has been obtained the substance to be investigated is 
added to it. 

When a '65 per cent, solution of NaCl is employed, the apex usually 
stops in diastole for a period varying from a few minutes to an hour and 
a half. It then begins to pulsate (Fig. 75, a), getting gradually weaker 
and weaker (Fig. 75, b and c), and finally stops in diastole. When the 
heart is in this condition its pulsations may be restored by the addition 
to the chloride of sodium solution of 1 to 10 per cent, of blood, or of 
serum, or of a solution of the ashes of serum. 



270 PHARMACOLOGY AND THERAPEUTICS. 

Minute quantities of several poisons such as delphinine or quinine, or 
a mixture of atropine and muscarine, also restore the rhythmical pulsa- 
tions after they have ceased in a heart-apex supplied with NaCl solution. 
A minute quantity of Na 2 C0 3 or -005 per cent, of NaHO restores or in- 
creases the beats for a time; afterwards the pulsations become again 
weaker and the heart stops a second time, but it stops in systole and not 
in diastole. 

Ringer has made the remarkable discovery that when the saline solu- 
tion is made with ordinary tap-water the beats become prolonged, but 
the addition of a trace of potash causes them at once to assume their 




Fig. 76.— After Ringer. Shows the effect produced upon the beat of the frog's heart fed with NaCl 
solution by the addition of a trace of calcium chloride. The beats in this case are induced by an 
induction shock. 



normal character, and a frog's heart may be kept beating for hours 
together with saline solution made in this way and containing a trace of 
potash, although the saline solution never does this when made with dis- 
tilled water. The addition of a minute trace of a calcium salt to distilled 
water produces the same effect as tap-water — the contractions become 
larger and longer (Fig. 76). When potash is then added, the length of 
the contractions becomes diminished to the normal without their strength 
becoming affected, and thus a pure saline solution made with distilled 
water and with the addition of minute traces of calcium and potassium 
will keep the heart beating perfectly for hours together. 

Dilute alkalies added to the saline solution have been shown by Gaskell 
to cause a tonic contraction of the muscular fibre of the apex, so that it 
may gradually cease to beat. This contraction may occur whether the 
apex is pulsating or not. If it remains at rest, a manometer connected 
with it simply shows a gradual rise in the mercury until the contraction 
of the apex is complete. If it is beating, the duration of full contraction 
at each systole becomes longer and relaxation during diastole less com- 
plete, until no diastolic relaxation occurs and the ventricle remains per- 
fectly still in a condition of complete contraction. 

Dilute acids have an opposite action to dilute alkalies, and when very 
dilute acid, e. </., lactic acid, is mixed with the saline solution, it produces 
;i condition of complete relaxation. 

[nsteadof increasing the duration of the systole like alkalies, acids 
firsl shorten it and then render it less and less powerful, until contractions 
altogether and the ventricle remains at rest in diastole. 

I )ilute acidfl and alkalies counteract each other's effects on the heart, so 
that after the beats have been very much lowered in force by acids, an alkali 
will firgl restore it to its original condition and then produce its own 
characteristic effect. The subsequent application of an acid will undo- 



ACTION OF DRUGS ON CIRCULATION. 271 

the effect of the alkali, again weakening the beats and again producing 
dilatation instead of contraction. 1 

The three alkalies, potash, soda, and ammonia, have all a somewhat 
similar tendency to increase the tonic contraction of the ventricle. When 
large doses are given they tend to paralyze the muscle, so that it again 
dilates after a period of tonic contraction. The paralyzing action of 
potash is much more powerful, and manifests itself much sooner than 
that of the other two. 

The excitability of the muscular fibre is also altered by alkalies. 
Soda and ammonia increase it, so that a faradaic stimulus applied to the 
ventricle has much more effect after the application of soda and ammonia 
than before. Potash has a different effect and diminishes the excitability 
of the ventricle, although sometimes the diminution may be preceded by 
a stage of increased excitability. 2 

A number of poisons act on the muscular fibre of the ventricle like 
alkalies, others act like acids. 

Antiarine, digitaline, helleborine, veratrine, physostigmine, barium, 
and probably all the substances belonging to the digitalin group, act like 
alkalies. 

Muscarine 3 acts like an acid, and so apparently do also pilocarpine, 4 
saponine, 5 and apomorphine. 

Neutral double salts of copper, chloral, iodal, and other members of 
the chloral group, 6 are probably to be classed along with salts of potash, 
first exciting and then paralyzing the cardiac muscle. 

In classifying cardiac poisons, when we say that some act like acids 
and others like alkalies, it must be borne in mind that the action though 
similar is not identical. Although the actions may be generally like one 
another, they may vary very considerably even in kind, and certainly very 
enormously in degree. Thus the action of barium and veratrine may be 
very similar, but veratrine is much the more powerful. We find a similar 
condition in other structures. Thus iodide of ammonium and curarine 
both paralyze the ends of motor nerves, but an enormously larger amount 
of the former is required to produce the effect. 

That there is considerable similarity in kind, however, between the 
action of the vegetable alkaloids and inorganic salts is shown by the fact 
that the action of veratrine may be neutralized by potassium chloride. 7 

The irritability of the heart is preserved for very different lengths of 
time in different gases. Thus Castell 8 found that the frog's heart con- 
tinued to beat in oxygen for 12 hours, in nitrogen fori hour, in hydrogen 
for 1^ hour, in C0 2 for 10 minutes, in nitrous oxide for 5 or 6 minutes, 
in carbonic oxide for 40 minutes, and in chlorine for 2 minutes. 



1 Gaskell, Journ. of Physiol, vol. iii., p. 48. 

2 Ringer, Ibid., vol. iii., p. 193. 

3 Gaskell, Journ. of Physiol., vol. iii., p. 61. 

4 Gaskell, op. cit. 

5 Schmiedeberg, Ludwigh Festgabe, p. 127. 

6 Harnack, Archivf. exp. Path. u. Pharm., Bd. xvii., p. 185. 

7 Ringer, Practitioner, vol. xxx., p. 17. 

8 Hermann's Handb. d. Phys., iv. 1, p. 357. 



272 PHARMACOLOGY AND THERAPEUTICS. 

Differences between the Heart Apex and the Heart. 

When the heart is tied on to a cannula in the same way as the apex, 
by a ligature round the auricles or even the sinus, so that, instead of con- 
taining no ganglia at all, it contains either Bidder's or Bidder's and 




Fig. 77.— Diagram to show the difference in the mode of experimenting with the heart and with the 
apex alone. In a the apex alone is attached to the cannula. In 6 the heart, consisting of ventricle 
and auricles, or of the venous sinus, also is attached to the cannula. 

Remak's ganglia, it also remains motionless in the same way as the apex 
when supplied with chloride of sodium solution, but its rhythmical power 
is restored by the addition of blood of serum, of solution of the ashes of 
serum, by a trace of Na 2 C0 3 , or still better by the addition of -0005 per 
cent, of NaHO and a trace of peptone or serum albumen. 

When supplied with pure serum, it does not beat regularly, but its 
pulsations occur in groups separated by long intervals. 1 When a little 




Fig. 78.— Periodic rhythm of the heart the pulsations occurring in groups separated 
by intervals of complete quiescence. 

hicmoglobin or blood is added to the serum, this grouping disappears, 
and the pulsations become regular. 2 

When the heart has been supplied with hemoglobin or blood and is 
beating regularly, the addition of a little veratrine causes the group to 
appear, and a similar effect is produced if the blood is not renewed, but 
allowed to remain in the heart till it becomes venous. 3 

This periodic stage docs not occur immediately after the heart has been tied 
on the rc mn n la and supplied with scrum. It is preceded by an initial stage, in 
which the beats arc at first very quick, then slow, and these are separated by 
lorn: pauses. N<xt comes the periodic stage in which the groups occur. It is 

seded by the Btage of crisis in which the groups are replaced by single pulsa- 
bione slower and Bmaller than the normal. 



1 Luciani, Ludmg's Arbeiten, 1872, p. 120. 
Soasbach, Ludvrig'a Arbeiten, 1*74, p. 92. 
Sosebach, op. tit., p. 93. 



ACTION OF DRUGS ON CIRCULATION. 273 

Atropine and nicotine do not prevent the occurrence of groups. Both of 
them make the groups longer and the pauses shorter. Atropine, however, even 
in small doses, soon kills the heart before it even enters an the stage of crisis. 
Nicotine, on the other hand, shortens the pauses, and rapidly induces the stage 
of crisis without destroying the energy of the heart, which is quite as great after 
poisoning by nicotine as in the normal condition. 

Moderate doses of muscarine make the pulsations smaller and slower, the 
groups shorter, and the pauses longer. Sometimes the heart becomes exhausted 
before the stage of crisis appears, at other times it does not. Large doses of 
muscarine arrest the movements of the heart. 

The activity of the heart which has been stopped by muscarine is again 
restored by atropine, but muscarine can render the beats smaller and slower, 
even after the previous application of atropine. 

The occurrence of groups appears to be most probably due to inter- 
ference of rhythms — of the ganglionic rhythm with that of muscular 
fibre. 

We find an indication of alternate interference and coincidence of two 
rhythms in the alterations which sometimes occur in the beats of a ven- 
tricle containing its ganglia but separated from the auricles. At first all 




Fig. 79. — After Kanvier, Legons, 1877-78. Tracing of the pulsations of a ventricle separated from the 
auricles by section at the auriculo-ventricular groove. 

the beats are of equal strength, but soon each alternate beat gets longer 
and shorter, till some disappear and others get much stronger than before 
(Fig. 79; cf. Fig. 42, p. 155). 

Action of Drugs on the Vagus in the Frog". — When the 
vagi are stimulated by an induced current, the heart usually stops in 
diastole. 

The effect of stimulation may be observed either on the heart simply 
exposed or by means of Ludwig and Coats' apparatus. The action of 
both vagi is not always alike. The right vagus has usually a greater 
power to arrest the heart than the left. The action of the vagus varies 
also according to the condition of the heart, and may produce different 
effects. It may cause, 1st, stoppage of the heart's beats, followed after 
an interval by slow pulsations or by small rapid pulsations, gradually 
becoming larger and stronger ; 2d, it may cause them to become small 
and slow without actual stoppage — this is the usual effect of irritation of 
the vagus in the living body. 3d, it may cause the pulsations to become 
simply small and rapid without any stoppage ; 4th, it may cause them to 
become rapid; 5th, it may cause them to become more powerful (Figs. 
86 to 89, pp. 287-88). 

It may also act differently on the auricles and ventricle, producing 
still-stand of the ventricle and rapid pulsation of the auricles. These 
18 



274 PHARMACOLOGY AKD THERAPEUTICS. 

differences are probably due to a great extent to the vagus of the frog 
being really the combined vagus and sympathetic. At present the chief 
point upon which I wish to insist is that irritation of the vagus usually 
causes still-stand of the heart. 

When the venous sinus is stimulated, still-stand of the heart is 
produced, which is even more complete and permanent than that which 
follows irritation of the vagus. 

Action of Drugs on Inhibition of the Heart. — The effect of 
certain drugs upon the still-stand produced by irritation of the vagus or 
of the venous sinus is very remarkable. A large number of drugs, more 
especially atropine, curare, conine, and nicotine, when injected into the 
circulation have the power of completely destroying the inhibitory power 
of the vagi as far as the rate of rhythm is concerned, so that when their 
fibres are stimulated the heart is not arrested, nor are its beats rendered 
slower, but they are, on the contrary, quickened. 

These poisons again may be divided into two classes : 
Class I. containing atropine and its congeners. 
Class II. containing curare, conine, nicotine, &c. 

These two classes agree in destroying the inhibitory power of the 
vagus nerve, so that irritation of its trunk will no longer produce still- 
stand or slowing of the heart. They differ in their action on the still- 
stand produced by irritation of the venous sinus. Atropine and its 
allies prevent any inhibition occurring when the venous sinus is stimu- 
lated, or when muscarine is applied to the heart directly. 

This action affects chiefly the rhythm of the heart, for muscarine can 
still reduce the force of the cardiac contractions after the application of 
atropine. Poisons of the second class do not prevent still-stand of the 
heart occurring as usual on irritation of the sinus, nor do they prevent 
muscarine from arresting the beats of the heart. This antagonism of 
atropine and muscarine has hitherto been explained on the supposition 
that muscarine greatly stimulates inhibitory centres in the sinus or 
auricle, while atropine paralyzes these. 

These two classes also agree in leaving unaffected the accelerating 
nerves of the heart. 1 

These complicated effects are very hard to explain on the ordinary 
hypothesis. 

It is still more strange that although atropine and muscarine have 
such apparently opposite effects, they both agree in ultimately paralyzing 
the inhibitory function of the vagus. 

Muscarine, as I have already mentioned, arrests the movements of 
the heart ; but, if the circulation be carried on, this arrest is only tem- 
porary, and is succeeded by a period, first of slowness, then of irregu- 
larity, and then of return to the normal; the stage of irritation of the 



1 In the frog the accelerating nerves appear to run along with the inhibitory 
fibres in the vagus trunk. In warm-blooded animals these fibres run in separate 
nerves, which pass out from the spinal cord along the vertebral artery and reach 
ill*- head through the sympathetic system. Although the chief accelerating fibres 
pass in these nerves, some are also contained in the vagus trunk, both in warm- 
blooded animals and in fro^s. In animals poisoned by atropine, irritation of the 
- OSnally produces acceleration of the pulse. 



ACTION OF DRUGS ON CIRCULATION. 275 

inhibitory centre by the muscarine gradually passing into that of com- 
plete paralysis. During the time when the pulse is still slow in conse- 
quence of the action of muscarine, irritation of the vagus itself has no 
power to arrest it, or even to increase the slowness, while at that very 
time irritation of the accelerating nerves quickens its pulsations just as 
it would those of a normal heart. 1 When the accelerating nerves are 
thus irritated, there is often not only an increase in the number but also 
in the size of the pulsations, very much as Gaskell has observed under 
other conditions from irritation of the vagus in the frog. This action is 
only to be observed in moderate conditions of poisoning. When the 
poisoning is very profound, irritation of the accelerating nerves has a 
very peculiar effect, sometimes producing so-called staircases, and some- 
times a prolonged condition of still-stand, half in systole and half in 
diastole. 

A marked difference is seen between the action of the accele- 
rating- nerves and the inhibitory fibres of the vagus, as the inhibi- 
tory action follows very shortly after the irritation of the vagus, and 
usually ceases very shortly after the irritation is removed, whereas that 
of the accelerating nerves does not occur until some time after the irri- 
tation has been applied, and often lasts a good while after the irritation 
has been removed. The inhibitory fibres also appear to influence a dif- 
ferent period of the heart's action, the inhibitory affecting the pause or 
relaxation, while the accelerating affect systole or contraction. This 
condition renders it not improbable that we may have to do here with an 
action of these nerves on two different parts of the heart — the ganglia 
and the cardiac muscle. 

It is quite clear that, in order to get any satisfactory explanation of 
these phenomena, we must take into consideration not only the rhyth- 
mical actions going on in the cardiac ganglia and those in the cardiac 
muscle separately, but also the relation to one another of these rhythms 
both as regards their energy and rate. 

Theories Regarding- the Mode of Action of Drugs upon the 

Heart. 

In order to explain the effects of various poisons upon the heart, a 
hypothetical view of its nervous system has been proposed by Professor 
Schmiedeberg, 2 and I have endeavored to represent this in the accom- 
panying diagram. 3 It consists of a ganglion, M, which keeps up a 
rhythmical contraction of those muscular fibres of the heart to which it 
is connected by the fine nervous filaments, e. This ganglion is con- 
nected by an intermediate apparatus with an inhibitory ganglion, I, 
which can retard or stop the muscular contractions which m produces; 
and by another apparatus, c, with another ganglion, Q, which quickens 
the contractions. I is connected by an intermediate apparatus, A, with 



1 Weinzweig. From experiments in von Basch's laboratory. Archivf. Anat. u. 
Phys., Phys. Alt., 1882, p. 527. 

2 Schmiedeberg, Ludwig's Arbeiten, 1870, p. 41. 

3 " Experimental Investigations of the Action of Medicines," Lauder Brunton, 
British Medical Journal, December 16, 1871. 



276 PHARMACOLOGY AND THERAPEUTICS. 

the retarding fibres, v, of the vagus, and D with the quickening nerve, 

s, of the heart. 

This schema has been adopted by Professor Harnack. 1 

It has been supposed that motor ganglia are present because the 

apex of the heart of the frog, which contains no ganglia, will not contract 

rhythmically if left entirely to itself, whereas the ventricle containing 

ganglia will do so. 2 







Fig. SO.— Diagram of the hypothetical nervous apparatus in the heart. M, motor ganglion. I, inhib- 
itory ganglion, q, quickening ganglion, v, inhibitory fibres ; and s, quickening fibres from the 
head, a, a', b, and c, intermediate apparatus, e, fibres passing from the motor ganglia, M, to the 
muscular substance, f. [For simplicity's sake only one set of motor ganglia has been represented, 
but other similar ones aie supposed to be present in other parts of the heart, and so connected 
with this set that they all work in unison. It must be remembered that this diagram is purely 
hypothetical : but if this be carefully borne in mind, the sketch will be found of service in remem- 
bering and comparing the action of different poisons on the heart.] 

It has been supposed that inhibitory ganglia are present, because 
when a little muscarine is applied to the heart it causes it to stop in 
diastole. This effect is not developed all at once, but goes on gradually 
increasing, and its action in this respect seems rather to point to its effect 
upon ganglia than upon nerve fibres. 

It has been supposed that the vagus acts through this inhibitory 
ganglion or ganglia because irritation of the vagus arrests the heart in 
diastole, just as muscarine does ; but it has been supposed to be connected 
by some intermediate apparatus with the inhibitory ganglia, because 
we find that when nicotine is applied to the heart irritation of the vagus 
will no longer arrest its beats, but that irritation of the venous sinus, in 
which the inhibitory ganglia have been supposed to be situated, will do so 
at once. 

It has been supposed that the inhibitory apparatus, I, was connected by an 
intermediate structure with the motor ganglia, m, because physostigma does not 
produce the extraordinary still-stand which muscarine docs, but it counteracts to 
B certain extent the (fleets of atropia which muscarine does not. Physostigma 
In small doses increases the excitability of the vagus, so that a slight stimulus 
applied to thai nerve, so slight that it would under ordinary circumstances be 

Pharmakoloffisehe Thatsachen fur die Phyaiologie des FroscMierzens, Halle, 1881. 

The recent researches of Gaskell have shown that the muscular fibre of the heart 
of the tortoise will contract, although it contains no ganglia. The question of mus- 
culai rhythm Independent of ganglia will be considered further on. 



ACTION OF DRUGS ON CIRCULATION. 277 

insufficient to affect the heart, will stop it. 1 In large doses, it appears to paralyze 
the vagus. The difference of action between muscarine and physostigma seemed 
to show that they acted on different nerve structures ; while the mutual power of 
atropia and physostigma to neutralize each other's effects within certain limits in- 
dicated that atropine acted on the same nerve structure as physostigma and 
consequently on a different one from muscarine. (Brit. Med. Journ., Dec, 1871.) 

When atropine is applied to the heart it completely removes the effect 
of muscarine and totally prevents any arrest being produced either by 
irritation of the vagus or the venous sinus. It has therefore been supposed 
that nicotine acts upon the intermediate apparatus, A, but that atropine 
acts either upon I or upon b. 

The reason why it has been supposed that quickening ganglia 
exist is, that when irritation is applied to the vagus after its inhibitory 
power has been destroyed by the administration of nicotine or atropine 
it no longer produces slowness or still-stand of the heart, but, on the con- 
trary, quickens its pulsation. But the quickening does not take 
place immediately, it only occurs some time after the application of 
the stimulus. If it is applied only for a short time, no quickening may 
take place until after its removal, but the quickening once induced, re- 
mains for a considerable time. This seems to indicate that the stimulus 
does not act through nerve fibres, as these would conduct the stimulus di- 
rectly to the muscle, but rather through some ganglionic apparatus. It has 
been supposed that this apparatus is not identical with the motor ganglia 
themselves, because if the heart is irritated directly, its pulsations at once 
become quickened, and the quickening does not last long after the irrita- 
tion is removed. 

It is evident, however, that though this hypothetical schema allows 
us to explain in a fairly satisfactory manner the action of many drugs, 
yet it can only be looked upon in the same light as the hypothesis of 
cycles and epicycles in astronomy, which was useful for a time and en- 
abled astronomers not only to recollect but to predict facts. Its use was 
only temporary, and the hypothesis just at the time of its greatest com- 
plication gave place to one of the greatest simplicity. 

It is probable, indeed almost certain, that the same thing will occur 
in regard to the action of drugs upon the heart, and that the whole com- 
plication of motor ganglia, inhibitory ganglia, accelerating ganglia, vagus 
endings, and intermediate fibres may resolve themselves simply into a 
question of the mutual relationships between the rate of rhythm and 
rapidity of conduction in the muscular fibres, nervous ganglia, and nerve 
fibres respectively. Schmiedeberg's hypothetical schema has been most 
useful for several years, but facts which it will not explain are beginning 
to accumulate, and we must look in another direction for their explana- 
tion. The whole question of the action of drugs upon the heart is far 
from being completely solved, but I shall try, if possible, to indicate the 
direction in which pharmacology is at present looking for an explanation. 

For this purpose it will be necessary to go still more fully into the 
physiology of the heart than we have already done. 



1 Arnstein and Sustschinsky, Wiirzburger Physiol. Untersuch., iii. 



278 



PHARMACOLOGY AXD THERAPEUTICS. 



Before doing so, however, it may be advantageous to put in a tabular 
form the action of the most important drugs on the various parts of the 
circulatory apparatus, according to the prevalent opinions at present. 1 




l.— Diagram of the heart and vessels to illustrate the action of drugs on the various parts of the 
circulatory apparatus as given in the following tables, a, indicates accelerating ganglia. 



1 In drawing up this table [see pp. 279-282] I have been greatly aided by the 
admirable paper of Professor Boehm, read before the International Congress in London 



in 1—1 



ACTION OF DRUGS ON CIRCULATION. 



279 



Vagus Centre. 



STIMULATED BY. 

[Stimulation is evidenced by slowing 
of the pulse, disappearing on section of 
the vagi.] 

Increased blood-pressure. 

Venous blood. 

Ammonia (in frogs). 

Carbonic oxide. 

Chloroform. 

Chloral hydrate. 

Croton chloral. 

Belladonna (atropine). 

Hyoscyamus (hyoscyamine). 

Stramonium (daturine). 

Aconite (aconitine). 

Veratrum viride (veratroidine). 

Tobacco (nicotine). 

Digitalis (digitalin). 

Hydrocyanic acid. 



DEPEESSED OE PAEALYZED BY. 

[Depression is evidenced by a quick 
pulse, which is not rendered slow by irri- 
tation of sensory nerves such as usually 
produce slowing of the pulse, e.g., the 
central end of one vagus.] 

Diminished blood-pressure and 
substances which produce it, 
e.g., nitrite of amyl and other 
nitrites. 
Large doses of such substances as 
stimulate it in small doses, vide 
adjoining list. 



Accelerating Centre. 



[Stimulation is evidenced by the injec- 
tion of the drug after previous section of 
the vagi rendering the pulse still more 
rapid than before.] 

Venous blood. 

Ammonia. 

Cicutoxine. 

Caffeine. 

Delphinine. 

Picrotoxine. 



[Little or nothing is known about the 
depression of the accelerating centres.] 
Saponine paralyzes accelerating 
nerves. 



Vaso-motor Centre. 



[Stimulation is evidenced by a rise of 
blood-pressure, which disappears on sec- 
tion of the spinal cord below the medulla, 
and does not occur if the cord has been 
divided before the injection of the drug. 
This rule is only partially true, because 
subsidiary vaso-motor centres occur in 
the spinal cord itself.] 

Salts of ammonia. 

Potassium (?). 

Caffeine (?). 

Cicutoxine. 

Delphinine. 

Picrotoxine. 

Strychnine. 

Digitalin (?). 

Sanguinaria. 

Thebaine. 

Veratrine. 

Ergot. 

Belladonna (atropine). 

Hyoscyamus (hyoscyamine). 

Stramonium (daturine). 

Carbolic acid (?). 

Salicylic acid. 

Ether (?). 

Chloroform (?) 

Chloral (?). 

Croton chloral (?). 

Turpentine. 

Camphor (rhythmically). 

Oil of rosemary, and other ethereal 
oils. 



[Depression is evidenced by fall in the 
blood-pressure not depending on failure 
of the heart's action. It is also shown 
by the absence of rise in blood-pressure, 
or irritation of sensory nerve.] 
Carbolic acid. 
Lobelia. 

Large doses of most drugs, such 
as those in the adjoining 
column, which stimulate in 
small doses. 
Depression usually occurs in the 
later stages of the action of 
such drugs even in moderate 
doses. 



] Stimulant ac- 
| tion doubtful, 
J slight, and 
J transient. 



280 



PHARMACOLOGY A.WD THEEAPEUTICS. 



Yagiis-ends in the Heart. 



STIMULATED BY. 

[Stimulation either of the ends of the 
vagus in the heart or of the inhibitory 
ganglia is shown by the injection of a 
drug rendering the pulse slow after pre- 
vious division of the trunks of the vagi.] 
Physostigma (?). 

It is said to render the peripheral 
ends of the vagus more sensi- 
tive, so that a slighter stimulus 
will stop the heart applied to 
the trunk. 



DEPEESSED OE PARALYZED BY. 

[Depression or paralysis is shown by 
irritation of the vagus trunk no longer 
producing slowness or stoppage of the 
pulsations of the heart, while the appli- 
cation of muscarine, or irritation of the 
venous sinus, will still cause stoppage.] 
Nicotine. 

Curare, methyl-strychnine, and 
probably all other poisons which 
paralyze motor nerves. 
Saponin. 
Lobeline. 

And, probably, by large doses of 
all drugs which have the power 
of paralyzing the ends of motor 
nerves. 



Inhibitory Ganglia. 



[Stimulation is shown by the direct 
application of the drug to the heart, stop- 
ping its spontaneous pulsations com- 
pletely, while it still contracts on the 
application of a stimulus either mechani- 
cal or electrical.] 

Muscarine. 

Pilocarpine. 



[Depression or paralysis is ghown by 
stimulation, not only of the vagus trunk 
but of the venous sinus itself, having lost 
all power to slow or stop the heart ; and 
by the direct application of muscarine, 
also having no action.] 

Atropine. 

Hyoscyamine. 

Daturine. 

Sparteine. 

Duboisine. 

Saponin. 



Motor Ganglia. 



[Stimulation is shown by increased 
rapidity and energy of contraction, which 
is observed, not only when the drug is 
given to an animal, but when it is ap- 
plied directly to the heart.] 

(iuanidine. 

Alcohol. 

Ether. 

Chloroform. 

Chloral. 

Anaesthetics generally. 
1 j Boogen. 
Arsenic. 
Quinine. 



[Depression is evidenced by slower 
and less powerful pulsations, with final 
stoppage in diastole. This stoppage is 
shown to be due to the action of the drug 
on the ganglia, and not on the cardiac 
muscle by the heart contracting on stim- 
ulation, either mechanical or electrical, 
after spontaneous pulsation has ceased.] 
Ergot. 

Antimony (?). The stoppage in 
diastole caused by antimony is 
converted into stoppage in sys- 
tole by helleboreine. 
Hydrocyanic acid. 
The same drugs that stimulate in 
small doses depress when used in larger 
quantity, or at a later stage of their 
action. 



ACTION OF DRUGS ON CIRCULATION. 



281 



Cardiac Muscle. 



STIMULATED BY. 



DEPEESSED OE PAEALYZED BY. 



IN 8 9 „ 

H _ <U £ 53 



«53 ^r^ 



O o 

© 






aa 

c3 



[Stimulation is shown by increased 
energy of contraction, the rate of pulsa- 
tion remaining the same or becoming 
slower.] 

Digitalin. 
Digitalein. 
Digitoxin. 
Erythrophleum. 
Hellebore'ine. 
- Nerein (Oleander). 
Scillain. 
Antiarin. 

Strophanthus hispidus. 
Thevetine. 
[ Theveresine. 
Veratrine. 
Barium salts. 
Caffeine (produces 

rigor). 
Potassium salts. 
Copper double salts. 
Zinc double salts. 

Guanidine. 

Physostigmine. 

Camphor. 

Monobromocamphor. 

Borneol. 

Arnica-camphor. 

Aniline sulphate. 
.S pd _b> •* o Cumarine. 



[Depression is shown by diminished 
energy of contraction with final stoppage 
in diastole. The cardiac muscle is shown 
to be paralyzed by no longer contracting 
on stimulation, either mechanical or 
electrical.] 

Salicylic acid. 

Potassium salts. 

Copper double salts. 

Zinc double salts. 

Quinine (?). 

Saponin (removes the systolic still- 
stand produced by digitalin). 

Apomorphine. 

Emetine. 

Muscarine. 

Pilocarpine. 

Veratrum viride (veratroidine and 
jervine). 



,3.3 g-a g£ . 



-: fe» U & -5 a 



§2 



CQ c3 



2 -P C3 03 
2 CO rt « 

*3 h 



<C ^2 



S 9 >i * 



^^2 ftcj 

This stoppage of the heart in systole 
occurs in frogs, but in higher animals 
the heart may stop in diastole. 



Vaso-motor Nerves. 



[It is very doubtful whether they are 
stimulated by drugs, and at any rate it 
is very difficult to ascertain whether 
any stimulation which may occur in the 
arterioles or capillaries is in the termi- 
nations of the vaso-motor nerves or in 
the muscular walls.] 



[Paralysis is shown by the vessels not 
contracting on stimulation of the vaso- 
motor nerves, while they still contract 
on direct stimulation. This has been 
chiefly observed in the vessels of the 
intestines after irritation of the splanch- 
nic nerves. The effect of irritation is 
ascertained by the alterations in color of 
the intestine, and also by the alterations 
in the general blood-pressure which 
occur after irritation.] 

Potassium salts. 

Arsenic. 

Antimony. 

Mercury. 

Iron. 



282 PHARMACOLOGY AXD THERAPEUTICS. 

Capillaries. 

STIMULATED BY. DEPRESSED OR PARALYZED BY. 

[Stimulation is shown by a rise in [Depression is shown by fall of blood- 

blood-pressure which remains after sec- pressure to a slight extent, even after the 
tion of the spinal cord at the occiput, spinal cord has been divided, and by in- 
and is produced by the injection of the creased rapidity of flow when artificial 
drug after previous division of the cord. circulation is kept up.] 
It is also ascertained by the rate of flow Acids, 

through the vessels being diminished by Nitrites. 

the drug when circulation is kept up Quinine (?). 

artificially in a frog whose nerve-centres 
have been destroyed, or in a single limb 
of a warm-blooded animal.] 

Alkalis. 

Digitalis and its allies. 

Barium salts. 

Potassium salts. 

Copper. 

Zinc, &c. 

Stannius's Experiments. 

Some of the most important experiments relating to the action of the various 
cavities of the frog's heart were first performed by Stannius, and bear his name. 

When the venous sinus is separated from the rest of the heart by cutting it 
off with a sharp razor, or by a ligature tightly drawn round it at its junction with 
the auricle, it continues to pulsate, but the auricle and ventricle stand perfectly 
still (a, Fig. 82). If now the auricle is separated from the ventricle by another 
cut fb, Fig. 82), or another ligature be applied (c, Fig. 82), at the auriculo- 
ventricular groove, the auricles remain motionless, but the ventricle begins to 

i he 




3 



.-,-: 



bwi 




a b c 

1 1 ( '- v --— ", diagram of frog's heart ligatured at the junction of the venous sinus with the auricles. 
The rense cav;e and sinus are represented with a crenated outline resembling the tracing which 
their beats might give if recorded on a revolving cylinder. The auricle and ventricle being mo- 
tionless would only trace a straight line if connected with a recording apparatus. Their outline 
•efore represented by a straight line, b, diagram of a frog's heart in which sections have 
been made at the junction of the sinus with the auricles, and at the auriculo-ventricular groove. 
The sin us and ventricles pulsate, whilst the auricles remain motionless. The beats of the ventricle 
should have been represented as slower than those of -the auricle as in/, Fig. 83. c, the same as 6, 
but with the parts of the heart separated by ligature instead of section. 

beat, bo that the venous sinus and ventricle are both pulsating, while the auricles 
are at rest. The venous sinus and the ventricle, however, no longer beat with 
the same rhythm, and the rate of the ventricular beats is usually much slower 
(j. Fig. 83). In this remarkable experiment the complete stoppage of the 
auricle- and ventricle which follows the removal of the venous sinus has been 
Supposed to show that the motor centres for the entire heart reside in the sinus, 
and that from them the motor impulses originate which keep up the rhythmical 
pulsations of the organ. But the fact that the ventricles begin to pulsate on 
theb own account when separated by another cut from the auricle seems to show 
that they also contain motor centres. The hypothesis has therefore been advanced 
that both venous sinus and ventricles contain motor centres, while the auricles 
contain inhibitory c-ntr 



ACTIOX OF DRUGS OX CIRCULATION. 283 

So long as the auricles are in connection both with the venous sinus and the 
ventricle, the motor centres in the latter two cavities are supposed to be suffi- 
ciently powerful to overcome the resistance offered by the inhibitory centres, and 
thus the cardiac rhythm is maintained. When the motor centres of the sinus 
are removed the inhibitory centres of the auricle are supposed to be so powerful 
as to keep both it and the ventricle in a state of rest. 

When the ventricle is separated from the auricles and their inhibitory in- 
fluence removed, it again begins to pulsate rhythmically. In order to obtain a 
clearer idea of the mechanism of the heart, many variations of the above funda- 
mental experiments have been made. 

The chief results of these are the following : — 

First, section or ligature of the venae cavae or of the venous sinus at any 
point before its junction with the ventricle does not affect the action of the heart 
(<*, Fig. 83). 

Second, section or ligature of the auricles at any point above the auriculo- 
ventricular groove arrests the movements of the part below them, while that 
connected with the venous sinus still continues to pulsate (e, Fig. 83). 



3$* 6P? 







V 




d e f 

Fig. S3. — d, diagram of a heart with ligature round the venous sinus, e, diagram of heart with ligature 
round middle of auricles. /, diagram of heart with ligature in the auriculo-ventricular groove. 
The pulsations of the ventricle are much slower than those of the auricle and venous sinus. This 
is indicated by the larger dentation of the outline of the ventricle. 

Third, irritation of the vagus nerves usually produces stoppage of the 
heart-beats. 

Fourth, ligature or section of the vagi before their entrance into the heart 
prevents their having any action upon it when they are stimulated. 

Fifth, ligature or section of the venous sinus or auricles prevents any action 
of the vagi upon the part of the heart below the ligature or section. 

It is evident that section or ligature of the heart at any point between the 
junction of the sinus and auricles and the auriculo-ventricular groove has the 
same action on the movements of the part below it as irritation of the vagus. 

But more than this, although, as we have seen, the motor ganglia of the heart 
appear to be situated chiefly in the venous sinus, yet irritation of the sinus 
produces complete still-stand of the heart, even more perfect and prolonged 




p, £p 



Fig. S4.—g, diagram of heart stopped by a ligature at the junction of the sinus and auricles. The out- 
side of the ventricle is irritated by a needle, and the even outline indicates that no contraction 
occurs. A, diagram similar to g, but with the inside of the ventricle irritated by a needle. The 
projections on the outline of the heart indicate that one contraction of the ventricle and three or 
four of the auricles occur, k, diagram similar to g and A, but with the outside of the auricle stim- 
ulated by a needle. The projections indicate that one contraction of the auricle and one of the 
ventricle occur. 

than irritation of the vagus. Strong stimulation of the venous sinus has there- 
fore the same effect as its removal. The parts whose motions have been arrested 



284 PHARMACOLOGY AND THERAPEUTICS. 

by section or by irritation, in the experiment just described, are not paralyzed : 
this is shown by the effect of stimulation upon them. 

When the auricles and ventricle are standing still after section or ligature 
of the venous sinus, irritation of the outside of the ventricle with a needle has 
no action (y, Fig. 84); but if its interior be irritated by a needle (h, Fig. 84), 
the auricle contracts first, then the ventricle, then the auricle again two or three 
times, but the ventricle does not respond. When the auricle is irritated by a 
needle applied to its outside, contraction both of the auricle and ventricle ensues 
(&, Fig. 84). When the auriculo-ventricular groove is irritated by a needle 
there are usually eight or ten contractions in response. When the outside of 
the auricle is irritated by an interrupted current, numerous and rhythmical con- 
tractions both of auricle and ventricle ensue. 

To sum up these results shortly, we find that either removal of the normal 
stimuli which pass in the direction of the circulation from the venous sinus 
to the auricle and then to the ventricle, or abnormally strong stimulation, 
produces arrest of the rhythmical movements of the heart, or, as it is usually 
termed, inhibition. 

Some exceedingly instructive experiments have been made by Gas- 
kell, who, instead of separating the cavities of the frog's heart from each 
other by sections or by a ligature, compresses more or less completely 
the point of junction, so as to impede to a certain extent the transmis- 
sion of stimuli from one cavity to another. 



ATI; " 



Fig. 85.— Diagram to illustrate Gaskell's experiment. At a the jaws of the clamp hold the heart with- 
out compressing it, and each beat of the auricle is succeeded by one of the ventricle as shown by 

the figure ^ At 6 the heart is compressed, and its rhythm disturbed, so that one beat of the ven- 
tricle only occurs for several of the auricles. 

He does this by a clamp the two limbs of which are placed one on each side 
of the heart. By means of a micrometer screw their edges can be approxi- 
mated so as either simply to hold the heart without pressure or to compress it 
to any desired extent. When the clamp is placed in the auriculo-ventricular 
groove, the beats of the auricles and ventricle are registered separately by levers 
above and below the clamp with which the auricles and ventricle are connected 
by threads. 

When the heart is simply held by the clamp without compression, each beat 
of the auricle is followed by one of the ventricle; but when the auriculo-ven- 
tricular groove is compressed the transmission of stimuli from the auricle to the 
ventricle appears to be blocked in somewhat the same way as it is by compres- 
Bion in the contractile tissue of medusa), and one beat of the ventricle then 
occurs with every second, third, fourth, or more auricular beats, according to the 
degree of pressure, and if this be very great the ventricle will cease beating 
altogether. 

The beatfl of the ventricle are shown in this experiment to be diminished 
or arrested bj hindering or blocking the transmission of stimuli to it from the 
venous sinus and auricle. I>ut, as one might expect, a diminution of the stimuli 
themselves has a similar effect as a block to their passage. Thus, if the auricle 
and sinus are heated, but not the ventricle, their rhythm is markedly quickened, 



ACTION OF DRUGS ON CIRCULATION. 285 

but the ventricle now beats only once for every two or even more pulsations of 
the auricle, the heat appearing to render the impulses proceeding from the auri- 
cle and sinus more rapid but more weak. If the ventricle be heated as well, it 
will respond to each beat of the auricle, so that the whole heart beats more 
quickly, but if the ventricle alone be heated its rhythm remains unchanged. 

Experiments which are likely to give useful information in regard to the 
action ot various drugs on the cardiac muscle and nerves have been made by 
Graskell by the aid of the clamp already described. 

General Considerations regarding the Heart. 

In ascidians the heart is a mere contractile sac open at both ends, and drives 
the fluid alternately in opposite directions. In snails it is a simple sac of proto- 
plasm without differentiated nerves, but drives the nutritive fluid in one direc- 
tion. In the amphioxus there is no special heart, but only numerous contractile 
dilatations in the chief blood-vessels. In fishes the heart may be said to consist 
of three parts — the auricle, ventricle, and arterial bulb. The heart of the frog 
has already been described, and that of mammals requires no description. 

Even the complicated mammalian heart may be regarded as a special develop- 
ment of the simple contractile tube endued with the power of peristaltic contrac- 
tion. The direction in which the contraction occurs is probably determined at 
first by slight differences in the stimuli to which the two ends of the tube are 
subjected, and the direction may be altered by altering the stimulus. Thus in 
the heart of a fish the contraction usually proceeds from the auricle to the ven- 
tricle and bulb, but by irritating the bulb the direction may be reversed so that 
the bulb contracts first and the auricle last, and this reversal of rhythm may 
persist for some time. 1 In the mammalian heart it is not perhaps so easy to re- 
verse the rhythm by simple irritation, and probably some interference with the 
cardiac nervous system is also requisite, but by introducing tincture of opium 
into the mammalian ventricle the rhythm may be reversed so that the beats of 
the auricle follow instead of preceding those of the ventricle. 2 

The cause of rhythmical pulsation in the heart is usually supposed to 
be the motor ganglia which it contains. Of late years numerous researches have 
shown that, although these are very important indeed, yet they are not to be 
looked upon as the exclusive originators of the rhythm. The heart of the snail, 
although it consists of simple protoplasm without nerves, beats rhythmically, 
and when a ligature is tied across the venous sinus in the frog the vense cavas 
and upper part of the sinus continue to beat although they possess no special 
ganglia, while the rest of the heart remains motionless, although it contains both 
Bidder's and Remak's ganglia. From this experiment one would be inclined at 
first to say that the initiation of rhythm in the heart is due to the mus- 
cular tissue of the venas cavas and sinus, and might be inclined to regard the 
nervous system of the heart as an apparatus for merely conducting 
stimuli from the sinus to the auricles and ventricle. 

Other experiments would seem to deprive the nerves even of this function, 
for Engelmann 3 and Graskell have shown that when Bidder's ganglia are excised, 
or the nerves cut through as they traverse the auricles, contractions still pass 
from the venous sinus to the ventricle, and continue to do so when the nerves 
have not only been divided but most of the muscular tissue of the auricle has 
been cut through and only a narrow bridge remains behind. This may seem 



1 Gaskell, Journ. of Physiol., vol. iv., p. 78. 

2 Ludwig, Physiologie, 1861, vol. ii., p. 88. 

3 Pfluger's Archiv, xi., p. 465. 



286 PHARMACOLOGY AND THERAPEUTICS. 

to prove that the muscular tissue of the heart conducts the motor stimuli from 
the venous sinus to the auricle and ventricle, which cause them to contract, and 
may appear to show that the cardiac nerves are entirely superfluous. A similar 
mode of reasoning, however, would lead us to say that the ganglia in medusae 
are also superfluous because the contractile tissue will pulsate rhythmically after 
they have been cut off", if it be placed in acidulated water. 

In regard to the conduction of stimuli, the fact probably is that under 
favorable conditions they may be conveyed by the muscular tissue alone from 
the sinus to the ventricle, but, under ordinary circumstances, they are conveyed 
in part, at least, by the nerves. 

Granglionic tissue is more sensitive than contractile tissue, and the stimuli 
which act on the ganglia of the medusa, under the conditions in which it lives, 
are insuflicient to excite contractile tissue. When the ganglia are paralyzed by 
a poison, the effect is the same as if they were cut off, and pulsation is arrested. 
A similar condition appears to occur in the ventricle. The muscular tissue 
forming the apex of the frog's heart under ordinary circumstances will not beat 
when separated from the rest unless an extra stimulus be applied to it. The 
ventricle containing Bidder's ganglia will usually pulsate rhythmically, and if 
its apex be dipped in a solution of chloral no effect is produced, but if its base 
be dipped in the solution so that the drug acts upon the ganglia, the pulsations 
are arrested apparently by paralysis of the ganglia (Harnack). 

We may consider then that ganglia are more susceptible to stimuli than 
muscular fibre, and have the function of making it pulsate rhythmically when it 
otherwise would not. 

It is probable also that they serve to prevent the occurrence of blocks at the 
junction between the different cavities of the heart which might occur if the 
stimuli were transmitted from each cavity by muscular tissue alone. 

When the heart is dying, and when we may fairly assume that its nerves 
are losing their functional activity, such blocks actually take place, and the 
ventricle may beat only once for every two or three or more beats of the auricle. 

The cardiac muscle is also without doubt losing its functional activity, yet 
it still retains it to such an extent that each cavity can contract powerfully. 
The same thing occurs when the heart is poisoned with chloral, iodal, or other 
members of the same group, which, as already mentioned, paralyze the cardiac 
ganglia. 1 

In the present state of our knowledge it is difficult to make any absolute 
statement regarding the function of the cardiac g-anglia, but I think we may 
fairly assume them to have two functions, (1) to originate rhythmical pul- 
sations in the heart when the muscular fibre alone, although capable of inde- 
pendent rhythmical pulsation, would not pulsate under the conditions which may 
be present ; (2) to transmit and receive stimuli from one cavity of the heart to 
ill' other, and thus prevent the occurrence of blocks at the junction of the 
cavities and consequent irregular action which might occur if the stimuli were 
transmitted only by the muscular fibre. 



Regulating Action of the Nervous System. 

'I'll, necessity of some means for regulating the action of the heart in ac- 
cordance with the wants of the body is obvious, and in the heart we find that 
suet an arrangement exists in relation both to the strength and rate of 
pulsation. 






1 Harnack and Witkowski, Arch.f. exp. Path, und Pharm., vol. xi., p. 15. 



ACTION OF DEUOS ON CIRCULATION. 287 

The action of the vagus upon the heart has long been a matter of great 
dispute, some physiologists holding it to be the motor nerve of the heart, while 
the majority regard it as inhibitory. The reason of this disagreement probably 
is that the right and left vagi have frequently different effects upon the heart, 
and that the effects even of the same vagus may vary according to the state of 
nutrition of the heart and other circumstances. We find for example in rabbits 
that both the right and left vagi can usually slow or stop the heart ; but some- 
times the right has much greater power in this respect than the left, and in 
some species of tortoise the left vagus has no inhibitory action upon the heart 
at all. A number of experiments made by Graskell on the heart in situ and 
with the clamping apparatus already mentioned, by which the beats of the 
auricle and ventricle may be simultaneously recorded, have led him to divide the 
effects produced on the heart by irritation of the vagi into two types : (a) affec- 
tions of the rate of rhythm ; and (6) affections of the strength, of the 
contractions. 

The effects of vagus stimulation on the heart of the frog may thus be 
divided into five classes. 

The 1st class is that which occurs with the heart of the tortoise or frog 
in situ or just after their removal from the body. The vagus here causes arrest 
by slowing the rate of rhythm ; and, in consequence, the first beats which 
occur after the heart again begins to beat are slower than those preceding the 
stimulation. 

In the next classes the vagus produces its effect by weakening the 
strength of the contractions so that they may become invisible and the heart 
remains still, but after it begins to beat their rate is as quick or quicker than 
before. 

The 2d class is an example of this. In it irritation of the nerve produces 
complete stoppage of both auricles and ventricles. This is followed by con- 
tractions, which are at first so small as to be hardly visible, but quickly grow 
larger until they are much greater than the normal ; from this they gradually 
decrease to the normal size (Fig. 86). 




Fig. 86. — After Gaskell. Tracing showing the action of the vagus on the heart. Aur. indicates the 
auricular, and Vent, the ventricular tracing. The part included between the upright lines indi- 
cates the time during which the vagus was stimulated. C. 8 indicates that the secondary coil used 
for stimulation was eight centimetres distant from the primary. The part of the tracing to the 
left hand shows the regular contractions of moderate height before stimulation. During stimula- 
tion, and for some time after, the movements of both auricle and ventricle are entirely arrested. 
After they again commence they are small at first, but soon acquire a much greater amplitude 
than before the application of the stimulus. 

The two types of action may occur together, the rhythm becoming slower 
and the contractions smaller. This is seen in Fig. 87. 

The 3d class is where irritation produces no still-stand of either auricles 
or ventricles, but only great diminution in the size of the beats, followed by a 
gradual increase and subsequent fall similar to that just described. This curve 
is like the first, but differs from it in the absence of the complete arrest 
(Fig. 88). 



288 



PHARMACOLOGY AND THERAPEUTICS. 



The 4th is that where there is no primary diminution, but gradual increase 
in the size of the beats, which again sink to the normal (Fig. 89). 



Vend Co. 



Tnnmnnfl/i/iiififinflfKKififii 



mmmimmi 



jUUUUUUiiJiJU^^ 



Fig. 87. — After Gaskell. Tracing showing diminished amplitude and slowing of the pulsations, with- 
out complete stoppage, during irritation of the vagus. 

The 5th is where irritation of the vagus does not stop the beats of the 
venous sinus but causes both auricles and ventricle to stop. 




Fio. B8.— After Gaskell. Tracing showing diminished amplitude of contraction without slowing or 
stoppage during irritation of vagus. 

The ordinary inhibitory effect of the vagus is the one which is noticed best 
in well nourished hearts, and as the heart becomes more exhausted and is dying, 




icing showing Increased cardiac contractions from irritation of the 
In thii figure the upper tracing shows the ventricular and the lower the auricular 

■ 



ACTION OF DEUGS ON CIRCULATION. 



289 



the motor power of the vagus becomes more and more pronounced. We find 
a similar occurrence in the case of the splanchnics, which lose their inhibitory 




-3-BM I . /UOWMAWAI 



Fig. 90. — Part of the posterior cardiac nerve, more highly magnified, showing the ganglia. 
(Ranvier, op. cil., p. 106.) 




Fig. 91. — Spiral ganglion cell from the pneumogastric of the frog. This figure is not taken from the 
cells in the cardiac nerves, as in them the connection between the spiral and straight fibres has 
not been clearly made out, but it is probable that these cells have a structure similar to the one 
figured (Ranvier, op. cit., pp. 114-20). a is the cell-body, n the nucleus, r the nucleolus, d nucleus 
of the capsule. / the straight fibre, g Henle's sheath, sf spiral fibre, g' its gaine, n nucleus of Henle's 
sheath (Ranvier, op. cit., p. 114). 

19 



290 PHARMACOLOGY AND THERAPEUTICS. 

power as the intestine dies. Nervous structures as a rule die sooner than 
muscle, and the conclusion is not unwarranted that the disappearance of the 
inhibitory action of the vagus is due to a gradual death of the nervous structures 
upon which it acts in the healthy heart, while its action on the muscular tissue, 
which has a more prolonged vitality, still remains. The actual increase, indeed, 
in its motor action we may attribute to the removal of nervous interference. 

Hypothesis regarding- the Action of the Vagus. — Nervous inter- 
ference as a cause of inhibition was clearly pointed out by Bernard, and in the 
case of the heart has been discussed by Ranvier with his usual clearness. 

In the gray matter of the spinal cord there is ample room for the slowing of 
nervous stimuli by transmission along paths of different lengths (p. 156), more 
especially as a small length of gray matter is equivalent to a great length of 
ordinary nerve fibre (p. 149). 

In the heart we might suppose there was no such provision, but, as Ranvier 
points out, the ganglion cells in the auricle have one of their fibres wound spirally, 
so as to give a great length in small space, and thus provide for retardation and 
interference of stimuli. If we suppose that some of the fibres of the vagus pass 
through these spiral ganglia while others pass on directly to these ganglia, we 
can understand that the different rates of transmission may lead to interference 
and stoppage of pulsation. Alterations in the rate of transmission along the 
spiral fibre may again convert interference into coincidence of waves and cause 
acceleration and increased action as in GaskelTs experiments just described. If 
these spiral fibres are affected by drugs so that the rate of transmission of stimuli 
along them is altered, we can understand that the interference may in some cases 
be increased, in others diminished, and that an increase of interference may 
readily pass into the opposite condition, so that irritation of the vagus no longer 
produces stoppage but acceleration of the heart, such as actually occurs on irrita- 
tion of the vagus after its inhibitory power has been paralyzed by atropine. 

We can understand also how curare and the large class of drugs which par- 
alyze the motor nerves may destroy the inhibitory power of the vagus. 

Inhibition in the Heart. — But it is probable that interference between 
the nervous structures is not the sole cause of inhibition in the heart, we must 
look also to the relationship between nervous and muscular rhythms. Thus 
distension of the ventricle frequently diminishes or abolishes the action of the 
vagus, the stimulus which the pressure within the heart exerts on the muscular 
fibre appearing to more than counteract the inhibitory action of the nerve. The 
condition of the muscular fibre too is probably very important. Thus, feeding 
the frog B heart with a solution containing soda appears to paralyze the power of 
the vagus, which is again restored by potash. 

It is indeed to an action on the muscle rather than on the nerve that we must 
probably look for the explanation of the action of atropine. For the heart in 
snails, though apparently destitute of both ganglia and nerves, is arrested by an 
interrupted current. This effect is prevented by atropine. 

It [fl exceedingly difficult, or perhaps impossible, with the physiological 
data which we at present possess, to give a complete and satisfactory ex- 
planation of the action of drugs on the heart, but it is evident that while 
all now discoveries tended for a while to render our ideas regarding the 
cardiac mechanism more and more complicated, our increasing knowledge 
now tend- to render our ideas more simple. Before long we may hope 
that systematic investigations into the action of drugs on the excitability, 
rhythm, and power to conduct stimuli of the cardiac muscle itself; on the 
action of drags upon the rhythm of the ganglia, and on the rate of 



ACTION OF DRUGS ON CIRCULATION. 291 

transmission by the nerves, as well as on the mutual relations of these 
various factors, will at last give us a clear understanding of this very 
difficult and complicated subject. 

Therapeutic Uses of Drug's acting* on the Circulation. 

The drugs which act on the circulation have been divided according 
to their action into stimulants, tonics, and sedatives. Each of these 
classes has been further subdivided into cardiac and vascular, according 
as its members act on the heart and vessels. There are thus six subdi- 
visions in all: cardiac stimulants, vascular stimulants, cardiac tonics, 
vascular tonics, cardiac sedatives, and vascular sedatives. 

Cardiac Stimulants. 

These are substances which rapidly increase the force and frequency 
of the pulse in conditions of depression. The most important are ammonia, 
and alcohol in its various forms, but there are also other substances which 
are sometimes useful : — 

Heat. 
Liquor ammoniae. B. P. Aqua Ether. 

ammoniae. U.S. P. Chloroform. 

Ammonium carbonate. Spirit of chloroform. 

Sal volatile (spiritus ammoniae Spirit of ether. 

aromaticus). Camphor. 

Alcohol. Aromatic volatile oils. 

Brandy. Oil of turpentine. 

Whisky. Heat and counter-irritants to the 

Eau de Cologne. praecordium. 

Gin. 

Liqueurs. 
Strong wines. 
Atropine. 

Cardiac stimulants are used to prevent or counteract sudden failure 
of the heart's action in syncope or shock due to mental emotion, physical 
injury, or poisoning by cardiac depressants, or by the bite of snakes, or 
when the action of the heart becomes much depressed in the course of 
fevers or other diseases. B 

Although alcohol after its absorption stimulates the heart, yet its 
effect on the heart is probably, to a considerable extent, due to a reflex 
action on it through the nerves of the mouth, gullet, and stomach. Its 
action is consequently very rapid, and begins before there has been time 
for much of it to be absorbed. On this account, however, it must be given 
in a somewhat concentrated form, and if much diluted, as in the form of 
weak wine or beer, which has little or no local action and can exert no 
reflex action, it has little or no power as an immediate stimulant. When 
given in disease it is best to administer it in small quantities frequently, 
and the rule by which to ascertain whether it is doing good or not is : 
Does it bring the circulation more nearly to the normal or not? If it 



292 PHARMACOLOGY AND THERAPEUTICS. 

does so it is beneficial ; if it does not it is harmful. Thus, if the pulse 
be too quick, alcohol should render it slower; if already abnormally slow, 
alcohol should make it quicker. If too small, soft, and compressible, 
alcohol should render it larger, fuller, and more resistant. There are 
other rules connected with the effect of alcohol on other organs which also 
regulate its use in disease, but these will be given further on. 

Ether alone or mixed with alcohol has a stimulant action almost more 
rapid than alcohol itself; and chloroform in small doses, and especially 
when mixed with alcohol, is also a powerful stimulant. 

Ammonia has not only a reflex action on the heart like that of alcohol, 
but has powerful stimulating action on the vaso-motor centre. Its action 
when applied to the nose in syncope has already been discussed. In 
cases of snake-bite thirty minims of liquor ammoniae have been injected 
directly into the veins. The immediate stimulating effect appears to be 
beneficial, although it is doubtful whether life can really be saved by this 
means. 

Camphor is useful as a cardiac stimulant in febrile conditions with 
tendency to failure of the circulation, as in typhus and typhoid fevers ; 
in exanthemata, when the rash does not appear ; in asthenic pneumonia, 
and in the typhoid condition depending on other diseases. 

Aromatic volatile oils and substances containing them have also been 
used in similar but less severe conditions. 

One of the most powerful of all cardiac stimulants is heat, and when 
the heart's action threatens to fail it may be frequently restored by warm 
fluid taken into the stomach, or by the application of an India-rubber 
bag 1 or bottle filled with hot water, or of a bag filled with hot sand or 
salt, or of a hot poultice to the cardiac region. 

Vascular Stimulants. 

These are substances which cause dilatation of the peripheral 
vessels, 2 and thus render the flow of blood through them more rapid. 
The most important are : 

Heat. 
Alcohol in its various forms. Dover's powder. 

Ether. Acetate of ammonia. 

Nitrous ether. 

Alcohol and ether, by stimulating the heart at the same time that they 

1 An India-rubber bag for holding hot water is one of the most useful things an 
invalid can carry about with him. It should have a flannel case fastened by bat- 
tons bo that it can easily be removed. This allows the heat to come gradually 
through without burning the skin. For a small gratuity the engine driver or stoker 
is usually willing to fill the bag with hot water, and the bag can be refilled if neces- 
sary at each station where there is a sufficiently long stoppage. This is sometimes 
a very great boon to invalids on long railway journeys such as they are often com- 
pelled to make oo kheif way to winter health resorts. 

Fiom this definition it will be observed that while cardiac stimulants increase 
the functional activity of the heart, vascular stimulants do not increase the contrac- 
tile power of the vessels, nor the activity of the vaso-motor centre, but on the con- 
trary diminish the contraction of the vessels. 



ACTION OF DRUGS ON CIRCULATION. 293 

dilate the vessels, render the peripheral circulation very vigorous. From 
its stimulant action on the vaso-motor centre, ammonia is less useful than 
alcohol. 

Vascular stimulants are useful in equalizing the circulation and pre- 
venting congestion of internal organs. Thus, from exposure to cold 
generally so that the whole surface of the body is chilled, or from a 
local chill due to a draught, or to the combined action of cold and mois- 
ture, as in wet feet, congestion of the respiratory tract, or of the stomach, 
intestines, or pelvic organs may occur. This frequently evidences itself 
immediately either by rigors or by localized pain. If the congestion be 
not relieved inflammation may occur, but if alcohol be taken either in a 
concentrated form or diluted with boiling water, the vessels of the sur- 
face dilate, a warm glow is felt throughout the body, the shivering and 
pains disappear, and frequently all injurious results of the chill are 
averted. If the external cold, however, is very excessive, and the expo- 
sure is to be prolonged, alcohol must be used with great care, as the 
blood becomes much more rapidly cooled when the cutaneous vessels are 
dilated than when they are contracted, and in arctic temperatures a per- 
son is much more readily frozen to death after the free use of alcohol. 
Dover's powder is also a useful vascular stimulant, though less powerful 
and rapid than alcohol. It is of use in similar cases to those just de- 
scribed, and may be given after the alcohol to supplement and continue 
its action. 

Slighter cases of chill may be treated by Dover's powder alone, and 
ten grains of it taken at night will often cut short commencing coryza, 
and will frequently prevent slight increase of consolidation occurring 
round a cavity after a chill in persons suffering from phthisis. Patients 
suffering from this disease should not omit to take a Dover's powder or 
some other vascular stimulant at night whenever they feel as if they had 
caught cold, and before any local mischief can be detected. 

All nitrites dilate the blood-vessels and thus act as vascular stimu- 
lants. The one most commonly employed is nitrite of ethyl in the form 
of spirits of nitrous ether. This remedy, taken in hot water or along 
with acetate of ammonia, is a useful vascular stimulant, and is often used 
for the same purposes as Dover's powder. 

Camphor is frequently used as a popular remedy instead of alcohol 
or Dover's powder in order to cut short coryza or catarrh, about ten 
drops of the tincture being taken on a piece of sugar. Local vascular 
stimulation is useful in removing chronic inflammation or consolidation. 
For a more detailed account of its action and uses, vide Irritants and 
Counter-irritants, p. 301. 

Cardiac Tonics. 

These are drugs which have no perceptible immediate action on the 
heart, but when given for a little while render its beats much more pow- 
erful, although usually much slower. The most important of them 
are: — 

Digitalis. Convallaria majalis. 

Digitalin. Convallamarin. 



294 PHARMACOLOGY AND THERAPEUTICS. 

Digitalein. Adonis vernalis. 

Digitoxin. Adonidin. 

Erythrophloeum (Casca). Squills. 

Erythrophlcein. Scilla'in. 

Strophanthus hispidus. Helleborein. 

Strophanthine. Antiarin. 

Caffeine. 
Nux vomica. 

Strychnine. 

All these drugs, as already mentioned, stimulate the cardiac muscle 
and render its contractions slower and stronger. Although in large doses 
they tend themselves to produce irregular and peristaltic contraction of 
the heart, yet in moderate doses they tend to remove irregularity already 
present. The cases in which they are most useful are those in which the 
left ventricle is unable to drive the blood with sufficient force into the 
aorta. It is evident that this inability may depend on simple weakness 
of the ventricle without any valvular lesion, or upon irregular action of 
the various cavities, or upon valvular lesions, or on a combination of two 
or more of these conditions. 

Weakness of the heart may occur in cases of general malnutrition, as 
anaemia and chlorosis, or in consequence of acute disease, such as fevers. 
It is not necessarily accompanied by dilatation, but if it continues for 
some time the cavities are apt to dilate. A considerable amount of dila- 
tation may sometimes occur without leading to valvular incompetence, but 
if it proceeds beyond a certain point the cusps of the tricuspid and mitral 
valves become insufficient to close the dilated orifices, and mitral or tri- 
cuspid regurgitation is the result. For it must be remembered that in 
the healthy heart the tricuspid and mitral orifices are much diminished 
in size by the contraction of the muscular tissue of the heart at the mo- 
ment of systole. 

In cases where the mitral valve is thus affected, a systolic murmur 
may be heard at the apex during life, but should death occur, the valves 
may be found perfectly competent to close the mitral orifice in the heart, 
which is then in a state of more or less complete rigor. In all such 
cases of weakness of the heart, either with or without dilatation and 
functional incompetence of the valves, digitalis is of the greatest possible 
service. I have also found erythrophloeum give most satisfactory results 
in simple dilatation without incompetence. 

The form of valvular disease in which cardiac tonics are especially 
useful is mitral regurgitation. In all forms of valvular disease there is 
a tendency to the occurrence of compensatory hypertrophy, which will 
enable the heart to do its work in spite of the hindrance caused by the 
disease. Wherever this is sufficient so that the circulation is well carried 
on, QOtwithstanding the valvular defect, cardiac tonics are useless and 
likely to be injurious. Nor should they be given when the compensatory 
hypertrophy is just beginning to take place. But when compensation is 
insufficient, cardiac tonics are of the very highest value. In mitral regur- 
gitation the Mood, instead of being driven entirely onwards by the left 
ventricle into the aorta, is partially driven backwards into the left auricle 



ACTION OF DRUGS ON CIRCULATION. 295 

at the very moment that the right ventricle is driving the blood into the 
pulmonary artery and lungs. Hence there is a tendency to pulmonary 
congestion, which may lead to haemoptysis. The right ventricle having 
to work against greatly increased pressure tends to dilate, the blood ac- 
cumulates in the venous system generally, and venous congestion of the 
stomach leads to loss of appetite, of the kidneys to albuminuria, and of 
the limbs to anasarca. While the venous system is gorged, the arterial 
is correspondingly empty, and it is not only the stomach, kidneys and 
limbs which suffer by the stagnation of the circulation, for a similar con- 
dition exists in the heart itself. In consequence of this its action may 
become not only weak, but irregular, and matters go on from bad to 
worse. 

In such a condition cardiac tonics are of the greatest possible service. 
By increasing the strength of the cardiac muscle they not only enable 
the left ventricle to drive a larger proportion of blood into the aorta, but 
they actually tend to lessen the opening of the mitral orifice in the same 
way as in functional incompetence. By rendering the pulse less fre- 
quent they allow the ventricle to become more completely filled during 
each diastole. The pressure on the lungs, right side of the heart, and 
venous system, is diminished, the arterial system becomes correspond- 
ingly filled, the congestion of the various organs is diminished and their 
function correspondingly improved. 

The consequence of this is that in the stomach we have increased 
appetite, in the kidneys diminished albumen, and in the limbs removal of 
anasarca. The heart also benefits by the improved circulation in it, its 
pulsations are more regular and powerful, and it will often continue to 
act well and carry on the circulation satisfactorily even after the tonics 
which first enabled it to do so have been discontinued. 

In mitral stenosis cardiac tonics probably are beneficial both by 
lengthening the diastole and thus allowing more time for the blood to 
run out of the auricle into the ventricle, and by strengthening the auricle 
itself. Besides this, mitral stenosis is usually accompanied by mitral re- 
gurgitation which will be benefited by cardiac tonics in the way just 
described. 

In aortic stenosis digitalis is of little or no use when there is sufficient 
compensatory hypertrophy, but may be useful if the heart is becoming 
feeble. 

There has been considerable difference of opinion regarding the use 
of digitalis in aortic regurgitation, some holding it to be useful and unat- 
tended with any risk, while others regard its administration as attended 
with considerable danger. In considering this question we must bear in 
mind that the risks which a patient runs from aortic regurgitation are 
not the same in all stages of the disease. While the aortic regurgitation 
is uncomplicated, and the ventricle strong enough to carry on the circu- 
lation, the risk to the patient is that of sudden death by syncope. 

It is easy to understand how this should be the case. When the 
aortic valves are healthy the arterial system may be regarded as a large- 
branched tube open only at one end — the capillaries — and through these 
the blood flows so slowly that there is no risk of syncope from the blood- 
pressure falling too low (Fig. 92, a). 



296 PHARMACOLOGY AND THERAPEUTICS. 

In a case of aortic regurgitation, on the contrary, the arterial system 
is open at both ends, and during the cardiac diastole the blood is not 
only running through the capillaries, but is running backwards into the 
left ventricle, so that the conditions are favorable for the blood-pressure 
falling so low as to induce syncope (Fig. b). It is evident that anything 
which prolongs the diastole, and thus allows more time for the arterial 
system to empty itself through the capillaries at one end and into the 




Fig. 92.— Diagram to illustrate the tendency to syncope in aortic regurgitation. In a the aortic valves 
are healthy and prevent regurgitation. The carotid and its branches are shown as full. In 6 
there is aoftic regurgitation, the blood flows out of the arterial system through the capillaries and 
into the heart. The carotid and its branches as shown are empty. In c the condition is the same 
as in b, but the patient is supposed to be in the recumbent posture, and the carotid and its branches 
remain full. 

ventricle at the other, will increase the risk of syncope, and for this 
reason digitalis cannot be regarded as free from danger in aortic regur- 
gitation. The danger may, however, be very considerably diminished by 
keeping the patient in a recumbent posture with the head low. The 
column of blood above the aortic valves being lower, there will be some- 
what less tendency to regurgitation ; and even should the arterial pres- 
sure fall much, the brain may still receive sufficient blood supply to 
prevent syncope. 

In cases of aortic disease, where compensatory hypertrophy is insuf- 
ficient, or where the hypertrophied heart is becoming enfeebled and 
dilated so that the mitral valves no longer close the orifice, the most 
urgent risk to the patient is no longer that of sudden syncope, but of 
pulmonary embarrassment, dropsy, and all the other consequences of 
mitral regurgitation. In such cases, as well as in those where organic 
disease of both mitral and aortic valves exist simultaneously, we must 
treat the urgent Bymptoms and give digitalis or other cardiac tonics. 

In dilatation of the right heart due to bronchitis or emphysema, digi- 
talis is frequently useful, though its benefit is less marked than in mitral 
diseai 

Bisks attending the Administration of Digitalis and other 
Cardiac Tonics. — The great risk attending the use of these drugs is 
sudden death from syncope. Whenever it is necessary to push them to 
any extent, the patient should be kept strictly in the recumbent posture, 
and not allowed to raise himself' quickly even into a sitting position on 



ACTION OF DRUGS ON CIRCULATION. 297 

any pretence whatever, even when there is no aortic complication. The 
effects of sudden change from the lying to the standing position in pro- 
ducing syncope have already been mentioned (p. 187), and when the 
patient is allowed to sit up he should be helped up slowly and with care. 
A change from the lying to the standing position by the patient getting 
out of bed is, of course, still more dangerous than simply sitting up in 
bed, and the most dangerous thing of all is for him to get up for the pur- 
pose of micturition. The reason of this has been already explained (p. 
231). 

Such strict precautions are, of course, not required excepting when 
the cardiac tonics have to be given in full doses. But when it is neces- 
sary to do this they should on no account be neglected. 

As digitalis is cumulative in its action, it is often advisable after con- 
tinuing it for several days to leave it off for a day or two, and then 
recommence, and this is a useful precaution when giving digitalis to 
out-patients who are seen at an interval of a week or more, even when 
the dose is comparatively small. Another difficulty in the administra- 
tion of cardiac tonics is the gastric disturbance, loss of appetite, and 
vomiting, which they are apt to produce. 

In cases where the arterial tension is already abnormally high, e.g., 
in cases of contracting kidney, and the heart seems unable to drive the 
blood into the aorta, the proper treatment of course is to reduce the 
abnormally high blood-pressure by purgatives, diuretics, and diaphoretics, 
and not to attempt to strengthen the heart by the use of cardiac tonics. 
If this be done the pressure may be raised still further and burst the 
vessels, giving rise to apoplexy. 

Vascular Tonics. 

Vascular tonics are substances which cause increased contraction of 
the arterioles or capillaries. They not only raise the blood-pressure, but 
influence to a considerable extent the quantity of lymph poured out into 
the tissues or absorbed from them, and thus modify tissue change. They 
are of special importance in the treatment of dropsy. 

The most important vuscular tonics are : — 

Digitalis. 

Iron. 

Strychnine. 

Pathology of Dropsy. — Dropsy consists in the accumulation of 
lymph, either in small lymph spaces in the tissues (oedema, anasarca), or 
large serous cavities (ascites, pleural or pericardial effusions). The 
accumulation is caused by more lymph being poured out from the capil- 
laries than can be removed by the lymphatics and veins. 

The chief causes of dropsy are — (1) Diminished removal of lymph from 
the spaces or serous cavities. This may be due to (a) obstruction of the 
veins, or (h) of the lymphatics. (2) Increased exudation of lymph from 
the capillaries. This increased exudation may be due to (a) changes in 
the walls of the capillaries themselves rendering them more permeable. 



298 



PHARMACOLOGY AND THERAPEUTICS. 



This appears to be the only condition which by itself can produce oedema. 
There are two others, however, which, although by themselves incapable 
of producing oedema, yet, along with others, are of the utmost impor- 
tance ; these are (b) a watery condition of the blood, and (c) vaso-motor 
paralysis. In many, indeed in most cases of dropsy, two or three of 
these factors are combined. 

Obstruction to the veins, or lymphatics alone, will rarely cause dropsy 
unless at the same time there is increased transudation from the capil- 
laries. Thus Ranvier found that ligaturing the vena cava of a dog did 
not produce dropsy in the legs, the lymph being removed either by the 



Vaso-motor— 
nerves i/ 

\ 



ucature\— 



i-ARTERIES 




Eight leg. Left leg. 

Fig. 'J.5.— Diagram of Ranvier's experiment on dropsy. The vena cava is ligatured, and in the left leg 
the trunk of the sciatic has been divided so that both the motor and vaso-motor nerves contained in 
it are paralyzed. On the right side the motor roots of the sciatic alone are divided and the vaso- 
motor left uninjured. There is thus motor paralysis on both sides, but vaso-motor paralysis and 
dropsy only on the left side. 

collateral venous circulation or by the lymphatics. On dividing the sciatic 
nerve on one side, however, after ligature of the vena cava, dropsy ap- 
peared in the corresponding leg, while it remained absent from the other. 
He showed that the dropsy was caused by paralysis of the vaso-motor, 
and not of the motor fibres contained in the sciatic, by dividing the motor 
roots of the sciatic on the other side, leaving the vaso-motor roots unin- 
jured. When this was done motor paralysis occurred equally in both 
legs, but dropsy only appeared in the one where the vaso-motor nerves 
had been divided. This experiment shows what an important factor the 
lose of Fascular tone is in the production of oedema, and we may legi- 
timately infer from it that vascular tonics, by increasing the contractility 
of the veeselfl, will tend to prevent oedema, or remove it when it is already 
present. 



ACTION OF DRUGS OX CIRCULATION. 299 

A watery condition of the blood does not of itself increase the exu- 
dation of lymph, nor does it produce oedema, yet in cases of anaemia or 
chlorosis we very frequently find a tendency to oedema of the ankles, and 
experiments in Cohnheim's laboratory have shown that, although a watery 
condition of the blood alone causes no increased exudation of lymph so 
long as the vaso-motor nerves are intact, yet it does so to a very great ex- 
tent when the vaso-motor nerves are paralyzed. 1 

Alteration of the capillaries by inflammation causes increased exuda- 
tion of lymph, and tends to produce a local oedema. This oedema is 
greatly increased if the vaso-motor nerves are paralyzed, not only attain- 
ing a much greater extent, but appearing more quickly and lasting longer. 
I have already mentioned that, in experiments on artificial circulation, 
acids added to the circulating fluid not only caused dilatation of the 
vessels, but increased transudation through them, and tended to render 
the tissues cedematous. It is not improbable that some alterations of the 
blood-vessels of the living body which tend to render them more per- 
meable maybe connected with imperfect oxidation, and the formation of 
sarco-lactic instead of carbonic acid. 

Arsenic has this power of lessening oxidation, 2 and it seems not 
improbable that the tendency to produce oedema of the eyelids which it 
possesses may be due to this peculiar action. 

It is evident that whatever tends to increase oxidation will have an 
opposite effect, and will tend to prevent any excessive exudation from the 
capillaries. In cases of anaemia iron is therefore serviceable, and as the 
condition of the blood improves the tendency to oedema disappears. 

What has just been said regarding the action of acids may seem to 
be in contradiction to the usually received opinion that the mineral acids 
act as vascular tonics. It is quite true that small doses of dilute acids, 
especially when given, as they usually are, along with bitters, frequently 
impart a feeling of strength and tone, whereas alkalies are frequently 
felt to be depressing, but in the case of both these classes of remedies this 
effect is probably not due to any direct action on the vessels themselves 
(vide Acids). 

Cardiac Sedatives. 

Cardiac sedatives are substances which lessen the force and frequency 
of the heart's action. 

They are chiefly used, either for the purpose of lessening violent 
action or palpitation of the heart, or of rendering the pulse slower in 
febrile conditions, especially those consequent on local inflammation. It 
has already been mentioned that belladonna diminishes the sensibility 
of the heart to changes of pressure, and that sometimes it is useful in 
palpitation consequent on cardiac strain. Simple pressure over the cardiac 
region appears to have the power of lessening palpitation, so that when 
this occurs in consequence of any sudden emotion, there is a natural 
tendency to press the hand over the region of the heart. It is impossible 
to say whether the relief which such pressure centainly affords is simply 



1 Jankowski, Virchow's Archiv, xciii., p. 259. 

2 Feitelberg, Inaug. Diss., Dorpat, 1883. 



300 PHARMACOLOGY AXD THERAPEUTICS. 

mechanical, or is due to reflex action on the heart through the cutaneous 
nerves. Plasters applied to the cardiac region have a beneficial action 
upon palpitation similar to that of the hand, and one of the most com- 
monly used and beneficial is belladonna plaster. In irritable heart of 
soldiers Dr. Da Costa found digitalis better than any other remedy. 1 

In palpitation depending on indigestion, hydrocyanic acid is useful. 
In palpitation due to aortic disease, senega has been recommended. It 
is probable that its efficacy depends upon the diminished action of the 
cardiac ganglia and muscle which its active principle, saponin, produces. 

An active circulation of blood is usually advantageous both for func- 
tional activity and for the repair of damage to an organ, but sometimes 
it may become excessive, and relief may be afforded by diminishing it 
(vide p. 303). 

The chief cardiac sedatives employed for this purpose are : — 

Aconite. 

Veratrum viride. 
Antimonial preparations. 

It is questionable whether in extensive inflammation of internal organs 
cardiac sedatives are of much service or not. They seem, however, to 
give relief in the feverish condition which accompanies more limited 
inflammation, such as tonsilitis, otitis, &c. In such cases the tincture of 
aconite is best employed in very small doses (one drop) frequently repeated. 
The introduction of this method of using the drug in divided doses is due 
in great measure to Ringer, and it has the very great advantage that the 
desired effect can be produced with greater certainty and with less risk of 
an overdose being given. 

Vascular Sedatives. 

Vascular sedatives are substances which, by increasing the contrac- 
tion of the vessels, lessen the flow of blood through them. They are 
chiefly used to lessen local inflammation or prevent haemorrhage. One 
of the most powerful of all vascular sedatives is cold. For its use in 
local inflammation vide p. 302. It is not only a vascular but a cardiac 
sedative, and ice swallowed in considerable quantity will tend to lessen 
the action of the heart. It is therefore one of the means to which we 
chiefly trust in cases of haemoptysis. In haematemesis it has the double 
action of lessening the activity of the heart, and of contracting the vessels 
in the stomach. 

The remedies which are chiefly employed in addition to cold are: — 

Digitalis. 
Ergot. 
Hamamelis. 
Lead acetate. 
Opium. 



Amer. Journ, Med. &e»., Jan., 1871. 



REMEDIES ACTING ON THE BODY. 301 

CHAPTER XII. 

REMEDIES ACTING ON THE SURFACE OF THE BODY. 
Irritants and Counter-irritants. 

Irritants are substances which, when applied to the skin, cause a 
greater or less degree of vascular excitement or inflammation. They 
are employed for the sake of their local action, to produce increased 
circulation in the part to which they are applied, and thus to remove ab- 
normal conditions already present in it. 

When irritants are employed for the purpose of affecting reflexly a 
part remote from the seat of application they are named Counter- 
irritants. 

Irritants are subdivided, according to the amount of effect produced, 
into rubefacients, vesicants, pustulants, and escharotics. 

Rubefacients produce simply congestion and redness, which may 
be merely temporary, passing off in a few minutes, or may be more per- 
manent, remaining for several days. 

When more powerful, so as to cause exudation between the true skin 
and epidermis, giving rise to vesicles, they are called vesicants, or 
epispastics. 

When they do not affect the whole skin alike, but do so unequally, 
and irritate isolated parts in it, such as the orifices of the sudoriferous 
glands, so powerfully as to give rise to pustules, they are called pus- 
tulants. 

When they destroy the tissues altogether,, forming a slough, they are 
called caustics or escharotics. 

The difference between these sub-classes is chiefly one of degree, and 
not of kind. The weaker ones produce the higher degrees of action 
when applied for a long time, and the stronger ones produce the slighter 
kinds of action when applied for a short time. 

It must be remembered that although inflammation is usually asso- 
ciated with increased circulation, the two things are essentially different. 

Inflammation is the injury to the tissue, the increased circulation is 
the attempt to repair it. 

Increased circulation occurs wherever we have increased functional 
activity, whether this be for the purpose of performing a normal function, 
as in glands during the process of secreting, and in muscles during con- 
traction, or for the purpose of repair. When repair is going on slowly, 
the process may be frequently quickened by increasing the supply of 
blood to the part, and this is the reason for using friction, and liniments 
and blisters of various kinds, in cases of chronic inflammation in 
joints or in ulcers. 

Sometimes irritation fails to cause absorption from being too weak. 
In a case of rheumatic gout which I saw some years ago, irritating lini- 
ments had been applied for some time in vain, until, by mistake on the 
patient's part, so much iodine liniment was put on at once as to cause vesi- 
cation over the whole back of the hand, when recovery began immediately. 

In acute inflammation, however, the greatly increased circulation, 
along with the heightened sensibility of the sensory nerves in the inflamed 



302 PHARMACOLOGY AND THERAPEUTICS. 

part, causes much pain, and this is relieved when the tension of the blood 
in the inflamed part is lessened. We notice this very clearly when the 
finger is inflamed in consequence of a thorn, bruise, or other injury. 
When it is allowed to hang by the side, the throbs of pain, coincident 
with every pulse-beat, become excruciating, while, if raised above the 
head, so that the pressure of blood in the vessels is less, the pain becomes 
greatly diminished. The tension in the vessels may be relieved likewise 
by causing contraction of the arteries leading to the part by a cold com- 
press around the arm, or by dipping the finger in cold water ; but relief 





Fig. 94.— Tracings from the radial artery at the wrist : A before and B after the application of a cloth 
dipped in cold water round the arm. After Winternitz. 

is also afforded by a warm poultice applied to the finger. At first sight 
it seems strange that heat and cold should both relieve the pain, but a 
little consideration will show that they both relieve the tension in the 
vessels of the inflamed part. Cold does so by causing a reflex contrac- 
tion of the afferent arteries, and thus diminishing the quantity of blood 
going to the inflamed part. Warmth, on the other hand, dilates the 
capillaries of the collateral circulation, and thus diverts the current away 
from the inflamed vessels. 

The use of counter-irritation as a remedial measure depends on 
the fact that similar alterations to those produced by heat and cold on the 
finger may be produced on the circulation in internal organs reflexly 
through the nervous system. 



Fig. 95.— Diagram to show the effects of heat and cold in lessening ihe pain of inflammation. The dia- 
gram is supposed to represent the end of the finger. The small star indicates the point of irrita- 
tion, e.g., a prick by a thorn. The line in the centre of each figure is intended to represent the 
nerve going to the injured part ; and at the side of each figure is an artery and vein connected by 
a capillary network. In a the capillary network around the seat of irritation is seen to be much 
congested: the nerve filaments are thus pressed upon and pain is occasioned, b represents the 
condition of the finger after the application of cold to the arm or hand. In consequence of the 
conti act Ion of t be afferent arteries the finger becomes ansemio ; no pressure is exerted on the ner- 
vous filaments, and pain is alleviated, 6 represents the finger after it has been incased in a warm 
poultice : the capillary network at the surface of the finger is dilated, and the blood is thus drawn 
away from the seat orirrltation and the pain therefore relieved. 

When ;m Irritant is applied to any part of the skin, it causes a 
local dilatation of the vessels and redness of that part, but contraction of 
the vessels in other parts of the body. Probably this contraction takes 
place with the greatest force in certain organs having a definite nervous 



REMEDIES ACTING ON THE BODY. 



303 



relation to that part of the surface which is irritated. ZUlzer found that 
when cantharides-collodion was painted repeatedly over the back of a 
rabbit for fourteen days, the vessels underneath the skin, and the super- 
ficial layers of muscles were congested. The deeper layers of the mus- 
cles, the thoracic wall, and even the lung itself, were much paler and 
more anaemic than those of the other side. 



Vaso-dilating nerves to the cuta- 
neous vessels. 
Vessels of the skin and surface. 

Blister applied to the chest-wall. 
Thoracic wall. 




Vaso-motor centre. 



Afferent nerves. 

Vaso-contracting nerves for the 

vessels of the lung. 
Vessels of the lung. 



Fig. 96.— Diagram to represent the mode of action of counter-irritants applied to the chest. 

It is probable that a similar condition occurs in man, and that when 
we apply a blister to the side we, sometimes at least, cause contraction 
of the vessels in the pleura and lung below, and thus relieve pain in the 
chest in much the same way as when we apply cold to an inflamed finger. 
It has been supposed that the action of a poultice or blister was simply 
to draw away blood from the inflamed part. We have seen that the 
poultice does this in the case of an inflamed finger, but in an inflamed 
lung the quantity which comes to the skin is insufficient to explain the 
relief. It is quite possible, however, that the vessels in the lung and 
pleura adjoining the inflamed district may be dilated by the application 
of a poultice or blister to the side, and thus relief is afforded in the same 
way as by the application of a poultice to the finger. It is not easy to 
say in which of these ways a poultice or blister acts in any particular 
case. Clinical experience seems to show that sometimes the blisters re- 
lieve acute inflammation by causing contraction of the afferent vessels 
(as represented in the accompanying diagram) and thus lessening the 
tension in the vessels of the inflamed part. If the blister is too near 
to the inflamed part, it may increase instead of diminishing the conges- 
tion, and thus do harm instead of good. 

As a matter of practice, the rule is usually insisted upon that in a 
case of pericarditis, for instance, the blister should not be put immedi- 
ately over the pericardium, but at some little distance from it. 

Counter-irritation is not only used however as a means of lessening 
congestion and pain in acute inflammation, it is also employed with much 
advantage to cause the re-absorption of inflammatory products. The 
use of the increased circulation which a blister causes in a chronic ulcer 
is unquestionable, and the rapid absorption of the thickened margins of 
the ulcer is perceptible to the eye. A similar absorption appears to oc- 
cur in deeper seated organs, such as the lung, on the application of coun- 
ter-irritation to the chest, and painting with iodine liniment is useful in 
promoting absorption of liquid effused into the pleural cavity or of the 
product of chronic inflammation of the lung. The mode in which the 
irritation acts is probably the same both in the chronic ulcer and in the 
lung, i. e., by increasing the circulation through the part affected. Where 



304 



PHARMACOLOGY AND THERAPEUTICS. 



the blister is applied, as in acute pericarditis, to lessen congestion, it is 
usually placed at a little distance from the inflamed part, but where we 
wish to increase absorption, as in consolidation of a part of the lung, we 
apply the counter-irritant directly over the consolidated part. 



Rubefacients. 

Mechanical as friction. 

Ammonia. — Solution of ammonia, 
compound camphor liniment. 

Alcohol (prevented from evaporat- 
ing by oil-silk or watch-glass). 

Arnica. 

Cajeput oil. 

Camphor. 

Capsicum. 

Chloroform (prevented from evapo- 
rating, like alcohol) ; chloroform 
liniment. 

Ether (like chloroform). 

Iodine and its preparations. — Io- 
dide of cadmium, iodide of lead. 

Menthol. 

Mustard. 

Oil of turpentine, of nutmeg, and 
many other volatile oils. 

Vesicants. 

Acetic acid (glacial). 
Heat of: 

Boiling water. 
Corrigan's hammer. 
Cantharides. — Solutions, plaster, 

cantharidine. 
Euphorbium. 
Mezereon. 



Volatile oil of mustard. 
Rhus toxicodendron. 

Pustulants. 

Croton oil. 
Tartarated antimony. 

Caustics. 

Acids: — Acetic (glacial). 
Carbolic. 
Chromic. 
Hydrochloric. 
Nitric. 
Osmic. 
Sulphuric. 
Alkalies : — Lime. 
Potash. 
Soda. 

Alum (burnt). 
Antimony (chloride). 
Arsenious oxide. 
Bromine. 

Soluble compounds of the heavier 
metals; as: 
Copper sulphate. 
Mercuric chloride. 
" nitrate. 
" oxide. 
Silver nitrate. 
Zinc chloride. 
Zinc sulphate. 



Rubefacients. — One of the simplest rubefacients is mere friction. 
This may be made either with the hand, or more effectually still, with a 
rough cloth or flesh-brush. Friction also greatly aids the action of many 
of the slighter rubefacients. 

Rubefacients may be used for their action upon the skin itself to 
relieve itching. They may also be used for their effect on deeper-seated 
structures. 

Friction, with firm pressure, is used in shampooing. Upward friction 
in the limbs will diminish their tension in dropsy, by removing part of 
the fluid from them. It also aids the circulation of the lymph, and by 
accelerating the passage of the products of muscular waste from the 
muscles themselves into the general circulation, it removes to a great 



REMEDIES ACTIXG ON THE BODY. 305 

extent the sense of fatigue after over-exertion. When applied along the 
back it soothes conditions of nervous excitement, and tends to produce 
sleep. Friction, along with stimulating liniments, applied to the joints 
after active inflammation has subsided in them, tends to remove the 
swelling and to restore their function. 

Neuralgic pains are frequently relieved by the application of rube- 
facients such as ammonia, chloroform applied by a watch-glass, or a 
mustard plaster to the painful spot. 

Conditions of nervous debility are sometimes benefited by the mustard 
liniment applied over the spine, and a mustard plaster to the nape of the 
neck is sometimes useful in nervous irritability with sleeplessness. In 
addition to the action which the mustard has on the vessels, it pro- 
duces a sharp pain, so that it is employed also to rouse persons suffering 
from narcotic poisoning, or from coma. 

Mustard leaves or iodine liniment applied over consolidated parts of 
the lung tend to cause absorption of inflammatory products and are used 
for this purpose in cases of effusion into the pleura or pericardium of 
chronic consolidation remaining after an attack of pleurisy or pneumonia, 
or in commencing phthisis. 

Vesicants. — Vesicants are employed locally in chronic ulcers 
and to cause absorption of effusions into joints, or chronic thickening 
about them. When applied around the inflamed joints in acute rheuma- 
tism, they not only relieve the local affection, but appear to have a 
curative action on the general febrile condition. 

In neuralgia, blisters over the painful point are useful, and sometimes, 
when neuralgia is in the side, or in the breast, it may be relieved by 
applying the blister over the corresponding part of the spine where there 
is usually a spot which is tender on pressure. In sciatica, the relief is 
often greater when the blister is applied to the heel, than over the nerve 
itself. 

In neuralgia also it not unfrequently happens that a slight application 
of the actual cautery is more efficacious than a blister. The most con- 
venient form of this is Paquelin's thermo-cautery. 

In inflammation of the pericardium or pleura, a blister frequently 
relieves the pain, and it sometimes lessens or cuts short the inflammation. 
Applied over the epigastrium, blisters relieve vomiting arising from 
various causes. 

In cerebral affections, such as obstinate headache, in meningitis and 
hydrocephalus, blisters to the nape of the neck or under the mastoid 
process are useful. 

Hysterical paralysis of the limbs sometimes yields to blisters locally 
applied ; and hysterical aphonia is sometimes removed by a blister over 
the larynx. 

Pustulants. — Pustulants are employed for the purpose of keeping 
up a continuous moderate irritation in chronic inflammations: tartar 
emetic ointment, and croton-oil liniment seem sometimes to be of consid- 
erable advantage in chronic inflammation of joints or synovial membranes, 
in chronic bronchitis and in pleurisy; perhaps sometimes in phthisis. 
They have been used also as an application to the spine in paralysis and 
hysteria, and to the head in tubercular meningitis, and to the nape of the 
20 



306 PHARMACOLOGY AND THERAPEUTICS. 

neck in chronic headache or giddiness. Though formerly these were 
much employed, iodine liniment of late years has to a great extent taken 
their place. 

Caustics. — Caustics are used to destroy excrescences on the surface 
of the skin and mucous membranes : warts, condylomata, or polyp ; to 
destroy exuberant and unhealthy granulations in ulcers and fungating 
sores : thus, a slight touch with nitrate of silver, sulphate of copper, or 
with nitric acid, will sometimes cause the tissues in an unhealthy wound 
after an operation to become less exuberant, and take on a healthy heal- 
ing action. 

Caustics are only used to destroy malignant growths, more generally 
in the surgical operation performed for this purpose. Sometimes 
patients have such a horror of the knife that they will not submit to 
an operation, and in such cases caustics are sometimes employed. For 
this purpose Vienna paste may be employed, consisting of caustic lime and 
caustic potash. Sulphuric acid mixed with sawdust has sometimes also 
been used, but is exceedingly painful. Arsenious acid made with various 
inert substances into a paste is not unfrequently employed with consider- 
able success by charlatans, who sometimes succeed in removing cancerous 
growths by its use in apparently hopeless cases, but the risk attending 
its use is considerable. 

Caustics are sometimes employed also to open abscesses, especially 
abscesses of the liver, where it is advisable to cause adhesions between 
the viscus and the abdominal wall before the abscess is opened, so as to 
avoid any risk of pus finding its way into the abdominal cavity. The 
substance usually employed for this purpose is caustic potash. 

Caustics are also used to keep up chronic irritation, as in chronic 
headache or epilepsy, a wound being first made by the use of the caustic, 
and prevented from healing by the introduction of a foreign body into it, 
or by the continued application of some irritating ointment, such as 
savine ointment. 

Caustics are also used as an application to the bites of venomous ser- 
pents, or of rabid dogs, in order to destroy the virus and prevent its 
general action on the organism. The weaker caustics are of no use for 
this purpose. I have seen a boy die of hydrophobia six weeks after he 
was bitten by a mad dog, although the wound had been thoroughly 
cauterized by nitrate of silver five minutes after the bite. In all cases the 
parts around the bite should be, if possible, excised, and then cauterized 
with a red-hot iron, a ligature being, if possible, placed between the 
bitten part and the heart until the operation has been effected, so as to 
prevent any absorption of the virus. 



Emollients and Demulcents. 

Emollients are substances which soften and relax, while Demul- 
cents are substances which protect and soothe the parts to which they 
are applied. 

Many substances exercise both of these actions, and so no very sharp 
line of distinction is drawn between them. Emollients, however, are 



BEMEDIES ACTING ON THE BODY 



307 



more generally spoken of in relation to their application to the skin, and 
demulcents to the mucous membranes. 



Emollients. 

Moist warmth — bathing with warm 
water, hot sponge, hot fomenta- 
tions, steam. 

Poultices made of substances which 
retain heat and moisture — bran, 
bread, figs, flour, linseed-meal, oat- 
meal, &c. 

Gelatinous substances. 

Fats — almond-oil, glycerin, lard, lin- 
seed-oil, neat's-foot oil, olive-oil, 
spermaceti, suet. 

Paraffin — petrolatum, vaseline, and 
unguentum petrolei. 

Soap, and other liniments. 



Demulcents. 

Bread. 

Collodion. 

Cotton-wool (for external use only). 

Figs. 

Fuller's earth. 

Gelatine. 

Iceland moss. 

Isinglass. 

Glycerine. 

Gum. 

Honey. 

Linseed. 

Linseed-tea. 

Marsh-mallows. 

Almond-oil. 

Olive-oil. 

Starch. 

White of egg. 



The action of Demulcents is chiefly mechanical. They form a 
smooth, soft coating to an inflamed mucous membrane, or to a skin 
deprived of its epidermis, and they thus protect the surface from external 
irritation, and allow the process of repair to go on. They are used ex- 
ternally in cases of irritating skin diseases, where the epidermis, from 
one cause or another, has been broken or removed, as by friction, ex- 
posure to cold, &c. Internally they are employed when the mucous 
membranes have been irritated, as, for example, in the after-treatment 
of cases of irritant poisoning. 

Mucilaginous substances are also used to relieve pain and irritation 
of the throat, and to lessen the irritable cough which frequently depends 
on congestion of the pharynx and upper parts of the respiratory passages. 

Such substances as figs, prunes, and even cabbage, are employed to 
protect the intestines from injury by hard and pointed substances which 
have been accidentally swallowed. They do this by leaving a bulky indi- 
gestible residue in which the pointed article becomes imbedded, and thus 
passes along the intestine without lacerating it. 

The action of Emollients is to relieve the tension and pain in 
inflamed parts ; warmth and moisture do this by dilating the collat- 
eral blood-vessels in the manner already described (p. 302). They also 
relax the tissues themselves and lessen the pressure upon the nerves of 
the part. 

Fatty emollients soften the skin and thus render it softer and more 
flexible. These emollients also aid the immediate effect of friction upon 
the skin, enabling it to be applied with greater advantage, and to act on the 
more deeply-seated tissues, as, for example, in cases of stiffness in joints. 



308 PHARMACOLOGY AND THERAPEUTICS. 

Therapeutic Uses. — Warmth and moisture are almost invariably 
used to relieve spasm and the pain attending it, as well as to relieve pain 
in all cases of inflammation, whether superficial or deep-seated, and to re- 
lieve so much, that with many people the connection between pain and 
poultice has come to be a household word. When poultices are intended 
to act directly on the part to which they are applied, the linseed, bran, or 
bread should be applied to the skin with nothing between, or at most with 
only a thin piece of muslin, but when intended to act on deep-seated or- 
gans, a considerable thickness of flannel should be interposed, so that the 
heat may come gradually through, and allow an excessively hot poultice 
to be applied without burning the skin. 

In cases of disease of the respiratory passages the warmth is usually ap- 
plied by means of inhalation. 

Fatty emollients, by softening the skin or mucous membranes, such as 
those of the lips, prevent them from cracking, and are used by persons 
with a delicate skin to prevent cracks forming on exposure to cold. 

They are also used to prevent friction between surfaces of skin con- 
stantly in contact, as between the nates and inner joints in children, and 
to prevent bed sores. 



These are substances which cause contraction of the tissues to which 
they are applied and lessen secretion from mucous membranes. 

Acids. Gallic acid. 

Alcohol. Tannic Acid. 

Alum. Vegetable substances containing these 

Chalk and Lime. acids, e.g. — 

Salts of the heavier metals, e.g. — Catechu. 

Bismuth subnitrate, &c. Galls. 

Cadmium sulphate. Kino. 

Copper sulphate. ( )ak-bark. 

Ferric chloride. Uva-Ursi. 

Lead acetate. Arbutine. 

Silver nitrate. 

Zinc sulphate. 

Astringents are usually divided into local and remote. 

Local astringents arc those which affect the part to which they are 
applied. Remote arc those which act on internal organs after their 
absorption into the blood. 

With the exception of gallic acid and ergot they all coagulate or pre- 
cipitate albumen. Dilute mineral acids do not coagulate albumen, but 
precipitate albuminous substances from the alkaline lluids in which they 
are naturally dissolved in the body. 

When applied to a surface from which the epidermis has been removed, 
the other astringents combine with the albuminous juices which moisten 
this Surface, ;i- \w|] as with the tissues themselves, and form a pellicle 
more or Less thick and dense, which in some measure protects the struct- 
ures beneath it from externa] irritation at the same time that they cause 



REMEDIES ACTING ON THE BODY. 309 

the structures themselves to become smaller and more dense. On a mu- 
cous membrane they have a similar action, and they lessen its secretion. 
It was formerly supposed that their action was partly due to their causing 
the blood-vessels going to a part of the body to contract, thus lessening 
the supply of fluid to it, as well as to their effect on the tissues themselves. 
But experiment has shown that, while nitrate of silver and acetate of lead 
possess this power, perchloride of iron and alum do not, and that tannic 
and gallic acids actually dilate the vessels. The astringent action of 
these latter drugs must therefore be exerted upon the tissues. (Ross- 
bach.) 

Uses. — Astringents may be employed locally in various forms. In 
the solid form, as a powder, or in various preparations, such as lotions, 
ointments, plasters, glycerines, &c, they are applied, especially the me- 
tallic astringents, to wounds and ulcers for the purpose of reducing the 
size and increasing the firmness of exuberant granulations, as well as of 
protecting the surface by forming a pellicle over it. They are used to 
lessen congestion and diminish the secretion of the various mucous mem- 
branes — as a lotion to the eye and mouth ; as a gargle or a spray to the 
throat ; in the form of an injection to the nose, urethra and vagina ; and 
of suppositories to the rectum. Administered internally, several astrin- 
gents have a powerful effect in checking diarrhoea, and certain of them 
may have a local action upon the stomach and intestines. 

The remote action of such astringents as acetate of lead and gallic 
acid, when absorbed into the blood, in lessening haemorrhage, is made 
available in the treatment of haemoptysis, heematemesis, hematuria, and 
loss of blood from other parts of the body. 

Styptics. 

Styptics are substances which arrest the flow of blood from broken or 
wounded surfaces or vessels. They may do this either by aiding the rapid 
formation of a coagulum which will plug up the wounded vessels, or by 
causing the vessels themselves to contract so much as to check the flow 
of blood out of them. They are closely connected with astringents, which, 
as we have already mentioned, nearly all coagulate albuminous sub- 
tances. 

Acids. Matico. 

Actual cautery. Spider's-web. 

Alum. Tannin. 

Collodion. Lead acetate. 

Ferric chloride. 

Substances acting on the blood-vessels : — 

Digitalis. 
Ergot. 

Action. — Matico and cobwebs act mechanically in aiding the 
formation of a clot around the fibres. Collodion also acts mechanically 
by exerting pressure over the surface, and thus preventing the blood from 
issuing. 



310 PHARMACOLOGY AND THERAPEUTICS. 

Aluru, lead acetate, and ferric chloride cause coagulation of the 
blood. 

Pressure to the surface, cold sponges or ice, cause the vessels to con- 
tract, and thus prevent the blood from running out of them. 

Lead acetate and gallic acid, when absorbed into the blood, not only 
tend to lessen secretion from the mucous membranes, but arrest haemor- 
rhage from internal organs. This is probably partly due to their effect in 
increasing the coagulability of the blood, and possibly partly also to 
their power of causing contraction of the anterioles. Ergot and digitalis 
also lessen or arrest haemorrhage, although they have little or no action 
on coagulation, and their action probably depends on their power to cause 
contraction of the blood-vessels. 

A dependent position increases the pressure of blood locally in the 
part, and thus tends to increase haemorrhage. It is therefore advisable 
to keep the bleeding part as much raised as possible. 

Powerful action of the heart tends to increase the blood-pressure 
generally. In cases of severe haemorrhage it is therefore of the greatest 
importance that the patient should keep absolutely quiet, and that 
all the food should be taken cold. 



CHAPTER XIII. 

ACTION OF DRUGS ON THE DIGESTIVE SYSTEM. 
Action of Drugs on the Teeth. 

Although the hurry and bustle of modern life is apt to make people 
forget it, mastication is a most important part of the digestive process. 
During early life the stomach and intestines may be able to digest im- 
perfectly-masticated food, but as years advance they cease to do so, and 
imperfect mastication becomes a fruitful source of dyspepsia. 

If the teeth are entirely or almost entirely gone, the person may 
chew with his gums, but if they are only partially gone it frequently 
happens that those which remain oppose one another only sufficiently to 
prevent the gums from closing, while they do not help mastication. 

The decay of teeth is chiefly due to the dentine being attacked by the 
acid products of the decomposition of food in the mouth. This decom- 
position is to a great extent due to bacteria, and antiseptics are therefore 
useful in preventing decay. 

By cleaning the teeth with a soft brush at night before going to bed, 
particles of food sticking between the teeth maybe removed, and thus its 
decomposition and consequent injurious action on the teeth may be 
avoided. Chalk is employed as a basis of most dentifrices, as its me- 
chanical action is sufficient to clean the teeth without injuring their polish, 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 311 

and at the same time it neutralizes any acid which may be present. 
Charcoal has also a useful mechanical action greater than that of chalk, 
but it is more liable to scratch the enamel. 

The antiseptics which are usually employed to cleanse the teeth are 
borax, quinine, and carbolic acid. Dilute solutions of permanganate of 
potash are also very useful, but have a very disagreeable taste. Where 
the gums are soft and spongy and are apt to leave the fang of the tooth 
more or less exposed, vegetable astringents, such as areca nut, catechu, kino 
and rhatany, are useful. Mineral acids, when given medicinally, cause an 
unpleasant feeling of the teeth being on edge, and are also injurious to 
the teeth ; they are therefore usually sucked up by means of a glass tube 
or quill instead of being simply swallowed. When used as gargles for the 
throat, their injurious action on the teeth may be to a considerable extent 
prevented by previously rubbing the teeth with oil, butter, or lard, and 
washing out the mouth or brushing the teeth with a weak solution of an 
alkaline bicarbonate or soap. Soluble preparations of iron, especially 
persalts, are apt to stain the teeth, and they are therefore also given by 
means of a tube ; alum appears also to have a very injurious action on 
the teeth ; alum gargles should therefore not be employed for a length 
of time together, and the same precautions should be used as with acid 
gargles. 

When the gums have receded somewhat from the crown of the teeth, 
a pain or soreness is not unfrequently felt in the teeth although no definite 
caries is present. This soreness appears to be due to the irritant action 
of acid secretions in the mouth upon the exposed fang, and it may be 
often to a great extent removed by washing the mouth out with a weak 
solution of bicarbonate of soda, or rubbing finely-powdered chalk or 
magnesia along the gums. When toothache occurs in consequence of 
caries, it may sometimes also be relieved by a small pledget of cotton- 
wool dipped in tincture or liquid extract of opium with a little bicarbonate 
of soda and placed in the cavity of the tooth. A pledget of cotton-wool 
dipped in creasote is often used for a similar purpose, and one of the 
most effectual remedies is to dip a small pledget of cotton-wool in pure 
carbolic acid liquefied by heat, and place it in the cavity of the toothy 
taking care to cover it well with clean cotton-wool so as to prevent the 
carbolic acid coming in contact with the tongue or cheeks. Chlorate of 
potash often lessens toothache if due to inflammation of a large open 
carious cavity. 

Sialagogues. 

These are remedies which increase the secretion of saliva. 

Anything which is chewed, or even turned about in the mouth, such 
as a pebble, will increase the secretion of saliva ; but the chief sialagogues 
have a stimulating action of their own. 

Action. — In the secretion of saliva there are two factors, first 
the activity of the secreting- cells ; secondly, the supply of new material 
to them, from which they may manufacture the secretion. This depends 
on the circulation. 

The secreting cells do not derive the new material from which they 
form the secretion directly from the blood. They obtain it from the 



312 PHARMACOLOGY AXD THERAPEUTICS. 

lymph which fills the adjacent lymph spaces. Hence they may continue 
to secrete for a short while after the circulation has ceased, as in the 
sweat glands of an amputated limb, or in the salivary glands after the 
head of the animal has been separated from the body. But the supply 
of lymph soon becomes exhausted unless a supply of fresh lymph in the 
spaces is kept up by exudation from the blood-vessels. We therefore 
find that abundant secretion is usually, though not invariably, associated 
with an abundant blood supply. If the flow of blood is not rapid the 
secretion must soon diminish or come to a stop, for, although it may 
occur rapidly at first, the lymph which has accumulated in the lymph 
spaces, supplying the cells, soon becomes exhausted. 



I/sssel s orGuArn 




f *#£ 



Fig. 97. — Diagram representing the general relation of nerves to the secreting cells and vessels of a 
gland. For the sake of simplicity only one afferent nerve and one nerve centre and one set of 
secreting and vascular nerves are here represented. 

In the salivary gland, when the secretion is going on, the arteries 
usually dilate, and the blood flows rapidly through them. The submax- 
illary gland, in which secretion has been best studied, appears to receive 
four kinds of nerves — two sets being contained in the chorda tympani and 
two in the sympathetic. 

The chorda contains some fibres which act on the blood-vessels, caus- 
ing them to dilate and allow the blood to flow freely through the gland, 
and others which stimulate the cells of the gland, to secrete a thin, watery 
saliva. These two kinds are spoken of as vaso-dilating and secreting, or 
secretory, fibres. 

At present the usually accepted theory is that the secretory nerves 
have a direct influence upon the tissue change in the cells of the gland. 
During secretion the granules in the cell decrease in number and gener- 
ally in size, the hyaline substance increases, and the network within the 
cell grows. 1 It is not at all improbable, however, that in addition to 
their action upon secreting nerves some drugs influence the amount of 
fluid poured out from the vessels. For if we inject a solution of quinine 
into the d«ct of the gland and thus destroy its secreting power, and after- 
wards irritate the chorda tympani, the lymph poured out from the blood- 
vessel- will accumulate in the gland and render it cedematous; but if 

1 Langley, Proceed '. Oamb. Phil. Soc, Nov. 12, 1883. 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 



313 



an animal be poisoned with atropine the gland does not become oedema- 
tous when chorda tynipani is stimulated — although the blood-vessels 
going to it are dilated and its power of secretion is completely destroyed. 
We might suppose that the gland did not become oedematous because the 
lymph, although not used up by the gland, had been carried away by the 
cervical lymphatics. But this is not the case, for Heidenhain has found 
that the flow of cervical lymph is not increased under these circumstances. 

It appears to me that this circumstance can hardly be explained 
otherwise than by supposing that atropine not only paralyzes the secreting 
fibres of the chorda, but acts upon the vessels in such a manner as to 
greatly diminish or prevent the exudation which would usually take place 
from them into the lymph spaces on irritation of the chorda. 

The sympathetic contains some fibres which cause the vessels of the 
gland to contract and the blood to flow slowly through it, and others 
which stimulate the cells to secrete a thick and viscid saliva. 

Besides the ordinary secretion of saliva regulated by the action of the 
nerves, there is a secretion which is usually termed paralytic, because it 
occurs, not after irritation, but after paralysis of the nerves going to the 
salivary gland. It occurs in the submaxillary gland, when its nerves have 
either been paralyzed by the injection of small doses of curare into the 
artery going to the heart, or by a section of the combined lingual nerve and 
chorda tympani, or extirpation of the submaxillary ganglion. It is not 
improbable that morphia also, like curare, produces it, because in moder- 
ate doses it causes dryness of the mouth, but in enormous doses causes 
excessive salivation. 




-TO/VGL/a 



SALIVARY 
CLAWO 

" !/CSS£-LS 
OrCLANO 



Fig. 98. — Diagram to show the afferent nerves by -which the secretion of saliva may be reflexly excited. 

The nerve -centre which regulates the secretion of the thin chorda 
saliva is probably the nucleus of the seventh nerve situated in the medulla 
oblongata. 

Efferent fibres pass out along the chorda tympani and reach the gland, 
some directly, and some after passing through the submaxillary ganglion. 



314 PHARMACOLOGY AXD THERAPEUTICS. 

The afferent fibres, which convey stimuli from the mouth to the 
medulla are contained in the lingual branch of the fifth, and the glosso- 
pharyngeal nerves. Those which convey stimuli from the stomach, and 
excite the salivation which accompanies nausea, are contained in the vagus. 
The salivary centre may also be stimulated by impulses sent down from 
the brain, and the nerves of sight and smell may act as afferent nerves to 
the salivary centre indirectly through the brain. 1 

Besides the nerve-centre in the medulla oblongata there are subsidi- 
ary nerve-centres. These are the submaxillary ganglion and small gan- 
glionic masses in the submaxillary gland itself. 

The secretion of saliva may be stimulated by the direct action of 
drugs upon secreting nerves in the gland itself, or reflexly through the 
sensory nerves of the mouth, stomach, eye, or nose. The mere smell, or 
sight, of appetizing food causes secretion of saliva, which is probably due 
to the nerves of smell and taste acting through the brain upon the me- 
dulla. The brain, when excited by mere recollection, may also stimu- 
ulate the secretion of saliva. 

Increased salivation is a common accompaniment of sickness or 
nausea. The afferent nerve here appears to be the gastric branches of the 
vagus. 

Sialagogues have been divided into two classes : 1st, topical, or 
direct ; and 2d, specific, remote, or indirect. The names direct and in- 
direct are complete misnomers, and ought not to be used ; inasmuch as 
the so-called direct sialagogues are those which act directly on the mouth, 
but do not act directly on the substance of the gland, or on the nervous 
structures contained within it or immediately connected with it. 

Topical Sialagogues. General Sialagogues. 

Acids, mineral and vegetable. Jaborandi. (Pilocarpine.) 

Acid salts. Muscarine. 

Alkalies. Physostigma. 

Ethereal bodies — Compounds of Iodine. 

Ether. Mercury and its compounds. 

Chloroform, &c. 
Pungent substances — 

Mustard. 

Horseradish. 

Ginger. 

Pyrethrum. 

Mezereon. 

Tobacco, ^v«-. 

Rhubarb. 

Cubebs. 



1 The nasal branches of the fifth nerve probably also act as afferent nerves for the 
stlivary secretion, for I have noticed that on dipping the tip of the nose into hot 
water containing a little compound tincture of benzoin, salivation occurred, ceased 
when the nose was withdrawn, and again occurred regularly whenever the nose 
Again introduced into the mixture. The mere inhalation of the vapor had no 
effect. 






ACTION OF DRUGS ON DIGESTIVE SYSTEM. 315 

The topical sialagogues, acids, ether, ginger, horseradish, niezereon, 
mustard, pyrethrum and rhubarb, all produce salivation by stimulating 
the salivary glands reflexly through the nerves of the mouth. 

The effect produced by topical or reflex sialagogues is not the same for 
each. Ether and dilute acids produce a thin, watery saliva, but alkalies 
cause the secretion of a thicker and more viscid saliva ; the former ap- 
pearing to affect chiefly the chorda tympani, and the latter the sympa- 
thetic. 

Mercury probably acts partly upon the glands tructures and partly 
reflexly through the nerves of the mouth. Jaborandi, physostigma, 
and tobacco, probably stimulate the terminal branches of the secretory 
nerves in the glands. Nauseants, such as tartar emetic, stimulate the 
gland reflexly through the vagus. 

The peripheral ends of the secreting nerves in the gland itself are 
stimulated by pilocarpine, muscarine, nicotine and physostigmine, so that 
secretion is induced by the injection of these substances into the blood 
even after all the nerves going to the gland have been cut. 

In large doses these substances paralyze the ends of the secreting 
nerves, so that irritation of the chorda tympani will no longer cause 
secretion. Physostigmine and nicotine, besides acting on the peripheral ter- 
minations of the secretory nerves, stimulate the central ends of those 
nerves so that section of the chorda tympani greatly lessens the secretion 
which these substances cause, although it may still persist from the effect 
of the drug upon the peripheral terminations. 

The peripheral action of physostigmine and nicotine is however much 
less marked than that of muscarine and pilocarpine, so that the secretion 
caused by the two former after the nerves have been divided is very much 
less than that produced by the latter. 

Physostigmine acts also on the sympathetic nerves, producing 
contraction of the vessels at the same time that it is stimulating the 
secreting centre in the medulla. In consequence of this double action, 
secretion is rapid at first, but, however, diminishes very quickly or ceases 
entirely, the circulation being so much lessened by the contraction of the 
vessels that the glands do not get sufficient supply of new material to go 
on secreting. 

Iodide of potassium may act partially as a reflex sialagogue, for it is 
secreted in the saliva, and it therefore comes to be present in the mouth 
more or less persistently. It is probable, however, that it acts also upon 
the gland structures, though it has not been determined whether the 
secreting cells or the nerves are chiefly affected. 

Excretion by the Saliva. 

Iodide of potassium is very quickly excreted by the kidneys, so that 
the great bulk of it passes out of the body in a short time after it has been 
taken. But a little of it is retained very persistently for a length of time. 
There may be more than one reason for this. It is possible that it be- 
comes combined with albuminous matters of the blood and tissues, and this 
combination being .only slowly broken up, the elimination of the drug 
continues for a length of time. Another reason appears to be that it is 



316 PHARMACOLOGY AND THERAPEUTICS. 

excreted even more readily by the salivary glands than by the urine. The 
saliva in which it is contained is swallowed, the iodide is again absorbed 
from the stomach and carried by the circulation to the salivary glands. It 
thus goes on in a continual round from mouth to stomach and from stom- 
ach to mouth. Iodide of iron, and probably other iodides, are eliminated 
by the saliva in the same way. Iodide of iron occurs in the saliva either 
when injected into the artery of the gland or when absorbed from the 
stomach. When lactate of iron and iodide of potassium are introduced 




Fig. 99. — Diagram of the gastro-salivary circulation. 

simultaneously, or at a short interval after each other, into the stomach, 
so that iodide of iron is formed there by their combination, iodide of iron 
is found in the saliva. 1 But if they are injected separately into the blood, 
iodide of potassium alone without any iron appears in the saliva. Iodine 
probably causes other substances besides potassium and iron to appear in 
the saliva when they arc combined with it. It probably does so to quinine, 
for when iodide of potassium and quinine are given together in a mixture, 
patients frequently complain of a very persistent bitter taste in the mouth 
much more marked than when the quinine is given in simple solution with 

acid. 

Uses. — Saliva is useful in keeping the mouth moist, and thus facili- 
tating mastication, solution, deglutition, and the movement of the tongue 
in speaking. By moistening the fauces, it also prevents or lessens thirst. 



' Bernard, Physiologie Expfrimentale, torn, ii., p. 99. 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 317 

A pebble placed under the tongue or masticated, will keep up a slight 
flow of saliva, and may be useful for these purposes. Where this is 
insufficient, dilute acids are employed. As the flow of blood to the glands 
is greatly increased through secretion, sialagogues have been used as 
derivatives to lessen inflammation, congestion, and pain, in other part of 
the head, as in tooth-ache, ear-ache, and inflammation of the ear, nose, 
or scalp. 

Saliva has also a digestive action on starch, and increase of the flow 
may be advantageous in imperfect digestion of this substance. When 
swallowed the saliva stimulates the secretion of gastric juice, and increased 
salivary secretion therefore tends to aid the gastric digestion of proteids 
also. To obtain this object it is best to chew a piece of ginger, pellitory, 
or rhubarb. 

Refrigerants. 

Refrigerants are remedies which allay thirst, and give a feeling of 
coolness. 

There appear to be two kinds of thirst : one of which is general, the 
other of which is local. Local thirst is occasioned by dryness of 
the mouth and fauces. It may be quenched by washing the mouth and 
gargling the throat with water, although none of it be swallowed, or by 
anything which will increase the flow of saliva, and thus keep the mouth 
and fauces moist. Thus, a pebble under the tongue, or chewed, will 
lessen thirst by increasing the secretion of saliva ; and acids, both min- 
eral and vegetable, as well as effervescing drinks containing carbonic acid 
and the juices of fruits, which contain either free vegetable acid or acid 
salts, acetates and tartrates, have a similar effect. When the secretion 
from the mouth and throat is very scanty, it is dried up by the passage of 
air to and fro in the process of respiration. The evaporation thus occa- 
sioned may be lessened, and the feeling of thirst diminished by the use 
of mucilaginous substances, which will form a thin coating over the mu- 
cous membrane of the mouth and pharynx. Thus, the addition of oat- 
meal to water will increase its power to quench thirst, and a very little 
milk added to water has a similar effect. 

General thirst depends upon the condition of the organism gen- 
erally, which appears to be due either to deficiency of water or excess of 
soluble and especially saline substances in the circulation. 

General thirst is very often accompanied by local thirst, and may be 
partially alleviated by the means already described, but cannot be removed 
excepting by the introduction of water into the organism, or removal from 
it of the saline or other substances which are present in excess, or by 
lessening the excitability of that part of the nervous system by which the 
sensation of thirst is perceived. 

This part of the nervous system, or thirst centre, as Nothnagel calls 
it, is probably situated according to him in the occipital lobes of the brain, 
and it is possible that it maybe irritated directly by mechanical injury, 
or by the condition of the blood circulating in it, as well as reflexly from 
mucous membranes, such as that of the mouth and throat, and possibly 
also from the kidneys. Its excitability is lessened by opium, and this 
may be used to diminish thirst in cases where other remedies fail to relieve. 



318 PHARMACOLOGY AXD THERAPEUTICS. 

Anti-sialics. 

Anti-sialics are substances which lessen the salivary secretion. 
They may do this : 

First, by removing the stimulus to secretion. 

Second, by lessening the excitability of the efferent nerves or reflex 
centres. 

Third, by paralyzing the efferent nerves, such as the chorda tympani. 

Fourth, by acting on the circulation through the gland. 

Fifth, by acting on the gland structures themselves. 

Borax and chlorate of potash are useful in the first of these ways by 
inducing a healthy condition of the mucous membrane of the mouth, and 
thus lessening the irritation which gives rise to salivation ; opium and 
morphia diminish the reflex excitability of the nerve-centre, and are thus 
powerful anti-sialics. 

Physostigma in large doses greatly lessens the supply of blood to the 
gland, and thus diminishes its secretion, and quinine, hydrochloric acid, 
and alkalies injected directly into the duct of the gland arrest secretion 
by affecting the secretory cells themselves. These latter drugs however 
cannot be used as anti-sialics. 

The most powerful of all anti-sialics is however atropine, which par- 
alyzes the peripheral terminations of secreting nerves. It does not affect 
the vaso-dilating nerves, so that in an animal poisoned by atropine electrical 
stimulation of the chorda tympani will cause dilatation of the vessels and 
a free flow of blood through the gland as usual, but not a drop of saliva 
will be secreted. That this absence of secretion is due to paralysis of 
secretory nerves and not of the secreting cells appears to be shown by 
the fact that at the time when the power of the chorda to induce secretion 
is completely paraylzed stimulation of the sympathetic will still induce 
secretion. 

Very large doses of atropine, however, paralyze the secreting power 
of the sympathetic in the cat, although this has not been noticed in the 
dog. 

The paralyzing action of atropine can be counteracted by physostig- 
mine. This is shown by poisoning an animal with atropine, and then 
injecting physostigmine into the gland of one side through the submental 
artery. It is then found that irritation of the chorda causes salivation 
in the gland which has received physostigmine, while it causes no secre- 
tion in the other. 

Iodide of ethyl-strychnia and cicutine have an action on the secret- 
ing and not on the vaso-dilating 1 fibres of the chorda tympani like that 
of atropine. 

Gastric Tonics. 

These are substances which increase the appetite and aid gastric 
digestion. 

From observations made on the stomach in persons or animals where 
tstric fistula has been present, it has been found that in the normal 



1 Jolyet, Gaz. Med. tie Paris, 1877. 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 



319 



condition, when the stomach is empty and quiet, the mucous membrane 
is of a pale rose color. When stimulated mechanically, by rubbing it 
gently with a feather or glass rod, the mucous membrane becomes redder, 
and such abundant secretion of gastric juice occurs that it runs down in 
drops along the walls of the stomach. 

When the irritation is greater, as, for example, when the mucous 
membrane is rubbed roughly instead of gently, an opposite effect is pro- 
duced. The vessels then contract, the mucous membrane becomes pale, 
and the secretion of gastric juice stops, secretion of mucus commences, 
and if the irritation be carried still further, vomiting occurs. 

Almost all substances which, when applied to the skin, act as irri- 
tants, as arsenic and salts of copper, silver, or zinc, and those also which, 
without irritating the skin, irritate the nerves of taste, as bitters, produce 
a feeling of appetite in the stomach, but they only do this in certain con- 
ditions of the stomach, and in certain quantities. The appetite appears 
to be associated with gentle stimulation of the gastric walls; stronger 
stimulation removes the appetite, still greater irritation causes nausea, 
and lastly vomiting. 

In cases of atonic dyspepsia, where the stomach is below par, as, for 
instance, in anaemia and debility, slight stimulants or irritants produce 
appetite. 




^tXQFSTOli* 6 * 



Fig. 100.— Diagram to illustrate the supposed nervous connections of the stomach. A gentle stimulus 
applied to the walls of the stomach is transmitted by the afferent nerves, a, to a nerve-centre, b, 
and thence along the vaso-dilating nerves, c, and the secreting nerves, d, to the vessels of the 
mucous membrane and the cells of the gastric follicles. A stronger stimulus is transmitted up to 
the nerve-centre, e, and thence along the vaso-constricting fibres, r, and the secreting fibres, D, of 
the mucous follicles. A still stronger stimulus is transmitted to h, and thence along the motor 
nerves to the abdominal walls, k, k, causing them to contract and produce retching or vomiting. 



In such cases, where the tongue is usually smooth and flabby, bitters 
and metallic salts are useful. But when the stomach is already too irri- 
table, and the tongue is red with enlarged papillae, such substances are 



320 PHARMACOLOGY AND THERAPEUTICS. 

likely to irritate still more, and thus, instead of increasing the appetite, 
to diminish it, and produce nausea. The increased irritability of the 
stomach which precedes a bilious attack is often signalized by an unu- 
sually good appetite, which continues during the meal, so that food is 
eaten with relish. A still greater irritability is characterized by a great 
appetite before meals, which disappears, giving place to anorexia as soon 
as a few mouthfuls have been swallowed, and the gastric irritation 
increased by the increased circulation consequent on the introduction of 
the food. In such cases, bitters are likely to do harm, and gastric seda- 
tives, such as bismuth, are required. 

Bismuth is probably only a milder irritant than the others, because 
so slowly dissolved, and mild irritation allays inflammatory conditions. 

But the stomach has not merely to receive food, it has to digest it, 
and in the process of digestion there are three factors : 1st, secre- 
tion of the gastric juice which is to render the food capable of absorption 
and of assimilation ; 2dly, movements of the stomach to break up the 
food and mix it thoroughly with the solvent juice; and 3dly, absorp- 
tion of the products of digestion. 

Action of Drugs on Secretion in the Stomach. 

The secretion of the gastric juice is stimulated by gentle mechani- 
cal and chemical irritation, as by dilute alkalies and alcohol. 

The name of peptogens is given to substances which increase the 
gastric secretions. Schiff has examined these, and states the most 
important of them to be dextrine (toasted bread), soups, peptones, &C. 1 

In order to obtain gentle mechanical stimulation, it is often advisable 
to make patients who are suffering from atonic dyspepsia commence their 
meals, and especially their breakfast, with solids, instead of commencing 
with a large draught of liquid. 

Dilute alkalies given before meals increase secretions of gastric 
juice; so much so, that the alkali is not only rapidly neutralized, but a 
large amount of acid gastric juice remains over. 

The alkaline saliva has a powerful stimulant action on the secretion 
of gastric juice, and as its quantity is much increased both by savory 
food and by the movements of mastication, it is important that the food 
should not only be well cooked, but slowly and perfectly masticated. 
Alcohol is one of the most powerful stimulants that we know, and is 
probably surpassed only by ether. In persons suffering from weak 
digestion, therefore, a little dilute alcohol with meals is sometimes very 
beneficial. 

Thorough mastication is also of the greatest importance in ensur- 
ing perfect digestion, inasmuch as the gastric juice penetrates with 
difficulty, and only slowly dissolves the masses of albuminous matter, 
while it would digest them very quickly if they were thoroughly broken 
up. 

In children and young people the stomach may be able to do more 
than its fair share of work, but it cannot do this in persons above middle 






1 Roberts, Digestive Ferments. 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 321 

age, and in them, imperfect mastication, either from deficient or decayed 
teeth, or from the habit of eating quickly, is one of the most common 
causes of dyspepsia. 

When the stomach is too much debilitated to secrete sufficiency of 
gastric juice, even when stimulated, as in the weakness consequent upon 
acute disease, general debility, or old age, we may supply artificially 
the digestive substances in the form of acids and of pepsin. Acids 
should be given for this purpose immediately after meals, or two hours 
after meals. Pepsin should be given either with, or immediately after, 
those meals which contain albuminous substances. As pepsin has no 
action on farinaceous food or salts, it is no use to give it after meals 
containing these only. 

Pancreatin, given two hours after meals, along with a little bicarbo- 
nate of soda, appears, in some cases, to complete digestion, and to give 
great relief and comfort. 



Action of Drug's on the Movements of the Stomach. 

The digestion is greatly aided by the movements of the stomach, 
which assist it by breaking up the food and mixing it thoroughly with 
the gastric juice. When these are deficient, it is probable that they are 
stimulated by nux vomica, or strychnine, and also by bitters. 

Absorption from the Stomach. — We know at present very 
little regarding the effect of drugs in stimulating absorption from the 
stomach, but it is probable that this is very greatly influenced by the 
condition of the liver. If there is any obstruction to the free flow of 
blood through the liver, the circulation in the stomach will necessarily 
be impeded and absorption probably diminished. 

All the processes which go on in the stomach — secretion, peristaltic 
action and absorption — are much influenced by the condition of the 
circulation. 

All the blood which circulates in the stomach has to pass through 
the liver before it gets into the general circulation, and thus the condi- 
tion of the stomach is necessarily much modified by the condition of the 
liver. If there is any obstruction to the free flow of blood through the 
liver, the circulation in the stomach will necessarily be impeded, and 
absorption probably diminished. 

Not only the blood from the stomach, but that from the intestines 
also, passes through the liver, and we may naturally expect that the 
liver itself will be influenced by the condition of the blood which passes 
to it from the intestinal canal. 

In Dr. Beaumont's observations on Alexis St. Martin, in whom a 
gastric fistula existed, he found that after the stomach had been deranged 
by various articles of food, including fat pork, there was distress in the 
stomach, headache, costiveness, and a coated tongue. In the stomach 
there were numerous white and pustular-looking spots. Half a dozen 
calomel pills produced catharsis, removed the symptoms, and restored the 
mucous membrane of the stomach to its normal condition. Whether this 
effect was due to the action of the pills on the liver, or on the intestines, 
21 



322 PHARMACOLOGY AND THERAPEUTICS. 

we cannot perhaps positively say, but at all events the improvement was 
readily evident to the observer's eye. 

Purgatives and Cholagogries may thus act as indirect gastric 
tonics. 1 

Absorption from the stomach is probably also much influenced by 
the condition of the nervous system. Bouley found that when the vagi 
were divided in a horse, strychnine no longer produced poisoning, the 
reason being that the absorption took place so slowly after a division of 
the nerves that the poison was excreted as fast as it was absorbed. The 
retarded absorption, however, he considers to be due, not to any altera- 
tion in the absorptive power of the stomach itself, but to diminished 
movement in its walls, so that its contents are not so quickly poured 
out into the intestine. Absorption normally goes on more slowly from 
the stomach than from the intestine, and so, while the poison remains in 
the stomach it is not absorbed quickly enough to cause poisoning. 



Antacids. 

Antacids are remedies employed to lessen or counteract acidity. The 
excessive acidity for which antacids are given may be present in the 
stomach, intestines, or urine. 

Antacids are divided into direct and indirect, or remote. Direct 
antacids lessen the acidity in the stomach, to which they are directly 
applied. Remote antacids lessen the acidity of the urine. Some sub- 
stances have both actions, such as potash and soda, or the carbonates and 
bi-carbonates. Other substances, such as the citrates, tartrates, and 
acetates of these bases, have no power to lessen acidity in the stom- 
ach, but, after absorption into the blood, they appear to undergo com- 
bustion, and become converted into carbonates — in this form they are 
excreted in the urine, and lessen its acidity. 

Ammonia and its carbonates are direct antacids, but not remote 
antacids. They lessen acidity in the stomach or intestines, but after 
absorption they undergo change and are eliminated in the form of urea, 
and, according to some, of nitric acid, so that they do not lessen the 
acidity of the urine. 

Direct Antacids. — Liquor potassge, potassium carbonate, potas- 
sium bi-carbonate, liquor sodse, sodium carbonate, sodium bi-carbonate, 
liquor lithire, lithium carbonate, lithium bi-carbonate, magnesia, magne- 
sium carbonate, magnesium bi-carbonate, lime water, saccharine solution 
of lime, chalk. 

Direct but not Remote Antacids. — Ammonium carbonate, 
aromatic spirit of ammonia. 

Remote Antacids. — Potassium acetate, potassium citrate, potas- 
sium tartrate, potassium bi-tartrate, sodium acetate, sodium citrate, tar- 
tarated soda, lithium citrate. 



Beaumont, Physiology of Digestion, Burlington, 1847, p. 118. 



ACTION OF DKUGS ON DIGESTIVE SYSTEM. 323 

Emetics. 

These are remedies which produce vomiting*. 

Action. — The act of vomiting consists in compression of the stom- 
ach bj the simultaneous spasmodic contraction of the diaphragm and 
abdominal muscles, while at the same time relaxation of its cardiac ori- 
fice is produced by contraction of the fibres which radiate out from the 
lower end of the oesophagus along the gastric walls. By their contrac- 
tion these fibres draw the stomach up towards the diaphragm and pull the 
walls of the oesophagus apart at its lower end so as to open the cardia. 
When the cardiac orifice dilates at the same moment that the stomach is 
compressed between the diaphragm and the abdominal muscles, its con- 
tents are expelled and vomiting- occurs ; but when the compression of 
the stomach and dilatation of the cardiac orifice do not take place simul- 
taneously, the contents of the stomach are retained and the efforts are 
then termed retelling. 

The nerve-centre which regulates the movements of vomiting is 
situated in the medulla oblongata. The movements of vomiting are 
modified expiratory actions, and the respiratory centre appears to be 
closely connected with the vomiting centre. Indeed some groups of 
ganglion cells probably take part both in respiration and vomiting, or in 
other words form part of both the respiratory and vomiting centres (Fig. 
54, p. 210). 

The reason for this supposition is not merely that the movements of 
vomiting consist of modified respiratory movements, but that drugs 
which cause vomiting also increase the respiratory activity. Emetics 
usually quicken the respiration considerably before they produce vomit- 
ing, and if injected into the veins they not only quicken the respiration, 
but prevent the condition of apnoea being produced by vigorous artificial 
respiration. 

On the other hand, the desire to vomit may be lessened to some ex- 
tent by taking frequent and deep inspirations, and narcotics which dimin- 
ish the excitability of the respiratory centre also lessen the tendency to 
vomit. 

The motor impulses from the vomiting centre are sent to the abdom- 
inal muscles, diaphragm, stomach and oesophagus by the intercostal, 
phrenic, and vagus nerves respectively. Section of the vagi generally, 
though not always, destroys the power to vomit, because it disturbs the 
co-ordination of the cardia and the abdominal muscles and diaphragm so 
that they no longer act simultaneously, and vomiting does not occur 
although retching may continue. 

The vomiting centre is usually excited by stimulation of afferent 
nerves passing upwards to it from the body, or by impulses sent down to 
it from the brain. 

The "brain may be stimulated so as to act on the vomiting centre in 
the medulla through impressions on the nerves of special sense, such as a 
disgusting sight, stench, or taste, or by the recollection of such subjects. 
Irritation of the brain itself or of its membranes by inflammation, tubercle, 
hemorrhage, softening, or cancer may also excite vomiting. The afferent 



324 



PHARMACOLOGY AND THERAPEUTICS. 



nerves are shown in the accompanying diagram. Those chiefly concerned 
with the action of emetics are : — 

1. Branches of the glossopharyngeal nerve to the soft palate, the root 
of the tongue, and the pharynx. Tickling these parts with the finger or 
with a feather is one of the readiest means of inducing vomiting. Vomit- 
ing also occurs when the soft palate, tonsils, or pharynx are inflamed, 
especially in children. 

2. The nerves of the stomach. These are chiefly branches of the 
pneumogastric, but they are contained also in the sympathetic system. 

3. Mesenteric nerves causing vomiting in hernia. 

4. Nerves of the liver and gall-duct. 

5. Nerves of the kidney and ureter. 

6. Vesical nerves. 

7. Uterine nerves. 

8. Pulmonary branches of the vagus causing vomiting in phthisis. 



Central afferent paths through"] 
which vomiting may be ex- > 
cited. J 



Pharyngeal branches of the "I _ 
glossopharyngeal nerve. J 



Liver and gall-bladder, with 
nerves going to them. 

Stomach and gastric branches ) 
of the vagus. j 



Kidney and ureter 



Intestine 

Uterus 

Bladder 

Vesical nerves 




Nervous centre of vomiting in 
the medulla oblongata, 



Spinal cord. 

Vagus nerve. 

Pulmonary branches of vagus. 
Splanchnics giving fibres to 

liver and intestines. 
Gall duct. 



Eenal nerves. 



Mesenteric nerves. 
Uterine nerves. 



FlO. 101.— Diagram showing the afferent nerves by which the vomiting centre may be excited to action. 



There are also ;i Dumber of other nerves which produce vomiting, but 
are more important in connection with pathological vomiting than with 
the action of cinctics. 

When Less was known regarding the action of the nervous system in 
vomiting, Emetics were divided according to their relation to the stom- 
ach into direct and indirect. Direct emetics were those which acted only 
when introduced into the stomach. Indirect were those which acted 
when injected into the blood. 



ACTION OF DEUGS ON DIGESTIVE SYSTEM. 325 

Their relation to the vomiting centre is of course the reverse. Drugs 
which are applied directly to the stomach act reflexly or indirectly on the 
vomiting centre, while those injected into the blood may be carried by the 
circulation to the medulla and act directly upon it. 

It is to be noted however that drugs injected into the circulation are 
carried not only to the nerve-centres but to the stomach, and may be 
excreted by the gastric mucous membrane. They may thus irritate the 
afferent nerves of the stomach and stimulate the vomiting centre reflexly 
just as they do when given by the mouth. Thus it has been shown by 
Brinton that tartar emetic injected into the veins of a dog is excreted 
in a few minutes into the stomach and may be found on testing its con- 
tents. 

It is therefore evident that the action of drugs in causing vomiting 
may be complex, and that drugs injected into the blood or under the 
skin may cause vomiting, both by (1) irritating- the vomiting centre 
in the medulla directly when conveyed to it by the circulation ; and (2) 
by irritating it reflexly from the stomach, whither they have also been 
conveyed by the blood. 

It is frequently very difficult to determine in which of these two 
ways a drug has acted, and sometimes almost impossible to decide with 
certainty. 

The reasons for believing that any drug injected into the circulation 
has caused vomiting by irritating the medulla reflexly through the stom- 
ach, and not by acting directly upon it, are : 

(a) When the vomiting does not take place immediately on injection, 
but only after sufficient time has elapsed to allow of excretion of the drug 
into the stomach. 

(b) When the quantity of a drug required to produce vomiting by 
injection into the veins is greater than that which is sufficient to produce 
a similar effect if introduced into the stomach. It is probable that some 
drugs, as tartar emetic, act in both ways, because, as has already been 
mentioned, it is excreted into the stomach and will there act as an irritant. 

But it will also produce vomiting when the stomach has been excised 
and replaced by a bladder as in Magendie's celebrated experiment. Even 
this experiment however does not prove that tartar emetic acts directly on 
the vomiting centre, inasmuch as it is possible that it may be excreted by 
the oesophagus or intestines and irritate the vomiting centre reflexly 
through them. As tartar emetic however appears to act as an irritant 
chiefly in those parts of the body where there is an acid secretion, it seems 
doubtful whether it would produce irritation in the oesophagus and intes- 
tines such as it does in the stomach. It therefore seems not improbable 
that the vomiting which it occasions after excision of the stomach is due 
to its direct action on the medulla oblongata, but this cannot be regarded 
as quite proved. In order to avoid the confusion which the terms direct 
and indirect emetics are likely to produce with regard to their relations 
to the stomach and vomiting, it is better to describe them as, and to 
employ the terms, topical or local and general emetics. 

Topical, or local, are such as produce vomiting by acting locally on 
the pharynx, oesophagus, or stomach ; and general, such as act through 
the medium of the circulation. The line between the two is not distinct, 



326 PHARMACOLOGY AND THERAPEUTICS. 

inasmuch as tartar emetic will produce vomiting in either way, and so 
will sulphate of zinc, or sulphate of copper. The local action of sul- 
phate of zinc and sulphate of copper, however, on the stomach is so 
much greater than their general action that they may be classed among 
the local emetics. 

Local Emetics. General Emetics. 

Alum. Tartar emetic. 

Ammonium carbonate. Ipecacuanha and Emetine. 

Copper sulphate. Apomorphine. 

Mustard. Senega. 

Salt. Squill. 

Subsulphate of Mercury. Muscarine, ] nQt uged 

Water (lukewarm and m Urechitme I med icinally 

copious draughts). Digitalis audits f ag ^^ 

Zinc sulphate. congeners, J 

Strong infusions of vege- 
table bitters, as camomile, 
quassia, &c. 

The action of local emetics is confined to that of producing vomit- 
ing, which is generally not long continued, ceasing after the emetic has 
been evacuated, and is not accompanied by much general depression. 

The vomiting occasioned by general emetics on the other hand is 
much longer continued, and is accompanied by much general depression, 
nausea, languor, muscular weakness, enfeeblement of the circulation, and 
increase of the secretions, especially those of saliva, sweat, and mucus in 
the oesophagus, stomach, and bronchial tubes. 

Uses. — Emetics may be used for the purpose of simply emptying 
the stomach, or the violent expulsive efforts which they occasion may 
be utilized in order to remove foreign bodies or secretions from the 
oesophagus or from the biliary or respiratory passages. 

1. Emetics may be used to cause the expulsion of foreign bodies 
such as pieces of gristle or meat which have become impacted in the 
upper part of the oesophagus, and, by pressing on the larynx, are giving 
rise to suffocation. In such cases apomorphine given subcutaneously, or 
injected into a vein in the dose of ^th or y^th of a grain, will be found 
of service. 

2. They may be used to remove the contents of the stomach, 
when these, instead of undergoing digestion and absorption in the normal 
manner, have undergone fermentative changes and become acid, acrid, 
and irritating, giving rise to pain, either in the stomach itself, or in some 
other organ, as in the head. In gastralgia, or in headache either 
depending upon indigestion, or associated like sick-headache with a ten- 
dency to vomiting, large draughts of warm water often give relief. 
Their emetic action may be aided if necessary by tickling the fauces with 
the finger, or by using strong camomile tea, or mustard and water in 
place of water alone. Simple draughts of warm water, however, may 
relieve the gastralgia or headache without causing vomiting. They 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 327 

appear to do so by simply diluting the acrid contents of the stomach so 
much that they no longer irritate the mucous membrane. 

3. Emetics remove the poison from the stomach in cases where it 
has been swallowed. Here mustard and water is very useful, as it is the 
emetic which is most likely to be at hand; but sulphate of copper and 
sulphate of zinc if readily procured are to be preferred, as they empty 
the stomach most quickly and effectually. In cases of poisoning by 
laudanum, the nerve-centres are so much deadened by the narcotic that 
they may not respond to the stimulus even of large doses of these emetics, 
and then it may be necessary to employ the stomach-pump or gastric 
syphon. 

4. To expel bile from the gall-bladder, to drive small gall-stones 
through the gall-duct. The bile is secreted under a very low pressure, 
and a very slight obstruction in front may prevent its flow through the 
gall-duct and occasion its accumulation in the gall-bladder and biliary 
capillaries. The compression of the liver between the diaphragm and 
abdomen muscles, even in ordinary respiration, tends greatly to dispel 
the bile from the liver, and this expulsive action is of course greatly 
increased during the violent efforts of vomiting. During these efforts 
the bile may be forced through the gall-duct, driving before it the 
obstruction which has been occasioned by the accumulation of mucus 
within it due to catarrh, or by the impaction of a small biliary calculus. 
In this manner emetics may remove jaundice due to obstruction. 

5. To remove bile from the body in cases of biliousness, 
fevers, and ague. In biliousness the emetics have got the double 
action of expelling the bile from the liver in the way just mentioned, 
and of removing it from the body through the stomach. When bile 
passes along the intestines, not only is it reabsorbed, but poisonous mat- 
ters from the intestine are absorbed with it. When it is ejected from 
the stomach by the efforts of vomiting, no time is allowed for its reab- 
sorption, and so both the bile itself, and any poisonous matter which it 
contains, are more rapidly and certainly removed from the body. It is 
probable that the malarious poison circulates in the bile, and possibly 
also other poisons which give rise to fevers. There can be no doubt of 
the advantages to be derived from the use of emetics in ague before the 
administration of quinine; and indeed cases of ague may be sometimes 
cured by the use of emetics alone without quinine, while quinine without 
emetics is not unfrequently of very little use in bad cases. Emetics 
have also been recommended in the early stages of continued fevers in 
order to remove the poison on which they are supposed to depend. For 
such purposes ipecacuanha or tartar emetic is best. 

6. To remove obstructions from the air-passages, such as false 
membranes from the trachea and bronchia in croup or diphtheria, or the 
over-abundant secretion which is clogging the bronchia and interfering 
with respiration in bronchitis, and more rarely in phthisis. Ipecacu- 
anha is the emetic most readily chosen in such cases, as it tends to 
increase the secretion from the air-passages, as well as to produce vom- 
iting. When it does not act rapidly, sulphate of zinc or sulphate of 
copper may be used, and a teaspoonful of alum is a very efficient remedy 
in croup. When there is much depression of the circulation, carbonate 



328 PHARMACOLOGY AND THERAPEUTICS. 

of ammonia is to be preferred as an emetic, inasmuch as it stimulates 
the circulation, as well as causes vomiting. 

Contra-in dications. — Emetics must be avoided in persons suffer- 
ing from aneurism, and used with care in persons suffering from 
atheroma or a tendency to haemorrhage from the lungs or uterus, 
lest the high blood-pressure which occurs during the efforts of vomiting 
should lead to the rupture of a blood-vessel. They should be used with 
caution also in persons suffering from hernia, or who have a tendency 
to it, or from prolapsus of the uterus. In pregnancy we often find 
obstinate vomiting lasting for a length of time, and yet producing no 
abortion ; but where a tendency to abortion exists, emetics should be 
avoided if possible. 

Gastric Sedatives and Anti-emetics. 

Gastric sedatives are substances which lessen the irritability of the 
stomach and thus diminish pain, nausea, and vomiting. 

Their action may be either local on the stomach, or general on the 
nervous system, and especially on the vomiting centre in the medulla 
oblongata. 

Local Sedatives. General Sedatives. 

Alcohol. Ether. Hydrocyanic acid. 

Alum. Hydrocyanic acid. Morphine. 

Arsenious acid in Ice. Opium. 

minute doses. Morphine. 

Atropine. Opium. 

Belladonna. Silver nitrate. 

Bismuth salts. 
Carbolic acid. 
Cerium oxalate. 
Chloroform. 
Creasote. 

The most powerful of all local sedatives is ice, and when vomiting 
is persistent, everything should be iced, and ice swallowed in small 
lumps. Hydrocyanic acid and morphia probably act by lessening 
the irritability of both the nerves in the stomach itself and of the 
vomiting centre as well. The mode of action of creasote and carbolic 
acid is rather uncertain, because, although they have a local anaesthetic 
action, yet they are found useful also in cases of reflex vomiting, such as 
the vomiting of pregnancy. 

As adjuvants to gastric sedatives, we may mention such substances 
as diminish or remove the irritation, although not lessening the sensi- 
bility of the stomach itself. Thus, where the irritant consists of very 
acrid fluid in the stomach, a large draught of water, by diluting it, 
may lessen pain, or nausea, and alkalies have a similar action. When 
the irritation IB due to congestion of the mucous membrane, astrin- 
gents will also have a sedative action. Probably this is the explanation 



ACTION OF DKUGS ON DIGESTIVE SYSTEM. 329 

of the use of alum in vomiting of phthisis, and possibly, also, of the use 
of nitrate of silver in the vomiting of chronic alcoholism. 

Uses. — Gastric sedatives are employed (1) to relieve pain in the 
stomach, as in gastrodynia. The most useful are small doses of mor- 
phia, hydrocyanic acid, belladonna, arsenic, and bismuth; (2) to relieve 
vomiting*. This depends upon the cause of the vomit. When it is 
due to acrid substances in the stomach, the best sedative is often a 
large draught of warm water, which either dilutes or renders them 
less irritating, or causes their removal by vomiting. 

Where it is due to acute irritation of the walls of the stomach 
itself, ice, hydrocyanic acid and morphia, and bismuth, are best. 

When due to the acrid products of fermentation in the stomach sul- 
phurous acid and creasote are very useful. 

When due to chronic irritation and congestion, alum, nitrate of 
silver, creasote, and carbolic acid are serviceable. 

When the vomiting is due to strangulated hernia, the hernia must 
be reduced, and in cases of intussusception or obstruction these condi- 
tions must be removed. In the vomiting of pregnancy, the irrita- 
bility of the vomiting centre must be reduced by bromide of potassium 
or morphia. 

It is only in extreme cases that the source of irritation, viz., the 
pregnant condition, is to be removed, but certain local means are some- 
times useful; such are separation of the membranes around the neck of 
the uterus, which may possibly act by lessening the irritation in the 
organ, and painting the os-uteri with stimulating applications which 
probably rather act by a kind of counter-irritation or inhibition. 



Carminatives. 

Carminatives are substances which aid the expulsion of gas from the 
stomach and intestines. They appear to do this by increasing the peris- 
taltic movements of these organs, and in the case of the stomach by caus- 
ing the lower end of the oesophagus or cardiac sphincter, and perhaps 
sometimes the pyloric sphincter, to dilate so as to allow of the exit of 
gas. The stomach naturally contains a certain amount of gas, chiefly 
nitrogen and carbonic acid. The nitrogen is derived from air which 
has been swallowed, the oxygen with which it was mixed being absorbed 
by the walls of the stomach. 

For respiration goes on in the stomach, as well as in the lungs, though 
to a much less extent in mammals, and oxygen is absorbed and carbonic 
acid excreted. The stomach, therefore, generally contains carbonic acid 
in addition to nitrogen ; some of the carbonic acid also is derived from 
the food. In addition to these gases there is frequently hydrogen present: 
hydrogen and a quantity of carbonic acid being formed by processes of 
fermentation going on in the food. Sometimes instead of pure hydrogen 
marsh-gas is formed, which takes fire when expelled from the stomach, 
and not unfrequently the hydrogen unites with sulphur, forming sulphur- 
etted hydrogen, causing to the patient an unpleasant taste of rotten eggs 
in the mouth, or giving their smell to the breath. It is probable that this 



330 



PHAKMACOLOGY AND THERAPEUTICS. 



last occurrence is due to the presence and decomposition in the stomach 
of bile, which contains sulphur as one of its constituents. 

When digestion is rapid and complete, little or no fermentation occurs, 
very much less gas is formed, and therefore there is no uncomfortable 
distension. 

There are several drugs which tend to prevent fermentation, while they 
hardly interfere at all with the action of the gastric juice. Among these 
may be mentioned creasote, sulphurous acid, and bitters. These sub- 
stances may all be regarded as adjuvants to carminatives, and so indeed 
may pepsin, dilute alkalies, and all other remedies which stimulate the 
secretion of gastric juice and thus aid digestion. 

Where there is any tendency to venous congestion in the stomach, 
there will be interference with the respiration in the stomach, and thus a 
greater tendency to the accumulation of gas. Any conditions interfering 
with the circulation, such as metral disease or hepatic congestion, will thus 
tend to cause flatulence, and in such cases digitalis and cholagogues will 
prove useful adjuvants to carminatives. 

It is possible that much mucus covering the surface of the stomach 
may interfere both with absorption and with gastric respiration. Charcoal 
has been given to remove flatulence on the supposition that it absorbs the 
gases in the stomach. But it only absorbs gas when it is dry, and the 
beneficial action which it certainly possesses is probably a mechanical one 
in removing mucus and stimulating circulation. Possibly bismuth and 
magnesium act similarly, though less powerfully. 

The chief Carminatives belong to the classes of aromatic oils, alcohols, 
or ethers. They are : — 






Allspice and oil. 

Anise and oil. 

Assafoetida. 

Cajeput oil. 

Capsicum. 

( '.n away and oil. 


Cinnamon and oil. 

Cloves and oil. 

Coriander and oil. 

Dil and oil. 

Ether and acetic ether. 

Fennel. 


Mace. 
Mustard. 
Nutmeg and oil. 
Pepper. 

Peppermint and oil 
Spearmint and oil. 


( \- in la moms. 

Chilies. 

Chloroform. 


Ginger. 
Horseradish. 


Spirits. 
Valerian and oil. 



Uses. — Carminatives are employed (1) to remove pain and distension 
of stomach and intestines caused by flatulence; (2) to render peristaltic 
action regular, and diminish local spasm and pain depending upon it. 
They arc useful both in cases where the spasm is due to irritation of the 
Stomach and intestines, by irritant articles of food, irritant secretions, or 
Lrritanl medicines. They are therefore commonly used not only in griping 
and colic pains due to indigestion, worms, or exposure to cold, but are 
commonly used as adjuvants to purgatives in order to lessen the griping 
pain, which they often cause when given alone. In addition to this, by 
rendering the peristaltic action of the bowel more regular, they assist the 
action of the purgatives. 



ACTION OF DKUGS ON DIGESTIVE SYSTEM. 



331 



ACTION OF DRUGS ON THE INTESTINES. 

Intestinal Movements and Secretion. — The peristaltic move- 
ments of the intestine occur even when it is separated entirely from the 
body. Their rhythmical occurrence appears to be due to the action of 
the ganglia contained in Auerbach's plexus, which lies between the outer 
longitudinal and internal circular layer of the muscular coat. The secre- 
tion is probably influenced by Meissner's plexus, which lies in the sub- 
mucous coat. 

Both the movements and the secretion of the intestine require to be 
regulated in accordance with the wants of the body, and this is done by 
the nerves which connect these plexuses with the cerebro-spinal centres. 
The chief of these nerves are the splanchnics and the vagi. Irritation of 
the vagi frequently causes movements of the intestine ; irritation of the 
splanchnics, on the other hand, arrests them, so that the splanchnics have 
been regarded as the inhibitory nerves of the intestine, just as the vagi 
are the inhibitory nerves of the heart. But this arrest is by no means 
constant, sometimes the movements instead of being arrested are distinctly 
increased ; so that it is evident that the splanchnics contain a mixture of 
stimulating and inhibitory fibres, or else that the same fibres are capable 
of exercising either function under different conditions. 

Paralytic Secretion. — When all nervous connection between the 
intestine and the higher nerve-centres is cut off" by completely dividing 
the intestinal nerves, a copious secretion, exactly resembling the rice- 
water stools of cholera, occurs in the intestine. This is best shown by 
isolating three loops of intestine, by means of ligatures, after they have 
been previously carefully emptied, as shown in Fig. 102. The nerve- 
fibres going to the middle loop are then divided, and the intestine is 




Fig. 102.— Diagram showing the effect of section of nerves on secretion from the intestine. The nerves 
going to the middle loop have been divided, and it is distended with the fluid secreted. 



returned to the abdominal cavity. After four or five hours the animal 
is killed, and the intestine examined ; it is then found that the loop, the 
nerves of which have been divided, is filled with fluid, while the other 
loops which have been under precisely the same circumstances, but the 
nerves of which have not been cut, remain empty. 

It is evident then, that certain nerve-centres possess the power of 
restraining- the secretion from the intestine. These nerve-centres 



332 PHARMACOLOGY AND THERAPEUTICS. 

have been shown by Pye- Smith and myself to be the smaller or inferior 
ganglia of the solar plexus, with the superior mesenteric, off-set from 
them. When these ganglia are destroyed, the same abundant secretion 
occurs in the intestine as when all the nerves are cut, but if these ganglia 
be left intact the spinal cord may be removed, the vagi and splanchnics 
cut, and the semilunar ganglia excised without any excessive secretion 
occurring in the intestine. 

The vascular supply of the intestines is regulated to a considerable 
extent by the splanchnics, irritation of .which causes contraction of the 
vessels. There appears also however to be an important relation between 
the intestinal vessels and the lumbar portion of the spinal cord, because 
when this part of the cord is destroyed with extirpation of the solar 
plexus, haemorrhage or hyperemia of the intestinal mucous membrane 
occurs, so that the internal surface of the intestine has a somewhat dysen- 
teric appearance. This does not occur when the solar plexus and semi- 
lunar ganglia are destroyed, the splanchnics divided, or the mesenteric 
nerves cut. 1 

The nervous arrangements for regulating intestinal movement and 
secretion are evidently exceedingly complex, and until our knowledge of 
their physiological relations is more perfect, we cannot expect to under- 
stand completely the effect which drugs produce upon them. These are 
occasionally very complicated, and vary considerably according to the 
quantity of the drug used. Drugs may affect the intestine by their 
local action on the intestine itself, by their direct action on the central 
nervous system, or by their indirect action through the alterations in 
the quality or supply of the blood. The quality of the blood which cir- 
culates in the intestine alters its movements very considerably. 

When the aorta is clamped, so that the blood which circulates in the 
intestine and in the lower part of the spinal cord becomes venous, the 
peristaltic movements are usually much increased ; when the compression 
is removed and arterial blood is allowed to circulate again, the peristalsis 
instead of diminishing, as one might expect, becomes still more intense. 
Compression of the vena cava inferior, or of the portal vein, sometimes 
causes a slight increase in the peristaltic movements, but it is inconsider- 
able as compared with those produced by clamping the aorta. During 
suffocation, when the blood becomes venous throughout the whole 
body and exercises an irritating action, not only on the nerve-centres 
present in the intestine and in the lumbar portion of the spinal cord, but 
also on the brain and upper part of the cord, the effect on the movements 
of the intestine is variable. They are sometimes increased, but some- 
times an inhibitory effect appears to be produced through the higher 
centres and their movements are arrested. 

It is evident therefore that when an animal has been poisoned by any 
drug, and the intestines are examined after death, two different con- 
ditions may be found which do not depend upon any peculiar action of 
the drug on the intestine, but only upon its effects on the higher nerve- 



1 T. Lander Brnntofl and Pye-Smith on " Intestinal Secretion and Movement," 
British Association H< ports, 1874, 1875, 1876. 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 



333 



centres, thus, if the higher centres have been in such a condition as to 
cause inhibition, the intestines may be found in a state of perfect rest, 
whereas, if they happen not to be in this condition, brisk peristalsis may 
be observed. It very often occurs that when the intestines are first 
exposed after an animal's .death, they are found to be at rest, but as the 
higher centres die from a stoppage of the circulation, the peristaltic move- 
ments become much accelerated. 

In order to simplify the problem presented by the complicated nervous 
arrangement in the intestine, Ludwig and Salvioli have used the plan of 
keeping up the circulation artificially in a small piece of intestine, 




Fig. 103. — Diagrammatic representation of apparatus for testing the action of drugs on the intestine 
by artificial circulation through it. For the sake of simplicity the means employed to keep up the 
temperature of the intestine and apparatus have been omitted, a, a board on which the intestine, 
b, is laid, c, a cannula tied into a branch of the mesenteric artery, n, d, two stopcocks, by means 
of which pure blood or poisoned blood may be passed at will through the cannula. E and f, two 
flasks, containing pure and poisoned blood, g, a block on which they stand, and by which they 
can be raised to a greater or less height, so as to alter the pressure under which the blood flows. 
When the apparatus is kept warm the pressure is more easily regulated by passing air into the 
flasks from a pressure bottle, h, the lever for registering the movements of the intestine. One 
end is weighted and rests on the intestine. I is the axis on which the lever works, k is a revolv- 
ing cylinder on which the movements are recorded. 





Fig. 104. — Shows the effect of anaemia. The upper 
tracing shows the movements of the intestine 
supplied with normal blood ; the lower shows 
the movements of an intestine rendered more 
vigorous by anaemia. 



Fig. 105.— Shows the effect of peptones. The first 
half of the tracing shows the movements of 
an intestine supplied with blood thoroughly 
oxygenated; the second half shows the effect 
of blood containing peptones. 





Fig. 106.— Shows the effect of nicotine. The part 
of the tracing marked A B shows the intes- 
tinal movements during the circulation of 
blood saturated with oxygen (apnoeic blood) ; 
the part N B of blood containing nicotine. 



Fig. 107.— Shows the effect of opium. In the first 
part of the tracing the intestine was supplied 
with apnoeic blood ; in the latter with blood 
containing opium. 



and then investigating its movements under various conditions. The 
intestine was laid on a piece of cork, in a warm chamber. It was supplied 
with blood by means of a cannula placed in the artery, and allowed to 
flow out through a cannula in the veins. Its movements were registered 
by a small lever placed upon it. When blood fully oxygenated passed 



334 PHARMACOLOGY AND THERAPEUTICS. 

through it, the lever traced only a straight line or gently oscillating curve, 
but when the flow of blood was stopped, so that the blood stagnated and 
became venous, contractions began which were indicated as a series of 
curves. A trace of peptone caused first strong contraction and then 
a number of irregular contractions, at the same time that the vessels 
become fuller of blood. Nicotine causes brisker movements of the 
intestine, and lessens the rapidity of the flow of blood. In large doses 
it causes tetanic contraction of the circular fibres. 

Atropine causes irritation of the vessels, while the muscular fibres 
remain at rest. The action of opium is very remarkable when a tinct- 
ure is added in the proportion of *04 to *01 per cent, to the blood which 
is circulating through the intestine, the circulation becomes at once 
lessened, but almost immediately afterwards the diminution passes 
abruptly into great increase, so that five or seven times as much blood 
flows through in a given time as formerly ; at the same time all the move- 
ments of the intestine are abolished, but the intestinal wall instead of 
being relaxed, as one would expect, is in a condition of considerable con- 
traction. When the opium is washed out of the vessels by pure blood, 
the after-effects vary according to the quantity which is used. If it is 
small, the movements and circulation in the intestine soon become normal, 
but if a large dose has been used, the circulation returns to the normal 
condition but the movements remain abolished for a length of time. The 
peristaltic action induced by nicotin is arrested by opium. The local 
action of this drug therefore seems to be that it converts the peristaltic 
movement into a steady contraction. 

A remarkable difference between the action of soda and potash on 
the intestine has been detected by Nothnagel. When the intestine is 
exposed, and a potash salt is applied to its external or peritoneal surfaces, 
it produces a contraction of the muscular walls, which remains localized 
to the point of contact, or simply causes a ring of contraction opposite 
the point. When a sodium salt is used instead, it produces a contraction 
which is not limited to the point of contact, but always spreads some 
little distance from it, and invariably does so in the direction towards the 
pylorus, and not towards the anus. This peculiar action appears to be 
due to the potassium salts acting as stronger muscular irritants than the 
sodium salts, while the progressive contractions caused by the sodium is 
due to the intestinal nerves, in their case more being involved. The 
effect of morphine is very remarkable. When the animal, in addition 
to being anaesthetized by ether only, as in the previous experiment, has 
a small dose of morphia injected also into the veins, it has a sedative 
effect, so that sodium salts applied to the intestine produce only a local 
contraction like potash-salts. But this is only when a certain dose of 
morphia is employed, about 0*01 to 0*03 of morphia for a rabbit. When 
the dose was increased from 0-05 to 0-1 gramme of morphia, an exactly 
contrary effect was produced, and the application of sodium salts, 
instead of being followed only by local contraction, caused a peristaltic 
contraction, which was usually very much more energetic than in the 
normal condition and not only spread upwards from the point of contact, 
hut downwards towards the large intestine, which it never did under other 
circumstances. The quieting or inhibitory effect of moderate doses of 



ACTION OF DKUGS ON DIGESTIVE SYSTEM. 335 

morphia upon the intestine, irritated by soda salts, appears to be exer- 
cised through the splanchnic nerves, inasmuch as when the mesentery, 
going to one part of the intestine, is divided in an animal that has received 
a moderate dose of morphia, the application of soda salts to this part is 
followed by a peristaltic wave ; while, in the other parts of the intestine 
where the nerves are uninjured, the soda still produces only local con- 
tractions. 

From these experiments it is evident that moderate doses' of morphia 
produce a very different effect upon the intestine from large ones : and 
this effect has indeed been long recognized in practice. 

Moderate doses of opium have a constipating action and are constantly 
used to check diarrhoea, but large doses, such as those taken by opium- 
eaters, really have no constipating effect. Indeed, large doses of opium 
injected directly into the jugular vein of a dog, act as most energetic 
purgatives, being much more prompt in their action than almost any other 
drug that we know. Immediately after their injection the whole intestinal 
tract is thrown into violent action and its contents expelled, after which 
it again becomes quiet. 

Very minute doses also seem to have a purgative action, as well as 
very large ones, and I have used them with considerable success in many 
cases of constipation. 

Constipation may be due to diminished peristaltic action, or dimin- 
ished secretion, or to both, and in some cases is associated with acceler- 
ated absorption. In all probability it is generally due to a diminution 
in the peristaltic action. In the normal condition this ought to go on 
regularly, so that the bowels should be evacuated, on an average, once 
a day, though in some persons evacuations normally occur two or 
three times a day, and in others only once in three or four days. In 
some apparently healthy persons I have observed an interval of as much 
as two or three weeks. In some persons the normal stimulus of ordinary 
easily digestible food does not seem to be sufficient to keep the bowels 
acting, but food which leaves much indigestible residue, such as brown or 
bran bread, salad, figs, prunes, or tamarinds, will do so. These latter 
fruits owe their laxative properties partly to the insoluble residue they 
leave and which acts as a mechanical irritant to the intestine, and partly 
to the salts and sugar and mild laxative principles they contain. Treacle 
and gingerbread also have a useful aperient action, and their pleasant 
taste makes them specially suitable for children. The effect of a some- 
what stimulant article of food is greater when taken on an empty 
stomach, and thus a fig before breakfast will have a much greater laxative 
effect than one taken after dinner. A glass of cold water also, by stimu- 
lating peristalsis, will have a laxative action when taken on an empty 
stomach at bed-time or on rising in the morning. "When these means 
are insufficient a slightly irritating substance, such as an aloetic pill taken 
on an empty stomach just before dinner, will aid the stimulating effect of 
the food which is taken afterwards, and will be sufficient to ensure per- 
fectly regular and normal evacuations which do not in any way incommode 
the person. In consequence of this many people continue to take 
such dinner pills regularly for many years together. Others, again, 
suffer from constipation, but with them small doses of purgative medicine 



336 PHARMACOLOGY AND THERAPEUTICS. 

if they act at all, act violently, and leave the person weak and uncom- 
fortable, while the bowels again become constipated. This condition is 
found not unfrequently among women, and is accompanied, sometimes at 
least, with pain or tenderness in one or both ovaries. In such persons 
also, contrary to the general rule, walking exercise increases instead of 
diminishing constipation. 

My friend Dr. Litteljohn noticed that in a case of ovarian tenderness 
half a grain of opium given to relieve the pain acted as a purgative. On 
thinking over this, it occurred to me that the constipation in such cases 
might be due to reflex irritation of the inhibitory intestinal nerves by the 




NERVE CENTRE 






OVARIAN NERVES 

'OVARY 

Fig. 108.— Diagram to show the way in which ovarian irritation probably causes constipation. 

tender ovary. It seemed therefore probable that by using graduated 
doses of opium, one might be able to lessen the action of the inhibitory 
nerves, or even to divert the stimulus from them on to the stimulating fibres, 
and thus produce purgation instead of constipation. Not knowing what 
dose would be sufficient to produce this effect, I began with one drop 
of tincture of opium given in a teaspoonful of water every night. 
To my astonishment this dose was, not only in most cases sufficient, but in 
one case it proved excessive, doing no good, while half a drop acted as a 
brisk purgative. It is evident that opium used in this way will not act 
as a purgative in cases of constipation depending upon general insensi- 
bility of the intestinal nerves. The cases in which it is most useful are 
those of delicate women of a nervous temperament, suffering from ovarian 
pain, and in whom, ordinarily, purgatives produce excessive action, fol- 
lowed by constipation. Small doses of belladonna have also been recom- 
mended in constipation, and it is probable that they act in a similar 
manner when given alone, and that belladonna, hyoscyamus, and essential 
oils assist the action of purgatives by tending to divert the stimulus, 
which the irritating constituent of a purgative produces, from the inhib- 
itory to the accelerating intestinal nerves. We know at present but little 
regarding diminished secretion as a cause of constipation. 

Action of Drugs on Absorption from the Intestines. — 
Ether introduced into the intestine greatly increases its vascularity. It 
also quickens absorption very much, as is shown by the fact that poisons 
act more quickly, and such substances as ferro-cyanide of potassium 
appear sooner in the urine, when they are administered along with 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 337 

ether than when given alone. Carbonic acid has a somewhat similar 
though weaker action. 

Coto bark has been used in diarrhoea, and as it has no proper 
astringent action, its utility has been ascribed to an antiseptic action by 
which it diminished the formation of irritant products in the intestines. 
Albertorii has investigated the action of the coto alkaloids, and finds 
that although cotoine somewhat lessens putrefaction and the development 
of bacteria, it does not stop them either in the organism or outside it. 
It has, however, a very peculiar action on the vessels of the intestine. 
By keeping up artificial circulation in a loop of intestine (vide p. 333), 
he finds that cotoine dilates the arteries, causes the blood to flow more 
readily into the veins, and preserves the vitality of the intestine. It 
also dilates the vessels of the kidney, and causes the blood to flow more 
rapidly through them, but does not alter the circulation in the sub- 
maxillary gland. 

Opium and chloral also dilate the vessels of the intestine, but their 
action is a paralyzing one, while that of cotoine is not. The action of 
paracotoine is similar to that of cotoine, but less marked. 

Albertoni thinks that the benefit which cotoine produces in diarrhoea 
is due to dilatation of the intestinal vessels, and the increased power of 
absorption which it causes. He considers that in many cases of diarrhoea 
diminished absorption is a most important factor. 1 

It is possible that the beneficial action of bael fruit in dysentery 
may depend on some similar property, as this substance has the pecu- 
liarity of acting as a laxative in health, while it lessens the evacuations 
in dysentery. 

Intestinal Astringents. — Diarrhoea may depend (1) upon exces- 
sive peristaltic action, whereby the contents of the intestine are hurried 
along before time has been allowed for their absorption, (2) upon 
diminished absorption, (3) upon excessive secretion. In one form of 
diarrhoea, where the introduction of food into the stomach seems to 
excite peristaltic action throughout the intestine so that the person is 
frequently forced to rise from the table in order to evacuate the bowels, 
small doses of one-half to two minims of liquor arsenicalis given imme- 
diately before meals, as recommended by Ringer, frequently act like a 
charm. In ordinary cases of diarrhoea, opium, by lessening the irrita- 
bility of the intestine, is most serviceable. Some medicines lessen 
peristaltic action, not by affecting the bowel, but simply by removing 
the stimuli which were exciting it. Thus small doses of soda are useful 
in the diarrhoea of children by neutralizing the acid which was acting 
as an irritant. Creasote has a similar action by lessening putrefaction 
or fermentation, and thus preventing the formation of irritant products. 
It is probable that lime acts also to a certain extent by its antacid pro- 
perties, but there is little doubt that there are other factors in its astrin- 
gent action which we do not yet understand. The effect of cotoine on 
intestinal absorption has just been mentioned. With the view of ascer- 
taining whether we could find any drug which would arrest the copious 
secretion from the intestine which takes place in cholera, Pye-Smith and 



1 Archiv fur exper. Path, und Pharm., p. 291, vol. xvii. 

22 



338 PHARMACOLOGY AND THERAPEUTICS. 



lated 



I made a large number of experiments. For this purpose we isolate 
loops of intestine, and into one injected sulphate of magnesia mixed 
with the drug to be tested. In some experiments we injected the sul- 
phate of magnesia into the intestine, and the drug which we wished to 
test into the veins. 

Sulphate of atropine, iodide of Diethyl-atropine, chloral-hydrate, 
emetine, morphine, sulphate of quinine, tannin, and sulphate of zinc, 
were all tried locally with negative results. Chloral and morphine 
injected subcutaneously also gave negative results. 1 

In many cases the best way of checking diarrhoea at its commence- 
ment is to give a purgative such as castor-oil, either alone or with a few 




Fig. 109.— Diagram illustrating diarrhoea depending on the presence of scybala in the intestine, a is 
a scybalous mass ; b is the fluid which it causes the intestine to secrete. 

drops of tincture of opium in it. The irritant substances which cause 
the diarrhoea are swept out of the intestine by the action of the purga- 
tive, and any irritation which remains is soothed by the opium. Chronic 
watery diarrhoea, alternating with constipation, is often best treated in 
the same way. We may suppose that here the presence of scybalous 
masses in the intestine gives rise to a watery discharge, which does not, 
however, wash away the scybala themselves. When a purgative is 
given which causes secretion from the intestine above the scybala, the 
fluid in its downward flow, assisted also by the increased peristalsis, 
washes away the scybala, and thus removes the source of irritation. 

Purgatives. 

Purgatives are substances which cause intestinal evacuations. 
They are divided according to their nature into laxatives, simple, 
drastic, and saline purgatives, hydragogues, and cliola- 
gogins. 

Laxatives are those which increase only slightly the action of the 
bowels and render the motions slightly more frequent and softer, without 
causing any irritation. Most articles of food which leave a large indi- 
gestible residue in the stomach act as laxatives : such are oatmeal, brown 



Report to Brit. Assoc, 1874. 



ACTIOX OF DRUGS OX DIGESTIVE SYSTEM. 339 

bread, and bran biscuits. Articles of food also which contain salts of 
vegetable acids and sugar in considerable quantity also act as laxatives. 
The chief laxatives are: — 



Honey. 


Cassia. 


Stewed apples. 


Treacle. 


Tamarinds. 


Sulphur. 


Gingerbread. 


Figs. 


Magnesia. 


Manna. 


Prunes. 


Castor-oil (in small 
doses). 






Figs, raspberries, and strawberries, in addition to containing sugar 
and vegetable acids, have a number of small seeds which are absolutely 
indigestible, and these have probably a mechanical action in stimulating 
the bowel. 

Simple purgatives, also, when given in small doses, act as laxa- 
tives : such are carbonate of magnesia, magnesia, olive-oil, and sulphur. 

Simple purgatives are more active than laxatives, and their adminis- 
tration is usually followed by one or more copious and somewhat liquid 
stools. Their action is sometimes accompanied by some irritation and 
griping. These are: — 

Aloes. Rhamnus (various species). 

Rhubarb. Castor-oil. 

Senna. 

Drastic purgatives are those which cause violent action of the 
bowels, usually accompanied by evidences of greatly increased peristaltic 
action, such as borborygmi. They cause irritation of the intestine, and 
when taken in large doses produce inflammation and symptoms of poison- 
ing. These are : — 

Elaterium. Gamboge. 

Colocynth. Podophyllin. 

Jalap. Croton oil. 
Scammony. 

Saline purgatives consist of neutral salts of metals of the alkalies 
or alkaline earths. The more commonly employed are : — 

Sulphate of potassium. Bi-tartrate of potassium. 

" sodium. Tartrate of potassium and sodium. 

" magnesium. Citrate of magnesium. 

Phosphate of sodium. Sulpho-vinate of sodium. 
Tartrate of potassium. 

Hydragogues are purgatives which excite a copious secretion from 
the intestinal mucous membrane and thus remove much water from the 
body ; some of them belong also to the drastic group and others to the 
saline. 



340 PHARMACOLOGY AND THERAPEUTICS. 

Bi-tartrate of potassium. 

Elaterium. 

Gamboge. 

Cholagogues are purgatives which remove bile from the body. 
Some of them probably do this by stimulating the secretion of the liver, 
others by quickening peristaltic action of the duodenum and small intes- 
tine and thus preventing the absorption of the secreted bile. 

Aloes. Euonymin. 

Rhubarb. Iridin. 

Mercurial preparations (blue Podophyllin. 
pill, calomel, gray-powder). 

Action, of Purgatives. — Purgatives may act in three ways: 1st, 
by quickening the peristaltic action of the bowels ; 2d, by increasing 
secretion of the intestinal membrane, and thus to some extent washing 
out its interior; 3d, by hindering absorption of the fluids of the intes- 
tines. 

Simple purgatives act chiefly by stimulating peristaltic movements 
and have little effect on the secretion. 

Hydragogue and cholagogue purgatives increase the secretion 
more than the peristaltic action, and drastics increase both. It has 
been held by several eminent German pharmacologists that the more 
watery stools produced by many purgatives are due only to more rapid 
peristaltic action, which hurries along the intestinal contents before there 
has been time for the absorption of their fluid constituents. 

This opinion is chiefly based on the observations of Thiry and Radzie- 
jewski. 

Thiry isolated a small piece of intestine, one end of which he attached 
to the abdomen and the other he sewed up. The part of the intestine 
from which this piece had been removed was again united by sutures, so 
that the intestine was perfect as before, though rather shorter. The small 
bag of intestine retains its vascular nerves supply uninjured and secreted 
readily when tickled with a feather, but purgative medicines, such as 
croton oil, senna, sulphate of magnesia, aloes, jalap, and sulphate of soda, 
when applied to it, produced no increased secretion. These experiments, 
led pharmacologists to believe that the ordinary idea that purgatives pro- 
duced increased secretion from the intestine was erroneous; and the neces- 
sity for any such supposition seemed to be removed by an experiment of 
Radziejewski, who made an intestinal fistula in the ascending colon of a 
dog, and found that the intestinal contents as poured into the large from 
the small intestine exactly resembled the stools which ordinarily follow 
the administration of a purgative. 

The ordinary phenomena produced by purgative medicines would 
therefore Beem to be readily explained by increased peristalsis alone, but 
-Mine oilier experiments by Colin and by Morcau have shown that the 
method employed by Thiry did not afford trustworthy results as to the 
action of purgatives on the intestines. Moreau isolated three loops of 
intestine by means of ligatures, carefully emptying the loops beforehand. 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 341 

He then injected a purgative medicine into the middle loop and returned 
the intestine to the abdomen. On examination some hours afterwards, it 
was found that although all three loops had been under similar condi- 
tions, the one into which the purgative had been injected was distended 
with fluid while the others remained perfectly empty. These experi- 
ments were repeated by Vulpian, and afterwards by myself, with similar 
results. There can be no doubt whatever, then, that purgatives act both 
by increasing peristaltic action and intestinal secretion. Some purga- 
tives act chiefly by the one, and some chiefly by the other. 

In the case of some of the salines, the secretion is greatly increased, 
while the peristaltic movement is so little affected that the secretion may 
lie so long in the intestine as to be again re-absorbed, and the drug 
therefore fails to produce purgation at all. For this reason it is usual to 
combine such salines with simple purgatives, which will accelerate the 
peristalsis. 

Laxatives have little action on the system beyond that which is due 
to the removal of waste and irritating substances from the bowels, but 
simple purgatives, and still more drastic purgatives, in addition to the 
direct action upon the bowels, exert an indirect effect upon the blood, 
removing from it a not inconsiderable portion of its fluid, and therefore 
causing a form of partial depletion. 

The action of cholagogues will be more particularly considered in 
another paragraph (p. 351). 

The action of purgatives generally and especially of saline cathartics 
has been a subject of very great dispute, and it is a matter of extreme 
difficulty to determine exactly. The question seems to be, however, set- 
tled by the masterly researches of Dr. Matthew Hay, and I cannot, I 
think, do better than give his conclusions in his own words : 

1. A saline purgative always excites more or less secretion from the 
alimentary canal, depending on the amount of the salt and the strength 
of its solution, and varying with the nature of the salt. 

2. The excito-secretory action of the salt is probably due to the bit- 
terness as well as to the irritant and specific properties of the salt, and 
not to osmosis. 

3. The low diffusibility of the salt impedes the absorption of the 
secreted fluid. 

4. Between stimulated secretion on the one hand, and impeded 
absorption on the other, there is an accumulation of fluid in the canal. 

5. The accumulated fluid, partly from ordinary dynamical laws, 
partly from a gentle stimulation of the peristaltic movements excited by 
distension, reaches the rectum and produces purgation. 

6. Purgation will not ensue if water be withheld from the diet for 
one or two days previous to the administration of the salt in a concen- 
trated form. 

7. The absence of purgation is not due to the want of water in the 
alimentary canal, but to its deficiency in the blood. 

8. Under ordinary conditions, with an unrestricted supply of water, 
the maximal amount of fluid accumulated within the canal corresponds 
very nearly to the quantity of water required to form a 5 or 6 per cent, 
solution of the amount of salt administered. 



342 PHARMACOLOGY AND THERAPEUTICS. 

9. If, therefore, a solution of this strength be given, it does not 
increase in bulk. 

10. If a solution of greater strength be administered, it rapidly 
increases in volume until the maximum is attained. This it accom- 
plishes in the case of a 20 per cent, solution in from one to one and 
half hours. 

11. After the maximum has been reached, the fluid begins gradually 
and slowly to diminish in quantity. 

12. Cceteris paribus, the weaker, or in other words, the more volu- 
minous the solution of the salt administered is, the more quickly is the 
maximum within the canal reached ; and accordingly purgation follows 
with greater rapidity. 

13. Unless the solution of the salt is more concentrated than 10 per 
cent, it excites little or no secretion in the stomach. 

14. The salt is absorbed with extreme slowness by the stomach of 
the cat. 

15. The salt excites an active secretion in the intestines, and probably 
for the most part in the small intestine, all portions of this viscus being 
capable of yielding the secretion in almost equal quantities. 

16. The bile and pancreatic juice participate but very little in the 
secretion. 

17. The scretion is probably a true suceus entericus, resembling the 
secretion obtained by Moreau after division of the mesenteric nerves. 

18. The secretion is promoted by local irritation of the intestine, as 
by ligatures, but only in the immediate vicinity of the irritation. 

19. Absorption by the intestine generally is reflexly stimulated by such 
irritation (the effect of numerous ligatures applied at points remote from 
the seat of the injected salt being to diminish the amount of purgative 
fluid by accelerated absorption). 

20. If the salt solution be injected directly into the small intestine, 
the stronger within certain limits the solution is, the greater will be the 
accumulation of fluid within the intestine. 

21. This difference is not observed when the salt is administered per 
os, as the strong solution becomes diluted in the stomach and duodenum 
before passing into the intestine generally. 

22. The difference is due to the local action of the salt on the mucous 
membrane, and probably more to an impeded absorption than to a stimu- 
lated secretion. 

23. When the salt is administered in the usual manner, it appears, in 
the case of the sulphate of magnesia and sulphate of soda, to become split up 
in the small intestine, the acid being more rapidly absorbed than the base. 

24. A portion of the absorbed acid shortly afterwards returns to the 
intestines. 



■>■-, 



'). After the maximum of excretion of the acid has been reached, 
the -alt begins very slowly and gradually to disappear by absorption, 
which is checked only by the occurrence of purgation. 

26. Daring the alternations of absorption and secretion of the acid, 
it is the salt left within the intestine which excites secretion, the absorbed 
and excreted acid exerting no such action whilst in the blood, or during 
the process of its excretion, as Headland believed. 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 343 

27. The salt does not purge when injected into the blood, and excites 
no intestinal secretion. 

28. Nor does it purge when injected subcutaneously, unless in virtue 
of its causing local irritation of the abdominal subcutaneous tissue, which 
acts reflexly on the intestines, dilating their blood-vessels, and perhaps 
stimulating their muscular movements. 

29. The sulphate of soda exhibits no poisonous action when injected 
into the circulation. 

30. The sulphate of magnesia is, on the other hand, powerfully toxic 
when so injected, paralyzing first the respiration and afterwards the 
heart, and abolishing sensation or paralyzing the sensory-motor reflex 
centres. 

31. Both salts, when administered in the usual manner, produce a 
gradual but well-marked increase in the tension of the pulse. 

32. According as the salt-solution within the intestine increases in 
amount, there occurs a corresponding diminution of the fluids of the 
blood. 

33. The blood recoups itself in a short time by absorbing from the 
tissues a nearly equal quantity of their fluids. 

34. The salt, after some hours, causes diuresis, and with it a second 
concentration of the blood, which continues so long as the diuresis is 
active. 

35. As the intestinal secretion excited by the salt contains a very 
small proportion of organic matter as compared with the inorganic matter, 
the purgative removes more of the latter than the former from the blood. 
In certain cases a large quantity of the salts of the blood is thus evacuated. 

36. The amount of the normal constituents of the urine is not affected 
by the salt. 

37. After the administration of sulphate of magnesia much more of 
the acid than of the base is excreted in the urine. 

38. The salt has no specific action in lowering the internal tempera- 
ture of the body, or has it only to a very small extent. 

39. It reduces, however, the absolute amount of heat in the body. 
Uses. — Purgatives are used, firstly, to remove from the intestinal 

tube faecal matters. They thus not only prevent the accumulation of 
such matters, but remove the irritation which their presence produces, 
and which may evidence itself in disturbances of other organs, producing, 
for example, headache and malaise. These disagreeable symptoms pro- 
duced by constipation are perhaps partly due to the irritation of the 
intestinal nerves producing reflex disturbance of the circulation, but it is 
probable also that they may be due in part to the toxic action of poisonous 
gases, liquids, or solids, generated in the intestine by imperfect digestion or 
decomposition of the food. For such purposes as this we may employ, as 
we find them necessary, laxatives or simple purgatives. 

The second use of purgatives is to remove liquid from the body 
in cases of dropsy, due either to heart or kidney disease. For such pur- 
poses we use saline hydragogue cathartics. 

From his researches on the action of saline cathartics Dr. Hay had 
found that if a salt be given in a concentrated solution when the ali- 
mentary canal contains little or no fluid, it produces an almost immediate 



344 PHARMACOLOGY AND THERAPEUTICS. 

and very decided concentration of the blood by the removal of a large 
quantity of its water in the form of intestinal secretion. But if the 
salt be given in sufficient water, or if the alimentary canal contain suffi- 
cient fluid at the time of administration, no such concentration occurs. 
The concentration reaches its maximum in half an hour, but does not 
last more than half an hour or an hour, when it begins to decline, and 
continues to do so until it reaches the normal at the end of about four 
hours. This return of the blood to its normal concentration is not due 
to re-absorption from the intestine, but to the absorption of lymph and 
fluids from the tissues. Some hours after the administration, either of a 
concentrated or dilute saline solution, the blood undergoes another con- 
centration, less than the first, but continuing longer. Saline cathartics 
as often used in dilute saline solution owe their use in dropsy to a great 
extent to their diuretic action. When given in concentrated 
solution under proper conditions, the benefit they produce by purgation 
is exceedingly great. These conditions are that the alimentary canal 
should be freed from food, and especially from liquids, by previous 
abstinence for some hours, and that the salt should be given along with 
the smallest possible quantity of water. Sulphate of magnesia being 
soluble in less than its own weight of water is most suitable. Alkaline 
tartrates and Rochelle salt may also be useful ; sulphate of soda is more 
insoluble, and therefore less suitable; phosphate of soda and sulphate of 
potash are too insoluble to be of any service. 1 

The third use is to lower the temperature in fever, and for 
this we chiefly use salines. The modus operandi here is not yet well 
understood, as they have no such action in health (p. 343). 

The fourth use is to lower the blood-pressure, and thus to 
prevent the rupture of a blood-vessel, and consequent apoplexy, or to 
prevent further extravasation in a case where the vessel has already 
burst. 

The regular use of aperients is especially necessary in gouty persons 
with contracting kidney and high blood-pressure. How far their utility 
is to be ascribed to their direct effect in lowering the blood-pressure and 
how far to the removal of waste products which might raise the pressure 
it is impossible at present to say. The utility of purgatives after apo- 
plexy has occurred may be doubtful, but they are usually administered, 
and probably, they do no good. Even if they do no good, they do no 
harm. A drop of croton-oil or a few grains of calomel on the tongue is 
the usual form of administration. 

A fifth use is to prevent straining at stool where violent efforts are 
dangerous, as in aneurism, hernia, &c. 

Action of Irritant Poisons. 

A great number of drugs which are employed in medicine, and are 
most useful when given in small doses, act as irritant poisons in large 
ones. Their action is then not restricted to the stomach, nor even to 



1 Land, April 21, 1883. 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 



345 



the whole of the intestinal canal, but they exercise, in addition, a marked 
effect upon other functions of the body, such as respiration and circula- 
tion. 

In considering the physiological action of many drugs it is necessary 
to describe the effect they will produce when given in large quantities, 
as, for example, in an overdose, as well as in moderate or small ones. 

It will save both time and space to consider here the action of irri- 
tant poisons generally, and to refer to this description when discussing 
the effect of individual drugs. 

The symptoms of irritant poisoning are to a great extent the same, 
whatever be the irritants swallowed; it is therefore convenient to give 
an account of these symptoms, and then to mention the special peculiar- 
ities which occur in the case of different poisons. 

A poison is most usually swallowed, and it then comes successively 
in contact with the lips, moutli and tongue, gullet and stomach. 
It may sometimes reach no further, being either evacuated by vomiting 
or absorbed. It frequently, however, also passes into the intestine. On 
all those parts which it reaches it exerts a local action ; besides this, 
however, it exerts a reflex action on the respiration and circulation. 
Corrosive poisons produce a feeling of burning in the lips, mouth, gul- 
let and stomach; the pain in the stomach, extending more or less 
over the abdomen, is accompanied by tenderness, and is increased by 
pressure. It is thus distinguished from the pain of colic, which is 
usually relieved by pressure. 




Fig. 110.— Diagram to show the nervous mechanism by which the action of the heart may be depressed 
by irritation of the stomach. The reflex irritation of the vagus may render the heart's action 
simply weak, or slow and weak {vide p. 287). 

The irritation of the stomach gives rise to vomiting- ; the vomited 
matters usually consisting, first of the contents of the stomach, next of 
bile or mucus, and lastly of mucus stained with blood. These matters 
may sometimes be more or less acted upon by the poison where this is a 
strong acid or alkali. The intense irritation in the stomach produces 
effects on the respiration and circulation very much like those caused by 
a severe blow in the epigastrium. The heart's action is greatly weakened 






346 PHARMACOLOGY AND THERAPEUTICS. 

at first, and it may be rendered slow from reflex irritation of the 
vagus, but in the later stages it is generally rapid, very small, weak, or 
almost imperceptible; sometimes it may be intermittent. On account 
of the weakness of the circulation the face and the general surface of 
the body are pale, the cheeks sunken, and the extremities cold. The 
frequency of the respiration may vary — may be either slower or 
quicker than normal, but it is almost always labored and shallow, as the 
intense irritation in the stomach renders the descent of the diaphragm 
in deep inspiration painful, and the sufferer therefore tries to avoid it. 

Although the pulse at the beginning of the poisoning may be slow, 
when advanced it is usually, as already mentioned, very rapid. Excep- 
tions to this rule may occur chiefly in the case of poisons which, after 
their absorption, have an action on the heart itself; these are potassium 
nitrate and salts of barium. In consequence of the weakness of the cir- 
culation the face is usually very pale, but an exception to this may occur 
in poisoning by corrosive sublimate, where the face may be flushed. In 
arsenical poisoning the face is not only pale, but assumes a bluish hue, 
and the pinching may be extreme, so that the condition resembles that 
of a person suffering from Asiatic cholera. 

Where the poison is exceedingly corrosive, as in the case of acids and 
alkalies, its local action on the stomach in causing swelling of the mucous 
membrane may tend partially to occlude the pylorus, and the greater 
part of the poison may either remain in the stomach itself or be ejected 
by vomiting without passing into the intestine. In such cases vomiting 
will occur alone without being accompanied by purging, and the pain in 
the abdomen may be less diffused. Most irritant poisons, however, pass 
from the stomach into the intestines, and thus violent purging is 
induced in addition to the vomiting. The inflammation of the intestines 
also causes the pain to be diffused over the whole abdomen. 

Peculiarities in the Action of different Irritant Poisons. 
— Acids throw down albumen as a white precipitate, and in consequence, 
when brought in contact with the lips or tongue in a concentrated condi- 
tion, they cause white stains. The white stain is most marked in the 
case of hydrochloric acid ; it may occur also from sulphuric ; but as the 
further action of the sulphuric is to char albumen or other organic sub- 
stances, the stain may acquire a brown or black color. Nitric acid pro- 
duces a yellow stain, rendered brighter by the application of ammonia. 
Perchloride of iron produces a yellowish-brown stain ; the caustic alka- 
lies remove the epidermis and give a soapy feeling to the surface, but do 
not leave any stain. After a short time the mucous membrane becomes 
injected and swollen from the irritation. 

In the mouth the taste peculiar to the poison often leads to its detec- 
tion, so that very little of it may be swallowed in cases where a person 
was about to take it unwittingly and not intentionally. Arsenic, although 
a powerful irritant in the stomach, is almost tasteless. As the poison 
passes down the gullet, it may have an important influence on the respir- 
atory tract ; this is especially the ease where it gives off* fumes like nitric 
acid, hydrochloric acid, and ammonia ; the fumes, passing into the larynx 
and trachea, excite irritation, spasm, and inflammation, and may cause 
death by suffocation. Death by suffocation may, however, sometimes 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 347 

occur from the action of poisons which do not fume, e.g., sulphuric acid ; 
the local irritation about the epiglottis being so great as to cause obstruc- 
tion to the respiratory passages. Sometimes, also, such poisons as sul- 
phuric acid may pass directly into the trachea instead of the oesophagus, 
and thus cause very rapid death from suffocation. 

Purging is usually absent and the bowels constipated in poisoning by 
strong alkalies or acids, and by salts of lead ; the former probably act by 
corroding the stomach, and partially occluding the pylorus ; the latter 
by lessening the peristaltic movements of the intestine. In the case of 
lead salts, the abdominal pain differs from that of ordinary irritant poi- 
sons, being of a colicky nature, and to a certain extent relieved by 
pressure. 

Secondary Effects of Irritant Poisoning-. — After the imme- 
diate condition of collapse caused by the powerful action of the irritant 
has passed off, the local inflammation which it has produced may give 
rise to a general febrile condition, with hot skin, flushed face, and quick 
bounding pulse. This condition may be accompanied by other symptoms 
due to the physiological action of the poison after its absorption ; thus, in 
the case of corrosive sublimate, there may be the metallic taste, sore 
gums, and profuse salivation. 

One of the most important instances of the secondary effects of 
irritant poisons is phosphorus ; after the primary symptoms of gastric 
irritation have passed off the patient may appear perfectly well, and then 
vomiting and purging may set in a second time. These are due, not to 
the local action of the phosphorus which has been swallowed on the 
stomach and intestines, but to changes in the liver, blood, and other 
organs, which the phosphorus has produced after its absorption. A sim- 
ilar condition has been observed in poisoning by arsenic, but usually the 
symptoms of arsenical poisoning are continuous, and do not exhibit a 
distinct intermission of this kind. 

Death may occur from the secondary action of some poisons a good 
while after the primary symptoms have disappeared ; thus strong acids 
and alkalies may produce death, weeks or even months after they have 
been swallowed, from the effects of their local action on the oesophagus 
or the stomach. During the passage down the oesophagus they may 
destroy the mucous membrane to such an extent that when it heals and 
the cicatrix begins to contract, the lumen of the tube may be completely 
obstructed, so that no food can reach the stomach, and the patient dies 
of starvation, or the mucous membrane of the stomach may be destroyed 
to such an extent that what remains is insufficient to digest the food, and 
the patient dies from non-assimilation. 

Action of Drugs on the Liver. 

The liver is by far the largest organ in the body, and it is placed in 
a very peculiar situation. It acts as a porter or doorkeeper to the circu- 
lation, all the substances which are absorbed from the intestinal canal 
having to pass through the portal vein and the capillaries of the liver 
before they can enter the general circulation. 

Since the discovery by Ludwig and Schmidt-Mulheim that peptones 
are poisonous when injected directly into the circulation, the liver has 



348 PHARMACOLOGY AND THERAPEUTICS. 

acquired a new importance. Schiff and Lautenbach indeed had previously 
made some experiments which they thought showed that a subtle 
poison existed in the blood even of healthy animals, but was destroyed 
by the liver. They based this idea on the observation that ligature of 
the portal vein causes death in animals with very much the same symp- 
toms as when they are bled to death. Ludwig had formerly explained 
this phenomenon by supposing that the ligature caused the blood to accu- 
mulate in the large and dilatable portal radicals and prevented it from 
getting into the general circulation again. The animal was thus, as 
Ludwig expressed it, bled to death into its own veins. Schiff and Lau- 
tenbach, however, thought the symptoms were due rather to poison than 
to this mechanical alteration in the circulation, because they found that 
when the blood of an animal whose portal vein had been ligatured was 
injected into a frog, it produced death within three hours, whereas blood 
from a similar animal whose portal vein had not been ligatured produced 
no effect. 

The liver therefore seems to have a most important function in 
destroying- the poisonous properties of peptones, and perhaps 
other substances produced during digestion, and possibly also of 
poisonous products of tissue waste. The peptones are converted by it 
into sugar and glycogenic substance. 1 

Drugs which act on the liver are usually divided into hepatic stimu- 
lants and cholagogues and into hepatic depressants. 

It has been for a very long time a matter of clinical experience that 
the administration of mercurial purgatives was frequently followed by 
the discharge of greenish bilious-looking evacuations and a great improve- 
ment in the general condition of the patient. These two results were 
classed together as cause and effect, and the improvement was considered 
to be due to the removal of bile. It was then supposed that the bile was 
formed in the blood and simply excreted by the liver, and, therefore, the 
bilious-looking stools were ascribed to stimulation of the secreting func- 
tion of the liver by the mercurials. Hepatic stimulants and cholagogues 
were therefore considered to be identical. We now know that the bile is 
formed in the liver and not simply excreted by it from the blood, and that 
bile formed in the liver may again be absorbed into the blood. Increased 
functional activity of the liver might thus lead to the presence of a greater 
instead of a less quantity of bile in the blood. Recent experiments have 
also shown that one of the most marked cholagogues which we know, 
viz.. calomel, appears rather to diminish than to increase the actual secre- 
tion of bile, so that we are now obliged to distinguish between hepatic 
stimulants and cholagogues. Hepatic stimulants are drugs which 
increase the functional activity of the liver, and the amount of bile which 
it forms. Cholagogues are substances which remove bile from the 
body, possibly by acting rather on the intestines; they do not necessarily 
increase the secretion of bile, they may only prevent its re-absorption and 
thus diminish the quantity in the circulation. Hepatic depressants are 
drugs which Lessen the quantity of bile secreted by the liver. 

In relation to tissue waste it is not to be forgotten that the products of 
the functional activity of one organ are not only poisonous to itself, but 



Seegen, rjlHyirs Arehiv, xxviii., p. 990. 






ACTION OF DRUGS ON DIGESTIVE SYSTEM. 349 

may be poisonous to other organs. Thus the waste products of muscular 
activity gradually poison the muscle and prevent its contraction, although 
as soon as they are washed out with salt solution the muscle recovers its 
power. 

Lactic acid also, which is a product of muscular waste, is poisonous 
not only to muscle but to some extent to nerves, and lessens the functional 
activity of the brain and produces sleep. At the same time it is possible 
that these waste products, poisonous in themselves, may through slight 
changes be rendered available for nutrition, just as peptones, which are 
themselves poisonous, are most important foods. 

Besides acting on peptones, the liver seems to have the power of 
destroying the poisonous properties of some vegetable alkaloids. 
For example, ■£$ th of a drop of nicotin given to a frog does not produce 
death, but 4^-th is sufficient, when the liver has been previously removed. 
Conia, cobra poison, and hyoscyamin, all exert much less poisonous action 
after they pass through the liver, before they reach the general circulation, 
than they do when injected directly into the blood. Curare, prussic acid 
and atropia, on the other hand, do not have their action modified. 1 

The result of these experiments may be partly explained on the sup- 
position that a good deal of the poison has been excreted along with 
the bile, and has thus been prevented from reaching the general circula- 
tion. But it is probable that in addition to the function of excreting 
poisons, the liver has also got the power of destroying poisons, and, it 
may be, the power of removing poisons from the circulation by merely' 
storing them for a time. 

In relation to this subject it is interesting to bear in mind that alka- 
loids, to which the name of ptomaines has been given, are formed 
in dead bodies during the process of decomposition, and that when a 
solution of peptone is treated with potash and ether it yields a body 
which appears to be a volatile alkaloid. If putrid peptone is treated in 
the same way, a solid non-volatile alkaloid is obtained. 2 

Ptomaines are not only formed in dead bodies, they are also formed 
in the intestine by the decomposition of parts of its contents. They have 
been found in large quantities by Bouchard both in the stools of persons 
suffering from diarrhoea or typhoid fever, and in normal faeces. They 
appear to be absorbed from the intestine into the blood and excreted by 
the urine. They have been found by Bouchard in the urine both in 
health and disease, and Bocci has shown that the human urine has 
a paralyzing action on frogs like that of curare, or of the ptomaines 
which Mosso and Guareschi have obtained from putrefied fibrin or brain. 

Some time ago I pointed out 3 the resemblance between the languor 
and weakness which occur in many cases of indigestion and the symp- 
toms of poisoning by curare, and drew attention to the probability that 
the languor was due to the effect of poisonous substances absorbed from 
the intestine. These I considered to be probably peptones, but it is possible 



1 Lautenbach, Philadelphia Medical Times, May 26, 1877. 

2 Tanret, Convptes Bendus, xcii., 1163. 

3 Lauder Brunton, " Indigestion as a Cause of Nervous Depression," Practitioner, 
vol. xxv., October and November, 1880. 



350 PHARMACOLOGY AND THERAPEUTICS. 

that they may be ptomaines. But whether the poisonous substances 
be peptones or ptomaines, the function of the liver is equally important 
in preventing them from reaching the general circulation. 

Bearing in mind, then, the office of the liver as a porter to prevent 
the passage of injurious substances from the intestinal canal into the 
blood, and the great effect that any alteration in the circulation through 
it may produce upon the circulation, and consequently on the functions 
of all the intestinal organs, we will much more readily understand the 
importance of this gland, the largest in the body, than if we look upon it 
simply as an instrument for secreting the bile which plays a useful but 
still subordinate part in the process of digestion. 

"We are still but imperfectly acquainted with its functions, but we 
may say that they are at least five: — 

1st, to form and store up glycogen, a material which will after- 
wards be used in evolving heat and muscular energy : it will thus, as it 
were, perform the office of a kind of coal-bunker to the body : 

2dly, to secrete bile for use in digestion ; 

3dly, to excrete bile; 

4thly, to destroy peptones which are poisonous when they are 
directly introduced into the general circulation, and to convert them into 
glycogen, &c. ; 

5thly, to destroy or store up and excrete other organic poisons 
which may have been formed in the alimentary canal during the process 
of digestion, or may have been introduced into it from without. 

The glycogenic function of the liver is influenced by a number of 
drugs, especially phosphorus, and substances belonging to the same 
chemical group. Phosphorus, arsenic, and antimony, all destroy the 
glycogenic function, and at the same time tend to cause fatty degenera- 
tion of the organ. It is possible that these effects of the poisons are 
closely connected, but the exact connection between them has not yet 
been ascertained. 

In consequence of the disappearance of glycogen from the liver 
which is caused by these drugs, puncture of the fourth ventricle will no 
longer cause glycosuria in animals which have been poisoned by 
them. Attempts have been made to utilize this fact in the treatment 
of diabetes, but as yet the results have not been very satisfactory. 

Hepatic Stimulants. — The action of drugs on the secretion of 
the liver has been very carefully studied by some observers, especially by 
Rohrig, Rutherford, and Vignal. The mode of experimenting was to cura- 
rize a dog, ligature the common bile duct and insert a cannula into it. 
The bile was thus entirely prevented from reaching the intestine, and the 
whole of it flowed through the cannula into a vessel in which it was col- 
lected, so that the amount secreted in a given time was readily estimated. 
The drug was then administered, usually by injection into the duodenum, 
and the increase or diminution which this caused in the bile was noticed. 

The ingestion of food greatly increases the secretion of bile, and 
in order to get rid of this disturbing factor, the experiments were all 
made on fasting animals. 

A great number of drugs were experimented upon, some of which 
were found to stimulate the liver, and increase the quantity of bile 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 



351 



without altering its quality, so that their action upon the liver would be 
nearly analogous to that of laxatives upon the intestine ; others increase 
the quantity of bile, and render it more watery ; others again had little 
effect upon the liver, but stimulated the intestinal secretion and move- 
ments. 

The following are hepatic stimulants : — 



Acid, dilute nitro- 

hydro-chloric. 1 
Aloes. 1 

Rochelle salt. 3 
Sodium sulphate. 2 
Sodium phosphate. 1 
Potassium sulphate. 2 
Mercuric chloride. 1 
Sodium salicylate. 1 



Sodium benzoate. 1 

Ammonium benzoate. 2 

Baptism. 2 

Euonymin. 1 

Hydrastin. 2 

Juglandin. 2 

Iridin. 1 

Leptandrin. 2 

Phylolaccin. 1 



Podophyllin. 1 
Sanguinarin. 1 
Colchicin. 1 
Colocynth. 1 
Jalap. 2 
Rhubarb. 2 
Ipecacuanha. 1 
Physostigma 3 
(extract). 



The most powerful stimulants in the preceding list are indicated by ( 1 ), the less 
powerful by ( 2 ) and ( 3 ). 

Those drugs which stimulate the intestine much, as a rule increase 
only slightly the secretion of bile by the liver, and podophyllin, which in 
certain doses acts as a powerful hepatic stimulant, ceases to have this 
effect when it produces marked purgation. These effects occur indepen- 
dently of the action of the drugs on the re-absorption and re-secretion of 
bile, inasmuch as in the experiments quoted the whole of the bile was 
collected directly from the liver and not allowed to pass at all into the 
intestine. 

Cliolagog-ues. — In making similar experiments, however, Schiff 
observed that the secretion of bile was very much greater for a short time 



Liver with bile duct lead- ) 
ing into the duodenum. J ' 

Portal vein with entero-] 
hepatic circulation show- i ( 
ing absorption and re- j 
excretion of bile 



Mesenteric veins. 




Stomach. 



Small intes- 
tine. 



— Colon. 



Fig. 111. 



immediately after the bile duct was tied, than it was later on ; and on fur- 
ther investigation he found that this was due to the fact that the liver has 
a double function : it not only forms new bile, but re-excretes 



352 PHARMACOLOGY AND THERAPEUTICS. 

the old bile which has been re-absorbed from the intestine. A certain 
quantity of bile is lost in the faeces, but a considerable portion of it seems 
to be utilized again and again ; being formed by the liver, poured out 
into the intestine, re-absorbed and again excreted. This circulation of 
bile between the intestine and the liver has been called by Lussana the 
entero-hepatic circulation. It has been shown that the bile which is 
absorbed from the duodenum does not merely act as a stimulus to the 
liver to cause a greater formation of new bile, but is actually re-excreted 
by injecting ox-bile, which gives Pettenkofer's reaction, into the duodenum 
of a guinea-pig, and finding that shortly afterwards the bile which issued 
from the gall duct gave this reaction while the bile normally secreted by 
the guinea-pig does not. 

Not only is bile re-excreted in this manner by the liver, but other sub- 
stances also, such as medicines and poisons, are likewise excreted. 
The absorption and re- excretion takes place with great rapidity, for 
Laffter, in some experiments made under Heidenhain's direction, found 
that rhubarb injected into the duodenum appeared in the bile in less 
than five minutes. Substances injected into the blood were also excreted 
by the bile with great rapidity, so that sulphindigotate of soda introduced 
directly into the circulation in some experiments, began to color the bile 
blue one minute after its injection. Other substances are also absorbed 
from the intestine and excreted by the liver and passed round in the 
entero-hepatic circulation, just like the bile. Curare is one of those, and 
to this probably is due in a great measure the absence of fatal effect from 
its introduction into the stomach. Iron also circulates with the bile, and it 
is probable that the beneficial effect of large doses may be due in part to 
the action of the iron upon the liver. The objection has been raised to 
the use of large doses that they are useless, inasmuch as the whole of the 
iron which is taken into the mouth is again expelled in the faeces, but 
there can be no doubt that clinically large doses of iron are sometimes 
beneficial. Copper and manganese also appear in the bile, arid it is 
probable that lead and all the heavy metals pass chiefly out of the body 
by this channel. 

It has been suggested by Lussana that the malarial poison also cir- 
culates in the entero-hepatic circulation. 

From the fact that bile is re-absorbed from the intestine, it is obvious 
that a hepatic stimulant which simply increases the secretion of the bile 
by the liver, will not of itself act as a cholagog'ue and remove 
the bile from the body. In order to do this, this action must be combined 
with increased peristaltic action of the bowels, which will hurry the bile 
out and prevent its re-absorption. If, in addition to increased peristalsis, 
we have increased secretion from the intestinal mucous membrane, so as 
to was] i out the intestine, we shall get the bile still more effectually 
removed from the body. The necessity for such a combination has indeed 
been long air" shown by clinical experience, and the advantages of 
following a mercurial pill by a saline purgative in order to clear it away 
have long beeE recognized. Some hepatic stimulants increase also the 
peristaltic movements and secretions from the intestine; for example, 
those substances which have been already enumerated as cholagogue 
purgatives. 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 353 

Aloes. Colocynth. Sulphate of potash. 

Baptism. Jalap. Sulphate of soda. 

Colchicum in large Podophyllin. Phosphate of soda, 

doses. Rhubarb. Mercury salts. 

In most cases, however, it is advisable to combine hepatic and 
intestinal stimulants in order to insure a more complete chola- 
gogue effect. Thus calomel as employed in Rutherford's experiments 
has no stimulant action on the liver, but stimulates the intestinal glands ; 
corrosive sublimate, on the contrary, stimulates the liver powerfully, but 
has a very feeble stimulant action on the intestine ; a combination of the 
two stimulates both the liver and the intestinal glands. When used in 
medicine, calomel is recognized to be a powerful cholagogue, one of the 
most powerful indeed that we possess, and it is by no means impossible 
that a small portion of it may be converted into a corrosive sublimate in 
the intestine, so that we thus get from the calomel, when given alone, 
the combined effects of both the mercurial preparations just mentioned. 
It is perhaps more probable, however, that the cholagogue action of cal- 
omel may be due to its having a peculiar stimulant action on the duo- 
denum and ileum, so as to hurry the bile along the intestine and prevent 
its re-absorption. The reason for supposing that this is the case rather 
than that part of it is converted into corrosive sublimate and stimulates 
the liver, is that when given to dogs with a permanent fistula it does not 
increase the flow of bile, which it would probably do if any corrosive 
sublimate were formed. Another is that after the administration of 
calomel, leucine and tyrosine, which are products of pancreatic diges- 
tion, are found in the stools, and it seems not improbable that their 
appearance under such circumstances is due to their having been hur- 
ried along the intestine from the duodenum to the anus, and evacuated 
without time being allowed for their absorption or decomposition in the 
intestine. 

Adjuncts to Cholagog-ues. — The pressure under which bile is 
secreted is very low, so that a very slight obstruction to its flow through 
the common bile duct is sufficient to cause its accumulation in the gall 
bladder and gall ducts, and thus to lead to its re-absorption. This is 
readily observed in cases of catarrh, either of the duodenum or of the 
gall ducts. In such cases the use of ipecacuanha is indicated. It has 
been found clinically to be of great service, and it probably acts by les- 
sening the tenacity of the mucus in the gall duct, and thus tends to 
remove the obstruction in front, while at the same time it increases the 
pressure behind, by stimulating the hepatic secretion. The movements 
of the diaphrag-m have a powerful action in aiding the expulsion of 
bile from the liver ; they do this to a certain extent in ordinary respi- 
ration, but their effect is much greater in forced inspiration. Exercise 
therefore tends to expel bile from the liver, and prevent its accumulation 
in the biliary capillaries, but a little brisk exercise, as in riding, 
rowing, climbing, tennis, &c, will have in a few minutes a more benefi- 
cial action than a lazy constitutional walk of a couple of hours. 

The secretion of bile is not only increased, but the pressure under 
which it is secreted is raised by sipping* fluids. This is in all 
23 



354 PHARMACOLOGY AND THERAPEUTICS. 

probability due to nervous influence, for it has been shown by Kronecker 
that taking a liquid in numerous small sips will for the time completely 
abolish the inhibitory action of the vagus on the heart. It is probable in 
consequence of this fact, that Carlsbad water when taken in numerous 
sips for an hour or more, as at Carlsbad itself, is so exceedingly effica- 
cious in hepatic diseases, while sodium sulphate, which is the main con- 
stituent of the water, was found by Rutherford to have only a very slight 
action as a stimulant to the liver. 

Uses of Hepatic Stimulants and Cholagogues. — The pres- 
sure under which the bile is secreted is very small, but the blood-pressure 
also in the portal vein is very low. In consequence of this a very slight 
increase in the tension of the bile within the gall ducts, or diminution of 
the pressure of blood in the vein, causes the bile to be absorbed. It is 
then carried by the circulation to various parts of the body and disturbs 
their functions. It lessens the power of the heart and appears to dimin- 
ish the activity of the brain, so that persons suffering from biliousness 
and presenting a slight icteric tinge of the conjunctiva, are apt to feel 
irritable, stupid, and out of sorts generally. Cholagogues are useful by 
removing bile from the body, and thus relieving the symptoms above 
mentioned. It is probable, however, that they also in some way 
improve the portal circulation, and thus lessen congestion of the 
stomach and intestines, as in Beaumont's experiments on Alexis 
St. Martin (p. 321). 

Hepatic Depressants. 

Purgatives will act as hepatic depressants and lessen the secretion of 
the liver by removing from the intestine the bile which would other- 
wise be re-absorbed, and by hurrying out also the food which might 
yield materials for the secretion of new bile, but some substances, 
such as calomel, castor-oil, gamboge, and magnesium sulphate, were found 
by Rutherford to depress the secretion in cases where the bile duct was 
ligatured and the animals fasting, so that in all probability the effect 
of the drugs in diminishing the secretion was due to their lowering 
the blood-pressure in the liver. 

Action of Drugs on the Pancreas. 

The pancreatic juice is important in the process of digestion, as it has 
the threefold power of converting starch into sugar, of digesting proteids 
with the formation of peptones, and of splitting up fats. 

The process of secretion in the pancreas is associated with increased 
blood supply as in other glands. Its nerves arise from the hepatic, 
-picnic and superior mesentery plexures, with branches from the vagi 
and splanchnics. Electrical stimulation of the gland itself will cause 

etion, and bo will stimulation of the medulla oblongata. It isarrested 
by powerful irritation of sensory nerves, such as the central end of the 

08, the crural or sciatic, and by the production of nausea or vomiting. 

The secretion is stimulated by the injection of ether into the stomach, 
and appear- to be paralyzed by atropine in the same way as the secretion 
of the Balivary gland. 



ACTION OF DRUGS ON DIGESTIVE SYSTEM. 355 

When fibrin is digested with pancreatic juice the solution soon begins 
to swarm with bacteria and products of decomposition occur, among which 
is indol with a peculiarly disagreeable odor. 

When calomel is added to pancreatic juice it does not impair its 
digestive action upon starch, proteids, or fats, but it arrests decomposition 
and thus prevents the formation of indol and scatol, although leucin and 
tyrosin, which are the normal products of pancreatic digestion, are still 
formed. Salicylic acid has a similar action. 1 

After the administration of calomel the stools are often of a green 
color, and this is due to unaltered bile. From the experiments on biliary 
fistulse already mentioned it is probable that this bile in the motions is 
not due to increased secretion by the liver but to occurrence of diminished 
absorption, caused by its more rapid passage through the intestine, and 
possibly also to lessened transformation from the effect of the calomel in 
preventing its decomposition. 

Anthelmintics. 

These are remedies which kill or expel intestinal worms. 

They have been divided into vermicides, which kill the worm, and 
vermifuges, which expel the worm without necessarily killing it, e.g. y 
purgatives. 

The chief worms which infest the intestine are tape worms, round 
worms, and thread worms. 

The chief Vermicides are : — 

For Thread Worms. — Local injections of alum, iron, lime-water, 
quassia, eucalyptol, sodium chloride, and tannin or substances containing 
it, as catechu, hamatoxylon, kino, rhatany. 

For Round Worms. — Santonin, santonica. 

For Tape Worms. — Areca nut, filix mas, kamala, kousso, pome- 
granate, turpentine. 

As Vermifuges. — Castor oil, scammony. 

Adjuncts. — Ammonium chloride, common salt and iron, and bitter 
tonics, are useful internally in preventing excessive secretion of intestinal 
mucus which affords a nidus for intestinal worms. 

Uses. — They are used to destroy and remove worms present in the 
intestine. In order that the remedies can come into more intimate con- 
tact with the worms, and thus destroy them more easily, it is usual to clear 
out the intestine by a purgative some hours before the administration of 
the remedy, which is usually given on an empty stomach, or with a small 
quantity of milk. After some hours another purgative is given in order 
to bring the worms away. As much mucus in the intestine forms a 
nidus for the worms, remedies which diminish it tend to prevent their 
occurrence. For this purpose preparations of iron and bitter tonics are 
useful. 



Zeitschr. f. physiol. Chem., vi. 2. 



356 PHARMACOLOGY AND THERAPEUTICS. 

CHAPTER XIV. 

DRUGS ACTING ON TISSUE CHANGE. 
Tonics. 

These are remedies which impart permanent strength to the body, or 
its parts. When an individual is loose and limp, and feels unfit for work, 
like a relaxed bowstring, tonics restore his energy and strength, and 
again fit him for work. As their action in this respect resembles the 
effect of tightening a bowstring, they have received their name, which is 
derived from rovoc, tension. The feeling of debility may depend on 
many different causes. It may be due to weakness of the muscles, or 
weakness of the nervous system. Again, the nerves and muscles may 
suffer because the circulation is languid and feeble, or because the blood 
which supplies them is deficient in oxygen, or in nutritive matter. 
These deficiencies again may depend on deficient nutrition, due to 
want of appetite, so that too little food is consumed, or to an improper 
or insufficient diet, or to imperfect digestion, so that it is not assimilated. 
But weakness may be also induced by the accumulation of waste pro- 
ducts in the body, which interfere with the functional activity of the 
muscular and nervous systems; and these products may accumulate, 
because they are formed in excess in the tissues themselves by overwork, 
or in the intestinal canal from imperfect digestion ; or because they may 
be allowed to pass too readily from the intestinal canal into the blood by 
deficient action of the liver. 

Or their excretion may be defective from the kidneys being insuffi- 
ciently active, or the bowels constipated. 

The mode of action of tonics is so manifold that they have been 
divided into blood tonics or hsematinics, vascular tonics, gastric tonics, 
intestinal tonics, and nervine tonics. 

Uses. — In order to ascertain what form of tonic is required, it is 
necessary to determine carefully what part of the organism is in fault. 
In very many cases the imperfect functional activity in the body gener- 
ally, which exhibits itself in languor and weakness, is due to accumula- 
tion of waste products, and not to deficient nutriment. In such cases the 
plan of loading the stomach with food, and giving iron, wine, and beef- 
tea, simply increases the mischief. If it is found on examination of the 
urine that the kidneys are not excreting a sufficient quantity of solids, 
and especially of urea, it is necessary to diminish the quantity of food, 
and especially of animal food, as all, or nearly all, the nitrogen taken 
into the body must be excreted by the kidneys. 

In order that no unnecessary work be thrown on the kidneys, we 
must as for as possible prevent products of imperfect digestion from 
being absorbed from the intestinal canal, and therefore the state of the 
liver must be carefully attended to, and the bowels themselves carefully 
regulated. 

In cases where the debility does not depend upon excessive waste 
products in the Mood and tissues, but upon defective oxidation due to 
deficiency of haemoglobin, the patient must be treated by hsematinics, 



DRUGS ACTING ON TISSUE CHANGE. 357 

such as iron, cod-liver oil, and phosphate of lime. When the digestion 
is imperfect, gastric or intestinal tonics must be used as the case 
requires. 

Where enfeeblement of the stomach appears to be present, as shown 
by loss of appetite, and such signs of imperfect digestion as flatulence or 
weight and pain after eating, gastric tonics are used. Should its mus- 
cular coat be feeble or inactive, as shown by tendency to dilatation and 
splashing of the contents on movement, strychnine is especially indicated, 
and galvanism or systematic kneading may be also employed. Where the 
stomach is too debilitated to respond sufficiently to this form of treat- 
ment, as after long-continued gastric catarrh, or in old age, its work 
must be partly done for it, and then such digestives as hydrochloric 
acid and pepsin are useful. When the muscular movements of the intes- 
tine are sluggish, as indicated by constipation and by a tendency to the 
distension of the bowel with gas, nux vomica and belladonna may be 
given ; and when its mucous membrane appears to be relaxed and flabby, 
and secreting too profusely, the mineral acids, astringents and metallic 
salts may be of much service. When the pulse is soft and feeble, and 
there is a tendency to vascular dilatation, either general or local, as 
shown by local congestion and oedema of the dependent parts, or by drow- 
siness in the upright position and sleeplessness in the recumbent posture, 
vascular tonics are serviceable. Xerve tonics are used where the 
nervous functions are imperfectly performed, as shown by dulness, loss 
of memory, incapacity for work, languor, paralysis, or tendency to spasm, 
as in chorea. As the functions of this system depend very greatly upon 
the quality of the blood with which the nervous system is supplied, and 
on the rapidity of the circulation, the other tonics frequently require to 
be given in addition to nervine tonics. 

Haematinics. 

Blood tonics, blood restoratives, analeptic tonics. — These 
are generally remedies which improve the quality of the blood ; but the 
name blood tonics or haematinics is generally applied specially to such 
remedies as increase the quantity of red blood-corpuscles and haemo- 
globin in the blood. The quality of the blood depends upon a number 
of conditions : upon the amount and nature of the food ingested, on the 
digestion, on the formation and excretion of the various products of 
tissue change, and more especially on the formation and destruction of 
the red blood-corpuscles themselves. 

The red "blood-corpuscles are probably formed in the spleen, 
the medulla of bones, the liver, and possibly other parts of the body, 
from leucocytes which lose their nucleus, take up haemoglobin, and alter 
their forms to that of the red corpuscles. 

The red corpuscles are probably destroyed, at least to a great 
extent, in the liver, and probably also in the spleen. The coloring 
matter of bile contains a quantity of iron, and appears to be formed 
from haemoglobin. 

An abnormal condition of the liver, by leading to excessive destruc- 
tion of blood-corpuscles, may therefore be an important cause of anaemia. 



358 PHARMACOLOGY A1SD THERAPEUTICS. 

The corpuscles contain albuminous matters as well as haemoglobin, and 
deficiency of albumen in the blood will lead to anaemia. Thus, in cases 
of Bright' s disease, the loss of albumen through the kidneys tends to pro- 
duce anaemia, and this must be combated by lessening the loss, if pos- 
sible, as well as by supplying albumen. 

The blood-corpuscles also contain fat, and deficiency of fatty food 
will tend to produce anaemia. Cod-liver oil, on the other hand, which 
is an easily assimilated form of fat, is a powerful haematinic. In anaemia 
there is a deficiency of iron in the blood, and chalybeate preparations 
are among the most powerful of all haematinics. 

One well-marked disease due to imperfect nutrition is scurvy. In it 
there is not only a deficiency of red blood-corpuscles, but a tendency to 
extravasation. Its pathology is not definitely made out, and it has been 
supposed to be due to a deficiency of potash in the blood, but it is much 
more likely that it is due to increase in the chlorides, and especially 
chloride of sodium, either absolutely or relatively to the carbonates. 

Excess of chloride of sodium causes the blood-corpuscles to pass out 
of the vessels (page 73), and potash salts alone, or beef-tea, which con- 
tains them, do not cure scurvy ; but it is removed by fresh vegetables 
or by lime juice. 

Alteratives. 

These are remedies which improve the nutrition of the body 
without exerting any very perceptible action on individual organs. 
The chief alteratives are: — 

Arsenic. Colchicum. 

Mercury. Guaiacum. 

Iodine. Iodides. Stillingia. 

Cod-liver oil. Sanguinaria. 

Sarsaparilla. Xanthoxylum. 

Gold. Mezereum. 

Action. — Healthy nutrition depends (1) upon a proper supply of 
oxygen and nutriment to each tissue and organ in the body, (2) on the 
proper amount and kind of tissue change in the various cells, (3) on the 
proper removal of waste. 

The proper supply of oxygen and of nutriment to the body generally 
will depend upon the state of the respiratory and digestive organs ; their 
proper supplies to the tissues, as well as the removal of waste from them, 
will depend upon the circulation ; and the removal of waste from the 
body generally will depend upon the bowels, skin, and kidneys. 

The drugs which act upon the different organs just mentioned are 
considered under other headings, but the changes which take place in 
the tissues themselves appear to be effected by drugs which produce no 
marked corresponding changes in assimilation, circulation, or excretion. 
It ie uncertain how they act; it is possible that they may alter in some 
way the action of enzymes in the body, but it is also possible that they 
act by replacing the normal constituents of the tissues and forming 
compounds which tend to break up in a different way from those which 
are ordinarily present. 



DRUGS ACTING ON TISSUE CHANGE. 359 

Thus chloride of sodium and nitrogenous bodies such as albumen 
are amongst the most important constituents of the body ; and we find 
that among the chief alteratives are substances which will replace chlo- 
rine, soda, or nitrogen in many compounds. Thus we have iodine and 
iodides, and nitric or nitrohydrochloric acids, which will displace or 
replace chlorine. We have chlorine itself, and chlorides which may 
alter the proportion of chlorides to other salts in the blood and tissues, 
and thus modify the solubility of various constituents of the tissues. We 
have salts of potash and lime, which may replace those of soda ; sulphur 
and sulphides, which may replace oxygen ; phosphorus, hypophosphites, 
antimony and arsenic, which may replace nitrogen ; mercury and its 
salts, which may replace calcium. 

Besides these we have organic alteratives, regarding the action of 
which we can at present form no hypothesis unless they influence the 
processes of digestion. Nitrohydrochloric acids, taraxacum, and small 
doses of mercurials, probably act either by modifying the digestion of 
food in the duodenum and jejunum, or by modifying the changes 
which it undergoes in the liver after absorption. 

The action of drugs upon tissue change has usually been investigated by 
ascertaining the amount of urea excreted before, during, and after the adminis- 
tration of a drug. Most of the older experiments on this subject are of little or 
no value, as sufficient care was not taken to ensure that the amount of nitro- 
genous food consumed each day during the experiment was exactly the same. As 
all the nitrogen taken in the food reappears in the urine, any irregularity in the 
quantity introduced into the body will cause a corresponding irregularity in the 
quantity excreted. After this fact was ascertained the plan adopted by some 
experimenters was to deprive an animal of food for several days until the excre- 
tion of urea due to the gradual destruction of its nitrogenous tissues became 
nearly constant. The plan now adopted is to give to a dog or a man a quantity 
of food of an uniform quality and the amount of nitrogen in which is exactly 
known. The quantity given each day is exactly weighed. The same amount 
of nitrogen is thus introduced into the organism every day, and therefore any 
variations in the amount of nitrogen excreted must he due to changes in the 
organism itself. 

Observations on the excretions of urea only give us a very partial and imper- 
fect knowledge of the process of tissue change, and they ought to be combined 
as in the experiments of Pettenkofer and Yoit, with observations on the amount 
of oxygen absorbed and of carbonic acid given off. Such experiments as these, 
although very valuable, are very laborious, and comparatively few have hitherto 
been made. 1 

From experiments made with those necessary precautions just 
described it has been found that free consumption of water increases tis- 
sue change very considerably, as is shown by the increased excretion of 
urea. 

Common salt, sulphate of soda, phosphate of soda, acetate of soda, 
borax, nitrate of potash, chloride of ammonium, carbonate of ammonium 



1 A complete account of the whole subject is given by Voit in Hermann's Handb. 
d. physiol, Band. VI., Theil. i. This contains also complete references to the litera- 
ture. 



360 PHARMACOLOGY AND THERAPEUTICS. 

and probably all salts which pass out in the urine carrying water with 
them, somewhat increase tissue change and the amount of urea excreted. 
Fats and fatty acids apparently lessen the decomposition of albumi- 
nous tissues and the excretion of urea, but glycerine has no action of this 
sort. Alcohol in small or moderate doses lessens, in large doses increases, 
tissue change. Benzoic acid, salicylic acid and benzamide, all increase 
tissue change and the excretion of urea. Contrary to what perhaps 
might have been expected, tea, coffee and cocoa, have no action whatever 
on the excretion of urea. 1 The experiments which seemed to show that 
they diminished it, appear to have been made without the necessary pre- 
cautions. Morphine slightly diminishes the excretion of urea but its 
action is much more marked on the consumption of oxygen and excre- 
tion of carbonic acid. These are greatly increased in the stage of excite- 
ment and greatly diminished in the stage of quiescence. It would appear 
that these changes are not due to the direct action of the morphine 
but only to the alterations of muscular activity which follow its adminis- 
tration. 

Quinine lessens tissue change, iron appears to increase it, mercury 
also slightly increases it, 2 while iodine appears to have little influence 
upon the quantity of urea excreted. This fact is of itself I think 
sufficient to show that the mere estimation of the quantity of urea 
excreted before and after the administration of a drug is quite insufficient 
to give us any precise information regarding their action on tissue meta- 
morphosis. 

Antimony, arsenic, and phosphorus have a special action on tissue 
change, and powerfully affect the glandular, nervous, respiratory and 
cutaneous systems. In large quantities they affect the liver very 
markedly, producing fatty degeneration ; and this also occurs in other 
tissues. 

This fatty degeneration is due to a twofold action : — 1st, 
increased tissue metamorphosis ; and 2d, diminished oxidation. In the 
normal condition albuminous tissues split up as indicated below : — 






Albuminous e< 
Tissues. s 



Non-nitrogenous l.S f Carbonic acid, 

substances e.g., Fat, &c. | r& "p \ excreted by lungs. 



Nitrogenous e.g., Leucine, c o> f Urea, 

substances, Tyrosine, &c. J Q A \ excreted by kidneys. 



In poisoning by antimony, arsenic, and phosphorus, the nitrogenous 
products of tissue waste appear in much larger quantity in the urine than 
normally, owing to the increased decomposition which is going on. They 
may appear in the urine in the form of an excessive quantity of urea, as 
in cases of phosphorus poisoning in the dog, but in man they may 
appear in the form of leucine and tyrosine. Owing to the diminished 
oxidation the non-nitrogenous substances remain in the body as fat instead 
of being oxidized and passing out of the body as carbonic acid. 

Voit, op. cit 



1 Voit, op. cit. 
Boeck, quoted by Voit, op. cit. 



DRUGS ACTING ON TISSUE CHANGE. 361 

The exact nature of their effect on the nervous system has not been 
made out. Their action on the skin and epithelial cells of the lungs 
seems to be that of causing fatty degeneration. 

Fatty degeneration of the liver occurs also in poisoning by salts of 
silver. 

Mercury has a peculiar power of breaking up newly deposited fibrin 
and of causing disorganization of syphilitic deposits. Iodine, iodides, 
and probably also chlorides, appear to act on the lymphatic system and 
promote absorption : their action is specially well marked in cases of 
glandular enlargement. 

Uses. — In general mal-nutrition without definite symptoms, mercu- 
rials, taraxacum, and nitrohydrochloric acid are used and are especially 
indicated where the liver is suspected to be in fault, as where there are 
symptoms of biliousness, and also where oxalates and urates are found 
abundantly in the urine. 

In gout, potash and colchicum are used. Phosphorus and arsenic 
are employed in nervous debility : and they as well as antimony are ser- 
viceable in neuralgia, chorea, and other nervous diseases. 

In diseases of the skin, arsenic is chiefly employed. 

In diseases of the respiratory organs, antimony is very serviceable 
when the attack is acute ; and arsenic is most valuable in some chronic 
conditions, especially in chronic consolidation, where it probably acts by 
producing fatty degeneration and softening of the effusion, so that it is 
either absorbed or expectorated. 

Mercury is employed specially to break up deposits of lymph and to 
prevent adhesions, as in iritis and pericarditis ; and is also used and is 
most serviceable in the treatment of syphilis. It is most generally em- 
ployed in the secondary stage of this disease : in the third stage it is 
either given along with, or entirely replaced by the use of, iodides. 

Antipyretics, Febrifuges. 

These are remedies which reduce the temperature of the body 
in fever. They act much more powerfully when the temperature is 
abnormally high than when it is normal. 

The constant temperature of warm-blooded animals depends upon the 
maintenance of a proper balance between the amount of heat generated 
in the body, chiefly by oxidation, and on the amount given off to the 
surrounding medium — air or water. The heat is chiefly generated in the 
muscles and glands. It is chiefly given off by the skin, although some 
is also lost by the lungs, etc. 

A little heat, but not much, may be given off by radiation alone. 
The power of dry air to take up heat is very slight, and so the skin is 
not much cooled, and very little sensation of cold is felt at temperatures 
much below 0° if the air is both still and dry. If the air be moist its 
capacity for heat is much greater, and the loss of heat from the skin being 
much more rapid, a person may actually feel the weather colder at 4° F. 
than at -40° F., the air being still in both cases. If air, either dry or 
moist, is in motion, so that fresh portions of it come successively into 
contact with the skin, the loss of heat is much more rapid, and a little 



362 



PHARMACOLOGY AND THERAPEUTICS. 



wind will render even dry air unbearably cold at a temperature which 
would be quite supportable if the air were still. 

It is to be observed that during sleep the action of the vaso-motor 
centre is less, the vessels of the surface dilate, and loss of heat, with dan- 
ger of consequent chill, takes place more rapidly. For the effects of 
local chill to the surface, vide Rossbach's experiments (p. 225). 

Antipyretics may be divided into two great classes : those which 
lessen the production of heat, and those which increase the loss 
of heat ; and these again may be subdivided as shown in the following 
table: — 



Anti- 
pyretics. 1 



Lessen production 
of heat 



Acting on tissue change. 



Quinine. 
Cinchonine. 
Quinidine. 
Cinchonidine. 
Berberin. 
Benzoic acid. 
Carbolic acid. 
Picric acid. 
Salicylic acid. 
Salicylate of soda. 

" quinine. 

" methyl, 

(oil of winter green). 
Salicin. 
Kairin. 
Camphor. 
Eucalvptol. 
Thymol. 

Other essential oils. 
Alcohol. 



f Generally... 






Acting on the circula- 
tion 



Antimony salts. 

Aconite. 

Digitalis. 

i Veratrine. 

I C dchicum. 

f Wet cupping. 
I Leeches. 
-\ Dry cupping. 
I Blisters. 
I Poultices. 



r By dilating the cutaneous vessels f Alcohol. 

and increasing radiation \ Nitrous ether. 



Locally. 



Increase loss of heat 



Mode of action un- 
certain 



By increasing the lossl 
of heat due to evapo- >Sudorifics... 
ration of perspiration J 



_ By abstracting heat from the body- 



Purgatives. 
Venesection. 



f Antimouial prepara- 
J tions. 

] Opium and ipecacuanha. 
I Nitrous ether. 

r Cold bath. 
Cold affusion. 
Cold sponging. 
Wet pack. 
Ice to the surface. 
Cold drinks. 
Cold enemata. 



The mode of action of those which affect the blood and tissues them- 
selves has already been considered tolerably fully under the head of 
" Oxidation of Protoplasm " (p. 77). They appear simply to diminish 
the temperature by lessening oxidation. The mode of action of anti- 
pyretics which produce their effect through the circulation, has not been 
investigated in detail with satisfactory exactitude, but it is supposed that 
by lessening the rapidity of the circulation through those parts of the 
body in which the increased tissue change is taking place, the temperature 
is reduced. 



DRUGS ACTING ON TISSUE CHANGE. 363 

Blisters will have this effect locally by causing contraction of the 
vessels in the inflamed part, as already described under the head of 
Counter-irritants (p. 303). 

Antipyretics, which increase the loss of lieat, may do so (1) 
by causing greater dilatation of the vessels of the skin, and thus allow- 
ing a quicker radiation of heat from the body; (2) by augmenting the 
secretion of sweat : and thus carrying off heat by means of evapora- 
tion ; or (3) they may actually remove warmth from the body, as 
cold baths, cold affusion, cold sponging, wet packing, cold enemata, or ice 
to the surface. 

Uses. — Antipyretics are used to lower the temperature when 
it has risen above the normal, whatever be the cause. A high tempera- 
ture may be produced simply by prolonged exposure to heat. This 
exposure, and the rise in temperature it occasions, seems to induce 
increased tissue change, and this increase of the tissue change will keep 
up a febrile temperature, even after the external temperature has fallen. 
Such thermal fever is found in warm climates, and in it quinine injected 
subcutaneously seems to be very efficient. 

A high temperature may also occur from specific fevers, as typhus, 
typhoid, scarlet fever, measles, and acute rheumatism. The most rapid 
and powerful antipyretic in such cases is the application of cold by 
bathing, or sponging ; and probably next come large doses of quinine or 
salicylate of soda. In typhoid fever, salicylate of soda does not seem to 
act so rapidly as it does in acute rheumatism. 

Venesection, though formerly the antipyretic which was chiefly relied 
upon, has now fallen to a great extent out of use — this is probably from 
its having been very much abused. 

In persons suffering from acute inflammation of the lungs or bronchi, 
where the amount of lung tissue which remains sound is insufficient to 
aerate the whole mass of blood, and the patient is becoming livid, small 
bleedings are serviceable, not only relieving the breathing, but lessening 
delirium which may be present. 

Venesection lowers the temperature for a short time, but it soon rises 
again in many cases, so that bleeding alone is by no means a powerful 
antipyretic, 1 unless the quantity of blood abstracted be so great as proba- 
bly to injure the patient seriously ; yet in combination with other anti- 
pyretics it may sometimes be of very great service. 

Local bleeding- by leeches or by wet cupping- sometimes gives 
very great relief, lessening both local inflammation and the general 
symptomatic fever consequent upon it, in pneumonia, pleurisy, pericar- 
ditis, peritonitis, etc. In such cases blisters may be used to diminish the 
local inflammation, and thus aid the action of other antipyretics. 

Vascular antipyretics, such as aconite and digitalis, also seem to be 
of more service in symptomatic fever than they are in specific fevers. 

Purgatives take an intermediate place between antipyretics which 
lessen the production of heat by acting on the tissues, and those which 
act on the circulation. They diminish the force of the circulation, and 

1 Wunderlich's Medical Thermometry, pp. 118, 134, 378, New Sydenham Society's 
edition. 



364 PHARMACOLOGY AND THERAPEUTICS. 

may in this way lessen the production of heat. It is not impossible also, 
however, although this is a point on which we have not sufficient infor- 
mation, that they may do so by removing from the body substances whose 
effect when present in the circulation or tissues would be to maintain the 
high temperature. 

Amongst antipyretics which increase the loss of heat we have : first, 
alcohol, which is included also in the former list of those which lessen 
the production of heat, for it appears to act in both ways, both diminishing 
oxidation and also increasing the loss of heat. It does this by dilating the 
vessels of the skin and allowing free radiation from the surface, and also 
by the cooling effect of evaporation of the sweat, although its action as 
a sudorific is not very marked. 

We have also the whole class of sudorific s. One of the most 
useful of these in checking a febrile condition just at its onset is a 
dose of compound ipecacuanha powder, or Dover's powder, which has 
now, to a great extent, taken the place of the older remedy, having a 
somewhat similar action, viz., antimonial powder, or James's powder. 

Another mixture in great favor is acetate of ammonia and spirits of 
nitrous ether. The most powerful, however, of all remedies which 
increase the loss of heat are the application of cold water or ice. 



CHAPTER XV. 

ACTION OF DRUGS ON EXCRETION. 

Action of Drug's on the Kidneys. 

The kidney has a twofold office. It has (1) to regulate the amount 
of water in the body under various conditions ; (2) to remove the products 
of tissue waste. These products must be removed in a state of solution 
from the part of the kidney where they are excreted, and yet sometimes 
provision must be made for the water, by which they are washed out, 
being retained in the body. The urine in mammals and amphibia is 
liquid ; in birds and reptiles it is semi-fluid or solid, yet the solid con- 
stituents are removed in solution from the urinary tubules, and the water 
in which they are dissolved is afterwards absorbed. We may say then 
that the kidney has not only a twofold, but a threefold action: — 1st, 
the excretion of waste products; 2dly, a provision for the removal 
of excessive water; and -idly, an arrangement for the retention of 
w ftter in the body by its re-absorption, after it has washed out the waste 
products. On looking at the kidney we find three structures which 
seem to be connected with these three functions, viz.: (1) convoluted 
tubules with epithelial cells, which in all probability are the chief 



ACTION OF DRUGS ON EXCRETION. 



365 



structures for excreting waste products ; (2) the Malpig-hian corpuscles 
for excreting water along with some solids, and (3) usually one or more 
constrictions in the tubule which may serve the purpose of preventing 
too rapid exit of the water, and thus allow time for its re-absorption in 
cases where its retention is desirable, as for example on a hot day and 
when the supply of drinking-water is very limited. 

The process of secretion in the kidney was regarded by Bowman 
as consisting of the filtration of water from the vessels of the glomeruli 
into the tubules, and the excretion of waste products by the epithelium 
lining the tubules. Ludwig, however, came to look upon it rather as a 
process of filtration and re-absorption ; a dilute solution of urea and salt 
being according to him poured out from the Malpighian corpuscles and 
gradually concentrated by the absorption of water in its passage along 
the tubules. This theory had so many facts in its favor that it was for 
a good while exclusively adopted, but latterly Heidenhain in an admirable 
series of experiments has shown that such substances as indigo are 




Fig. 112. — Diagram showing the form of the urinary tubules in different classes of animals, after 
Hiifner. 1. Fish. 2. Frog. 3. Tortoise. 4. Bird. 5. Mammal. The letters have the same signi- 
fication in each. a. Capsule of the glomerulus, b. Convoluted tubule, c. Loop. d. Collecting 
tubule, u in 2 indicates the transverse section of the ureter. 

certainly excreted by the epithelium of the tubules. At the same time 
Hiifner has shown by a comparison of the structure of the kidney in 
fishes, frogs, tortoises, birds and mammals, that the form of the tubules 
closely agrees with that required for the re-absorption of water in each 
case. Fishes have a low blood-pressure, and so the resistance in the 
kidney requires to be small in order to allow of the secretion of urine. 
Living as they do in water, they do not require any apparatus for its 
retention in the body. In them therefore the tubule is short and wi'de, 
and destitute of any constriction which would retard the outflow of fluid. 
In frogs there must be ample provision for the retention of water in the 



66 PHARMACOLOGY AND THERAPEUTICS. 



body, as evaporation takes place freely from their skin. In them we 
find, as we might expect, that the tubule, and especially the contracted 
part of it, is very long. In tortoises no evaporation from the skin can 
take place, and in them the contracted part of the tubule is short. This 
renders it probable that, while the ideas advanced by Bowman and 
supported by Heidenhain are in the main true, the re -absorption of 
water on which Ludwig lays so much stress is also an important factor 
in the secretion of urine under different circumstances. 

But it is not only rendered probable by the facts of comparative 
anatomy ; it appears to be proved by direct experiment. Bibbert 1 
has extirpated the medullary substance of the kidney in the rabbit while 
leaving the cortical substance. He has thus succeeded in collecting the 
urine as it is excreted by the Malpighian corpuscles before it has passed 
through Henle's loops, and has found that the urine secreted by the 
cortical substance alone is much more watery than that which is secreted 
by the entire kidney, a fact which appears conclusively to prove that 
water is actually re-absorbed, and the urine rendered more concentrated, 
during its passage through the tubules of the medullary substance. 

In the frog and triton the arrangement of the kidney is such as to 
allow of a much more complete investigation of the different factors in 
secretion, than in mammals, because in amphibia, the glomeruli which 
separate the water and the tubules which excrete the solids, receive their 
blood supply to a great extent independently. The glomeruli are sup- 
plied by branches of the renal artery. The tubules are supplied by a 
vein which proceeds from the posterior extremities and, entering the kid- 
ney, breaks up into a capillary plexus bearing a somewhat similar rela- 
tion to the renal tubules as that which the portal vein does to the lobules 
of the liver. It is therefore called the portal vein of the kidney. 

The arterial circulation in the glomeruli and the venous portal cir- 
culation round the tubules are not entirely distinct, for the efferent 
arteries of the glomeruli unite with the portal capillaries, and, moreover, 
arterial twigs also pass directly from the renal artery into the capillary 
venous plexus. The two systems are, however, so far distinct that Nuss- 
baum has been able to ascertain with considerable exactitude the part 
played by each in secretion. By ligaturing the renal artery he destroyed 
the functional activity of the glomeruli, and by ligaturing the portal vein 
of the kidney he destroyed that of the tubules. By injecting a substance 
into the circulation after ligature either of the artery or the vein, and 
observing whether it is excreted or not, he determines whether it is 
excreted by the glomeruli or by the tubules. In this way he finds 
that sugar, peptones, and albumen pass out through the glomeruli exclu- 
sively, for they are not excreted when the renal arties are tied. Albu- 
men, however, only passes out through the glomeruli when an abnormal 
change has already occurred in the vascular wall ; as, for example, after 
the circulation has been arrested for a while by ligature of the renal 
artery. Indigo-carmine, when injected after ligature of the renal arteries, 
passes into the epithelium of the tubules, but it does not give rise to any 

etionofwater,so that thebladderis found empty. Urea, on the contrary, 

'Ribbert, Virchow'a Archiv, July, 1883, p. 189. 



ACTION OF DRUGS ON EXCRETION. 



367 



is not only excreted by the tubules after ligature of the renal artery, but 
carries with it, in the process of secretion, from the venous plexus, a 
considerable quantity of water, so that the bladder becomes partially 
filled. 

Branch of renal artery 

Afferent artery to the glomerulus .... .^^ / 

Connecting branch 
Artery passing directly to thel 
plexus (corresponding to one of 
the arterise rectfe). j 

Glomerulus with efferent artery - - -J?- - - - -^. f|||§? ) J? 



Union of arterial and venous 
branches to form the plexus. 



Portal vein of the kidney 

Urinary tubule — 




-Abdominal vein. 



-Small branch connecting the efferent 
artery from the glomerulus direct- 
ly with the abdominal vein. 



Fig. 113.— Diagram of the circulation in the kidney of the newt. Modified from Nussbaum. 

. The excretion of water, therefore, takes place in a double man- 
ner : it passes out through the glomeruli when the renal arteries are free, 
and it passes out from the venous plexus along with urea, even although 
the renal arteries are tied. 




Fig. 114. — Diagrammatic sketch of the blood-vessels in a mammalian kidney; from Schweigger-Seidel, 
Die, Nieren, Halle, 1865. is an artery ascending into the cortical substance of the kidney; p is a 
branch from it which divides into two branches, q and P. q breaks up at once into a number of 
twigs. Pis the afferent artery to a glomerulus, S, of the lowest row. t is the efferent vessel of the 
glomerulus. It divides into two branches, one of which, u, ascends towards the cortex, whilst the 
other, v, descends towards the medulla. 



In the kidneys of the higher animals and of man the glomeruli and 
the tubules do not receive blood from two entirely different sources ; but 
there is an arrangement somewhat similar, for the plexus surrounding the 
tubules does not receive blood only from the efferent vessels of the Mal- 
pighian corpuscles, but gets it also directly from the renal arteries. There 
are three channels by which the blood may pass from the renal arteries 
into the venous plexus without going through the glomeruli. The first is 
the inosculation which takes place between the terminal twigs of the renal 
artery and the venous plexus on the surface of the kidney directly under 



368 



PHARMACOLOGY AND THERAPEUTICS. 



the capsule. 1 The second channel is formed by small branches given off 
directly by the interlobular arteries or by the afferent arteries before 
they reach the glomeruli. The former of these may be regarded as cor- 
responding to the artery which passes directly to the plexus in the newt, 
and the latter to the branch connecting it with the afferent artery (Fig. 
113). These arterial twigs are found not only near the surface of the kidney, 




Arteriae 
rectse. 






Fig. 115.— Diagram of the tubules and vascular supply of the kidney. On the left is a tubule alone ; in 
the middle is a tubule along with the blood-vessels ; on the right are blood-vessels only. 

but, also in the deeper layers of the cortical substance. 2 The third and 
most important channel is afforded by the arteriae rectae, which spring 
from the branches of the renal artery at the boundary between the cortical 
and medullary substance and pass into the medulla, where they form a 
plexus with elongated meshes surrounding Henle's loops and the collect- 
ing tubules. Near their origiD the arteriae rectae inosculate with the 
venous plexus surrounding the convoluted tubules. 



1 Ludwig, Handworterbuch d. Physiol., v., R. Wagner, Brt. 2. 

2 Bchweigger-Seidel, Die Nieren, p. 67; Heidenhain, Hermann's Handbuch d. 
Physiologic, vol. v., Tli. 1, p. 293. 



ACTION OF DRUGS ON EXCRETION. 369 

Through these three channels it is possible for blood to reach the 
secreting structures of the kidney and there get rid of urea, salts, &c, 
without losing water by its passage through the glomeruli. On the other 
hand, if these vessels contract, while the size of the renal artery and the 
pressure of the blood within it remain unaltered, more blood will be forced 
into the Malpighian corpuscles, and thus the quantity of water excreted 
will be increased. At the same time the contraction of the arterise rectae 
will probably diminish absorption from the tubules, and thus the quantity 
of water excreted will be increased in a twofold manner. 

Circumstances Modifying- the Secretion of Urine. — The 
experiments of Ludwig and his pupils have shown that the amount of 
urine secreted depends very closely upon the pressure of blood in the Mal- 
pighian corpuscles, or, to put it more exactly, on the difference of pres- 
sure between the blood in these corpuscles and the pressure within the 
tubules. For if the ureter be tied so that the pressure of urine in the 
tubules is increased, the secretion is greatly diminished, and even arrested, 
even though the pressure of blood in the renal artery be high. 

A somewhat similar effect to that of ligature of the ureter is produced 
by ligature of the renal vein, for the blood accumulating in the venous 
plexus surrounding the tubules compresses them so as to prevent the flow 
of urine through them. A similar condition may occur from cardiac or 
pulmonary disease obstructing the venous circulation. 

But unless under exceptional circumstances which alter the pressure 
within the tubules, such as compression of the tubules by congestion of 
the venous plexus, as in cardiac disease, impaction of a calculus in the 
ureter, or pressure on the ureters by dropsical accumulations or tumors, 
the rapidity of the secretion of urine depends on two factors : — (1) 
arterial pressure in the glomeruli ; and (2) the composition of the 
olood. 

The pressure of blood in the glomeruli may be raised : 

(1) By increase of the arterial tension generally. 

(2) By increased tension locally. 

Such a general increase may be brought about by greater action of the 
heart, or by contraction of the blood-vessels in other vascular areas, such 
as the intestines, muscles or skin, by nervous stimulation, exposure to 
cold, or the action of drugs. 

The pressure may be increased locally by dilatation of the renal 
arteries, e.g., from section of the vaso-motor nerves, or possibly stimulation 
of vaso-dilating nerves. 

In addition to such increase of pressure in the glomeruli by increase 
of blood supply to them, we must not, however, forget the possibility of 
increased pressure in them by contraction of the efferent vessels leading 
from them, as well as of those arterial twigs (arteriae rectae) which pass 
directly to the venous plexus surrounding the tubules, and which form no 
inconsiderable part of the vascular supply of the kidney. 

Alterations in the size of the renal vessels were formerly ascertained 
simply by exposing the kidney and observing its color, contraction of the 
arteries being associated with paleness, and dilatation with redness of 
the organ. A much more exact method has been introduced by Roy, 
who incloses the kidney in a capsule filled with oil and connected with a 
24 



370 PHARMACOLOGY AND THERAPEUTICS. 

registering apparatus. When the vessels dilate, the kidney increases in 
size, and diminishes when it contracts, so that the alterations can be 
readily recorded on the same revolving cylinder on which the general 
blood-pressure is registered by the manometer. 

The pressure of blood in the glomeruli may be diminished gen- 
erally : 

(1) By failure of the heart's action, or 

(2) By dilatation of the vessels of large areas, as the intestines, mus- 

cles, or skin. 

The pressure of blood in the glomeruli may be diminished locally 
by contraction of the renal arteries, or of the afferent branches to the 
glomeruli. 

The heart's action may fail from many causes, which have already 
been discussed more particularly. 

Dilatation of the vessels in the skin, intestines, &c, may be caused 
by exposure to warmth, by the action of drugs, or by paralysis due to 
nervous injury. 

Section of the splanchnics or of the spinal cord causes paralysis of 
the renal arteries, and ought, therefore, to increase the secretion of urine. 
This does occur, though not invariably, when the splanchnics are divided ; 
but section of the spinal cord, by paralyzing the intestinal and other 
vessels, lowers the blood-pressure so much that the supply of blood to 
the kidney is not only much below the normal, but is so small that the 
secretion of urine is generally almost completely arrested. 

The nerves of the kidney consist of a number of small branches 
running along the renal artery and containing a number of ganglia. 
When these nerves are cut the vessels of the kidney dilate; when they 
are stimulated the vessels contract. A number of those fibres pass to 
the kidney from the spinal cord through the splanchnics, so that when 
the splanchnics are cut the vessels of the kidney usually dilate, and 
when they are irritated they contract. 

The whole of the nerves, however, do not pass through the splanch- 
nics, for stimulation of a sensory nerve, of the medulla oblongata, or of 
the spinal cord in the neck, will cause contraction of the renal vessels 
after both splanchnics have been cut, and section of the splanchnics does 
not always cause the renal vessels to dilate. 

The nervous centre for the renal arteries is probably, like the 
chief vaso-motor centre for the body generally, in the medulla oblongata ; 
but in all probability there are also subsidiary centres in the spinal cord 
and in the solar and mesenteric plexuses. 

The reason for supposing these latter centres to exist is, that stimula- 
tion of the peripheral end of the splanchnic, divided at its passage 
through the diaphragm, causes contraction of both kidneys, and the 
vessels of the kidney of the side opposite to the stimulated nerve com- 
mence to contract later than that on the same side. A delay like this 
in the action of the stimulus indicates that it has not acted directly, but 
through the medium of ganglia. 

When the splanchnics are divided the vessels of the kidney some- 
times dilate and the kidney increases in size; a profuse secretion of urine 
may take place, which quickly increases to a maximum and remains for 



ACTION OF DRUGS OX EXCEETIOX 



371 



a considerable time. This, however, is not a constant effect, and not 
unfrequently the vessels do not dilate, and the kidney instead of increas- 
ing, diminishes in size. This is what to a certain extent might be 
expected, inasmuch as a section of the splanchnics causes dilatation of 
the intestinal vessels and lowers the blood-pressure, an thus diminishes 
the supply of blood to the kidney. 

When a puncture is made in the medulla oblongata in the fourth 
floor of the ventricle, profuse secretion also occurs, but this differs from 
that caused by section of the splanchnics, in being preceded by a slight 
diminution, by rising rapidly to a maximum and then rapidly falling. 
These characters seem to show that it is due to irritation of some vaso- 
dilating mechanism, 1 rather than to any paralysis. 

Stimulation of the vaso-motor centre in the medulla oblongata by 
venous blood, or by drugs such as strychnine or digitalis, has a two- 
fold action on the kidney, for it tends to cause contraction not only in 
the vessels of the kidney, but in those of other parts of the body. The 
effect upon the kidney is thus a complicated one, for the contraction of 
the intestinal and other vessels by raising the blood-pressure tends to 
drive blood into the kidneys, at the same time that the contraction of 
the renal arteries tends to keep it out. When the renal nerves are cut, 



£2 



£•§ 




Fig. 116. — Curres showing the effect of erythrophloeum upon the blood-pressure and secretion of urine. 

Froni Phil. Trans., vol. clsviL 

the renal vessels no longer oppose the entrance of blood, and therefore 
the renal vessels dilate very greatly when the vaso-motor centre is stimu- 
lated ; but when the renal nerves are intact the result is a varying one, for 
sometimes contraction of the renal vessels may be so great as to prevent 
the entrance of blood into the kidney, however high the general blood- 
pressure may rise ; at other times the general high blood-pressure may 
be able to dilate the renal arteries in spite of any resistance they may 



1 Heidenhain, Hermann's Handbuch der Physiologie, vol. v., Th. 1, p, 366. 



372 PHARMACOLOGY AND THERAPEUTICS. 

offer. These different conditions may occur subsequently to one another ; 
and this stimulation of the vaso-motor centre may cause contraction of 
the renal vessels succeeded by dilatation, or vice versa. Thus Mr. 
Power and I found that on injecting digitalis into the circulation of a 
dog, the blood-pressure rose, but the secretion of urine was either greatly 
diminished or ceased altogether. Here it is evident that the renal ves- 
sels had contracted so much as to prevent the circulation through the 
kidney, notwithstanding the rise which had taken place in the blood- 
pressure. After a while the blood-pressure began to fall, and then the 
secretion of urine rose much above its normal, showing that the general 
blood-pressure was then able again to drive the blood into the kidneys. 1 

Similar observations were made by Mr. Pye and myself with regard 
to erythrophloeum ; and the accompanying curves show well the result 
upon the urine of the mutual action of the rise in blood-pressure and the 
contraction of the renal arteries upon the secretion of urine. It will be 
noticed that at first the blood-pressure rises more quickly than the secre- 
tion of urine, the circulation through the kidney appearing to be opposed 
by the renal arteries. This opposition is then overcome, and the secre- 
tion of the urine rises more quickly than the general blood-pressure. 
The renal vessels again appear to contract, so that the urine diminishes 
while the blood-pressure rises still further. We have then oscillations, 
due first to one factor and then to the other being predominant; and 
then, when the blood-pressure rises to its maximum, we find that the 
urine is at its minimum, the secretion of urine again rising as the blood- 
pressure falls. 

A good deal of discussion has arisen regarding the mode of action of 
digitalis, and it has been stated by many to act as a diuretic only in 
cases of heart disease, and to have no diuretic action in health. In my 
own experiments, however, I found that it acted as a very marked diu- 
retic even in health, and the explanation of this discrepancy may possibly 
be that, in my own case, the blood-pressure was low, whereas in the 
others it was probably much higher; but I am uncertain regarding the 
true explanation, though I am certain of the fact. 

By causing increased secretion of water through the kidneys diuret- 
ics may increase the concentration of the blood, and thus produce thirst, 
or cause absorption of water from the intercellular tissue or serous cavi- 
ties in dropsies. In my own experiments on digitalis I weighed all my 
food and measured all my drink for nearly six months, taking exactly 
the same quantity every day. After producing profuse diuresis by a 
large dose of digitaline (sixty milligrammes in two days), such thirst 
ensued that I was forced to take a quantity of water to allay it. 2 

Mode of Action of Diuretics. — From what has already been said, 
it is evident that diuretics may act in several ways. They may act: 
A, on the circulation in the kidney, raising the pressure in the 
glomeruli, (1) locally, (a) by contracting the efferent vessels, or the 
arterial twigs which pass directly to the capillary plexus ; (b) by causing 



1 Royal Society's Proceedings, No. 153, 1874. 

2 The experiments were made in 1855, and published in part in my thesis on 
Digitalis, with some Observations on Urine. London: Churchill & Co., 1868. 



ACTION OF DRUGS ON EXCRETION. 



373 



dilatation of the renal arteries, and thus increasing the supply of blood 
to the kidney. This they may do also, in more ways than one, for they 
may either paralyze the vaso-motor nerves of the kidney, or act on vaso- 
dilating mechanisms. (2) they may raise the blood-pressure generally 
by causing the contraction of vessels in other parts of the body. 



Afferent vessels. (?) Dilated by nitrous 
ether, potassium nitrite. 



Efferent vessels. (?) Contracted by digi- 
talis, strychnine, erythrophloeum, squill. 



Tubules. (?) Stimulated by urea and po- 
tassium nitrite, acetate, &c. Caffeine, 
turpentine, cantharidine (?) Paralyzed 
by curare (?) 




Fig. 117. — Diagram to show the parts of the secreting apparatus of the kidney which are probably 

affected by different diuretics. 

B. Other diuretics may act on the secreting- cells of the 
tubules, and may increase both the amount of water and the amount 
of solids excreted by them. 

Diuretics have already been classified as stimulating and sedative; 
and the sedative class agrees very closely with the one which we have 
just indicated as acting on the kidney through the circulation. 

From what has been said of the action of diuretics it is evident that 
we may hope to do much more by combining them than by using them 
singly. Thus we see that digitalis instead of acting as a diuretic may 
completely arrest the renal circulation and stop the secretion altogether. 
If, however, we can combine it with something which will produce dila- 
tation of the renal vessels, while the general blood-pressure remains high, 
we shall greatly increase the circulation through the kidney, and obtain 
the desired result. Experiments in regard to this were made by Grutzner 
with nitrite of soda. He found that this substance increased the secretion 
of urine when the blood-pressure was reduced to a minimum by curare ; 
and he found that it also had this effect when the blood-pressure was 
raised by imperfect respiration. When the vaso-motor centre was greatly 
stimulated however, by allowing the blood to become very venous, the 
nitrite of soda no longer produced any increase of secretion. 



Diuretics. 



Refrigerant Diuretics. 

Water in large quantities. 
Carbonic acid (aerated waters). 
Potassium salts, especially the 

Acetate. 

Citrate. 



Stimulant Diuretics. 

Alcohol. 

Gin. 

Hock. 
Cantharides. 
Blatta Orientalis. 



374 



PHARMACOLOGY AXD THERAPEUTICS. 



Refrigerant Diuretics— continued. 

Potassium salts, especially the 

Bitartrate. 

Chlorate. 

Nitrate. 
Sodium salts, e.g., common salt. 
Hydragogue diuretics — 

Adonis Yernalis. 

Broom. 

Caffeine. 

Colchicum. 

Digitalis. 

Erythrophlceum. 

Nitrous ether. 

Squill. 

Strophanthus. 



Stimulant Diuretics— continued. 

Oleo-resins, resins and volatile 
oils — 

Turpentine. 

Juniper. 

Savine. 

Copaiba. 

Cubebs. 

Black pepper. 

Matico. 

Kava. 

Guaiac. 
Umbelliferous plants chiefly con- 
taining volatile oils — 

Parsley. 

Carrot. 

Dill. 

Fennel. 
Cruciferous plants — 

Mustard. 

Horseradish. 

Asparagus. 
Uva ursi. 
Sarsaparilla. 
Buchu. 
Pareira. 
Chimaphila. 
Taraxacum. 
Ononis spinosum. 
Santonica. 



The following tabular view of the probable mode of action of the 
various diuretics may help to show it more distinctly :- 



Raise arterial 
pressure 



Generally. 



(Increased action of the f digitalis, 
heart ( alcohol. 

Contraction of vessels in intestine and through- 
out the body. 



Locally in 
kidney 



' Contract efferent vessels 
or arterite rectse so as 
to raise pressure in • 
glomerulus and lessen 
absorption in tubules, 
or both. 



Dilate afferent vessels. 



By action on vaso- 
motor centres. 



f Digitalis. 

Erythrophlceum. 
I Strophanthus. 
■ Squill. 

Convallaria. 

Strychnia. 

Cold to surface. 

? The same as in 
preceding list. 



Act on the se- f 
crtting nerves 
or secreting-^ 
cells of the I 
kidney itself. ! 



Increase water excreted. 



Increase solids excreted. 



Urea. 
Caffeine. 



By local action on 
vessels or nervous 
structures in the' 
kidney itself. 

Paralyze vaso-motor 
nerves or involun- 
tary muscular fibre, ■ 
or stimulate vaso- 
dilating nerves. 



? Broom. 
? Turpentine. 
? Juniper. 
? Copaiba. 
? Cantharides. 



Nitrites. 
Alcohol. 
? Urea.* 



{ Liquor potassse. 

1 Potassium acetate, 4c. 



♦When a current of blood is pasted artificially through an excised kidney, the stream is much 
accelerated by the addition of urea. Abeles, Sitz-Ber. d. k. k. Wiener Akad. Bd. 87, Abt. 3, April, 1883. 



ACTION OF DRUGS ON EXCRETION. 375 

Uses. — Diuretics may be employed for the purpose of removing* 
either water or solids from the body. They are used : 

1st, to remove the excess of fluid met with in the tissues and serous 
cavities in cases of dropsy. 

2d, to hasten the removal of injurious waste products and poisonous 
substances from the blood. 

3d, to dilute the urine. 

In cases where the accumulation of fluid depends on venous conges- 
tion, as for example in cardiac dropsy, those diuretics which act on the 
general vascular system, like digitalis, strophanthus, squill or erythro- 
phloeum, are most efficient because they tend to remove the cause of the 
dropsy (p. 295), as well as to assist the absorption and excretion of the 
fluid already effused. 

When the dropsy depends on the disease of the kidneys or liver, 
other diuretics should either be given instead of, or along with, digitalis 
or squill. Even in cases of cardiac disease where digitalis or squill are 
not proving efficacious, the addition of a little blue pill greatly assists 
their action, though it would be hard to say in what way it does so. 

In dropsy depending on kidney disease, decoction of broom, oil of 
juniper, and nitrous ether, are amongst the most reliable diuretics, and 
copaiba in hepatic dropsy. 

Diuretics are used to increase the secretion of solids in febrile con- 
ditions, and in cases of kidney disease where the excretion of waste 
products is deficient, and their retention threatens to prove injurious. 
In such cases, nitrate and bi- tartrate of potash, turpentine, juniper, and 
caffeine are useful. 

Diuretics are also used to increase the proportion of water in the 
urine, and thus to prevent the solids being deposited from it and forming 
calculi in the kidney or bladder ; or even to dissolve again such concre- 
tions as have been already formed. 

Adjuvants to Diuretics. — As the amount of urine secreted 
depends upon the difference in pressure between the blood in the glo- 
meruli and the urine in the tubules, it is evident that any pressure on the 
tubules, whether caused by obstruction of the ureter by a calculus, by 
the mechanical pressure of dropsical accumulations in the abdomen, or by 
distension of the venous plexus in the kidney itself, will tend to lessen 
the secretion of urine. Consequently we sometimes find that in such 
cases diuretics fail to act until the pressure has been relieved by para- 
centesis in cases of dropsy, or the venous congestion lessened by the 
use of a brisk purgative, or by cupping- over the loins. 

If the venous congestion is very great, as in cases of mitral disease 
or of chronic bronchitis with emphysema and dilated heart, bleeding 
from the arm may be advantageous or even imperatively necessary. In 
dilated heart and in mitral incompetence, the action of digitalis on the 
heart itself, strengthening its action and enabling it more effectually to 
pump the blood out of the venous into the arterial system, and thus 
reduce venous congestion, will aid its action upon the kidneys. 

Action of Drugs on Albuminuria. — In the normal kidney no 
albumen passes from the vessels or lymphatics into the urinary tubules, but 
under abnormal conditions it may do so and the urine become albuminous. 



376 PHARMACOLOGY AXD THERAPEUTICS. 

Albuminuria may be produced by ligature or compression of the 
renal artery ; by ligature of the renal vein ; and, though to a less extent, 
by ligature of the ureter. A similar effect to that of ligature of the renal 
artery may be produced by causing it to contract temporarily by means 
of drugs such as digitalis. In the experiments made by Mr. Power and 
myself we noticed that the urine which was secreted after the secretion 
had been completely stopped by digitalis was albuminous. 

Albuminuria is also noticed after poisoning by strychnine, which, as 
Griitzner has shown, has a similar action to digitalis, and in cases of suf- 
focation or of epilepsy, where the vaso-motor center is stimulated by 
venous blood. 

Other drugs appear to cause albuminuria by a direct action on the 
kidney itself. A marked example of this is cantharides, which produces 
both albuminuria and hematuria. Shortly after its injection the kidney 
appears congested and swollen, and on microscopic examination it is found 
that the alterations begin first in the glomeruli and convoluted tubules, 
and gradually extend to the straight- tubules. These changes consist in 
intense congestion, especially of the glomeruli, with increased tension of 
blood in the vessels. Then the liquid constituents of the blood pass 
through the vascular walls, carrying along with them granules, red cor- 
puscles, and white corpuscles. This exudation then passes from the 
glomerulus along the whole length of the tubules, the epithelium of which 
next becomes changed, the cells which line them swelling up, multiplying, 
and becoming modified in form, migration of leucocytes also occurring. 
In short, we have the signs of inflammation beginning in the glomeruli 
and passing along the tubules. 

Lead produces also disease of the kidney, but of a different kind. 
The kidney in animals poisoned by it is pale and granular, with an adhe- 
rent capsule and with atrophy of the cortical substance, in which crystals 
are often present. These appearances are due to chronic interstitial 
nephritis caused by calcareous deposits in Henle's loops. These block up 
the tubuli, produce subacute inflammation of the glomeruli and tubules, 
with atrophy and cirrhosis. A similar result is produced also by mercury. 
Chlorate of potash has a very peculiar action on the kidney. In large 
doses it produces a peculiar kind of hematuria, the urine being dark 
brown and containing large quantities of broken-up blood corpuscles. The 
drug arrests the secretion of the urine by blocking up the tubules with 
plugs of broken-up blood corpuscles. 

Tannin and tannate of soda appear to have a certain power to lessen 
the exudation of albumen through the Malpighian tufts, as Ribbert found 
that when albuminuria was produced artificially in rabbits by temporary 
ligature of the renal artery, both tannin and tannate of soda either les- 
sened or prevented the exudation of albumen. Arbutine, the active 
principle of uva ursi, appears to be still more efficacious, but requires to 
be given in somewhat large doses. 

Lithontriptics. 

These are remedies employed for the purpose of preventing the solids 
of the urine from being deposited, or of causing re-solution. 



ACTION OF DRUGS ON EXCRETION. 377 

One of the most important is the abundant use of water, and some- 
times it is advisable to use distilled water in place of ordinary water, as 
distilled water is free from salts of all kinds. Distilled water has a dis- 
agreeable, flat taste, but it may be made quite agreeable by charging it 
with carbonic acid in a gasogene. 

The substances which most generally are deposited from the urine are 
uric acid, acid urates, oxalate of lime and phosphates ; the two former 
are liable to be deposited when the urine is too acid, and the two latter 
when it is alkaline or neutral. Oxalate of lime also may be deposited 
from faintly acid urine. These substances may be deposited either in 
the kidney or bladder, and thus give rise to renal or vesical calculi. 

The lithontriptics generally employed when uric acid, or acid urates, 
are present, are salts of lithia and potash, as the urate of potash is more 
soluble than the urate of soda, and the urate of lithia more soluble than 
even that of potash. On account of the low atomic weight of lithium 
its salts have the further advantage of combining with a much larger 
relative proportion of uric acid than the salts of potash or soda. When 
phosphates are present, mineral acids, such as phosphoric, are sometimes 
employed, but it is difficult to render the urine acid by the internal admin- 
istration of mineral acids, although it is easy to render it alkaline by 
the administration of alkalies. Benzoic and cinnamic acids, however, in 
passing through the body, are converted into hippuric acid, and they ren- 
der the urine acid. They may either be given alone, or in combination 
with ammonia as benzoate of ammonia, because although ammonia is 
alkaline, yet it appears to undergo conversion into urea in the body, and 
does not render the urine alkaline. 

The deposition of oxalate of lime is usually connected with disturb- 
ances in the digestive system, and I have observed in a hospital ward, 
that a deposit of it is very commonly found in the urine after the patients 
have had cabbage for dinner. The administration of nitro-muriatic acid 
frequently tends to prevent the deposition of oxalates, and this is perhaps, 
on the whole, the best remedy for the form of dyspepsia to which the 
name of oxalic diathesis is sometimes given. Sometimes, however, car- 
bonate of soda, by aiding the digestion, seems to be more beneficial. 

Action of Drugs on the Skin. 
Diaphoretics and Sudorifics. 

The difference between these classes of remedies is simply one of 
degree. When the drugs increase the secretion of sweat only slightly, 
so that it can still evaporate from the skin without running down in drops, 
they are called diaphoretics ; but when they increase it so greatly that 
it can no longer evaporate, and streams down the skin, they are called 
sudorifics. 

The secretion of sweat, like that of saliva, consists in the formation 
of the secretion by the cells of the gland from the material which is 
yielded by the fluid in the lymph spaces around the gland. 

New material is constantly supplied to this fluid by the blood which 
circulates in the vessels. We therefore find that increased circulation 
of blood through the cutaneous vessels and increased secretion of sweat 



Q 



78 PHARMACOLOGY AXD THERAPEUTICS. 



usually accompany one another, but this is not always the case. In the 
sweat glands, as in the salivary glands, the secreting- nerves which 
regulate the activity of the cells are independent of the vascular nerves 
which regulate the capacity of the vessels. In fever or in poisoning by 
atropine the vessels may be widely dilated and the current of blood 
through them rapid, while the secretion of sweat is arrested. On the 
other hand, in dying persons we see a copious secretion of sweat occur, 
while the circulation through the skin has become very feeble or almost 
stagnant. A certain amount of sweat, indeed, may even be secreted by 
amputated limbs, the material for it being afforded by the lymph around 
the glands. But profuse secretion of sweat cannot go on long unless 
the gland is freely supplied with blood, for otherwise the supply of new 
material would cease. Dilatation of the vessels therefore aids the secre- 
tion of sweat. Dilatation may be induced by section of vaso-motor 
nerves or stimulation of vaso-dilating nerves. Thus, when the sympa- 
thetic is cut in the neck of a horse, dilatation of the vessels is produced 
by the section, and sweating occurs on that side. 

The vaso-dilating and secreting nerves of the sweat glands usually 
run together, and by irritation of a nerve trunk, such as that of the 
sciatic, the vessels of the foot may be dilated, and sweating excited. 

Warmth usually increases both the circulation of blood in the skin 
and the secretion of sweat ; while cold has the the contrary effect. 

The nerve centres which excite the secretion of sweat appear to 
be situated in the spinal cord ; the centre for the posterior extremities 
being situated in the upper lumbar and lower thoracic part of the cord 
in the cat ; while that for the upper extremities in the same animal is 
situated in the under part of the cervical part of the cord. 

The sweat glands may be excited to secrete : 

(1) By the action of drugs upon the terminations of nerves in the 

glands. 

(2) By the action of drugs on the sweat centres themselves. 

(3) Reflexly by stimulation of sensory nerves. 

(4) By mental stimuli. 

An example of the stimulation of sweating by the action of drugs on 
the nervous terminations in the glands themselves is afforded by 
pilocarpin, which will cause secretion even when the nerves which connect 
the centres with the glands have been cutt. 

Secretion may be also arrested by the paralyzing action of drugs 
upon the terminal fibres; thus, atropine locally injected, prevents the 
secretion of sweat, however much the nerves going to the gland or the 
nerve centres be stimulated ; and atropine also antagonizes the effect of 
pilocarpine on the nervous terminations, and arrests the secretion which 
the latter causes. 

The nerve centres may be stimulated directly by the condition of 
the blood which is passing through them, or reflexly by irritation of 
sensory nerves. Stimulants of these nerve-centres are: (1) a venous 
condition of the blood ; (2) high temperature of the blood ; and (3) poi- 
sons, especially nicotine. 

A venous condition of the blood is one of the most powerful stimu- 
lants, and it is to this that the sweats which precede death are in all 



ACTION OF DRUGS ON EXCRETION. 379 

probability due, for I have watched a patient dying, and observed that 
drops of sweat appeared on the brow just at the time that the blood 
became venous, as was evidenced by the commencing lividity of the 
finger-nails and lobes of the ears. Under such conditions, while the 
secreting cells are strongly stimulated, the circulation is very feeble. 

A high temperature is also a powerful stimulant. In considering 
its action we must take into account the effect of the warm blood upon 
the sweat centres in the cord, as it circulates through them, and its local 
action also on the sweat glands themselves. Up to a certain point it 
appears to have the effect of dilating vessels and of increasing the 
activity of the glands by acting both on the sweat centres and on the 
periphery. 

Local warmth to one foot increases the secretion of sweat, and local 
cold diminishes it in that foot, when the glands in all four feet of an 
animal are stimulated equally either by excitement of the sweat centres 
or by the action of pilocarpine on the peripheral ends of the sweat 
nerves. 1 

The sweat centres appear to be directly stimulated by nicotine, but 
the action of this drug may be partly due also to a reflex effect on those 
centres through the nerves of the stomach. 

The sweat centres appear to be reflexly excited by severe irritation 
of any sensory nerve passing from the surface of the body, and the point 
at which the irritation is applied does not seem to be of much impor- 
tance. They are probably stimulated reflexly from the stomach, as in 
the sweating which accompanies nausea. 

The power of the brain to stimulate the sweat centres is shown in 
the effect of mental emotion, and direct irritation of the medulla oblon- 
gata will cause sweating in cats even some time after death. 

Excretion by the Sweat Glands. — A number of substances taken 
into the body pass out in small quantities through the skin. Aromatic 
and volatile substances appear to pass readily, so also benzoic acid, 
hippuric and cinnamic acid, tartaric acid, succinic acid, iodide of 
potassium, quinine, corrosive sublimate, arseniates of soda and potash. 
When arseniate of iron has been taken, curiously enough, arsenious 
acid has been found in the sweat and iron in the urine. Some 
coloring matters are excreted especially by the skin of the arm- 
pits, and the underclothing may sometimes be found stained of a 
brick-red color at these parts. I have observed this in some cases 
after drinking claret or port, but it only occurs exceptionally after the 
employment of these wines, and it is possible that it is due to adultera- 
tion with foreign coloring matters, for I have also noticed it in cases 
where no wine has been drunk, but where pickled red cabbage or beet- 
root has been eaten. 

Relation between Sweat Glands and Kidneys. — The sweat 
glands and the kidneys both remove water and small quantities of salts 
from the blood, and thus tend to keep it at its normal concentration. 
Their functions are complementary, so that when much water is excreted 
by the skin less is excreted by the kidneys, and vice versa. 

1 Luchsinger, Pfliiger's Archiv, 1876, vol. xviii., p. 480. 



380 PHARMACOLOGY AND THERAPEUTICS. 

The amount of sweat and of urine is in inverse ratio — when the skin 
acts more, the kidneys act less. This is to a great extent due to the 
different distribution of blood under varying conditions, because when 
both are stimulated, as, for example, by salts of ammonia, diuresis will 
occur, if the blood be driven towards the kidneys by external cold ; and 
diaphoresis if it be attracted to the skin by external warmth. 

The quantity of solids contained in the sweat is very small, only a 
little over one per cent. — three-fourths of these being organic, and one- 
fourth inorganic. The organic are chiefly fats, fatty acids, and small 
quantities of urea — about one-tenth per cent. When the kidneys are 
insufficient, however, to excrete urea, the quantity in the sweat becomes 
greatly increased, and it has even been found crystallized upon the skin. 

Action of the Skin in Regulating- Temperature. — As I have 
already mentioned, the skin has an excreting function complementary to 
that of the kidneys, and it may to some extent relieve them when they 
are doing their work imperfectly. But its chief function is that of regu- 
lating the bodily temperature. The quantity of heat which is changed 
into potential energy, in converting liquid water into gaseous steam, is 
very great. Five and a half times as much heat is required to convert 
boiling water into steam, as to raise the same amount of water from the 
freezing to the boiling point. The immense loss of heat thus occasioned, 
converts the healthy skin under the influence of great heat into an actual 
cooling apparatus. In negroes on the west coast of Africa it has been 
noticed that while the skin is perspiring profusely, it is as cold as marble, 
and Sir Charles Blagdon observed that in a room with a temperature of 
198° Fahr. his side felt quite cold to the touch. 

Uses. — Diaphoretics are used in cases of threatened catarrh or 
inflammation of mucous or serous surfaces, or internal organs after expo- 
sure to cold. Their beneficial action in such cases may be partly due to 
the withdrawal of blood from internal organs to the surface of the body by 
the use of diaphoretics, but it is not improbable that in addition to this the 
condition of the skin which they induce exercises a favorable action 
reflexly on internal parts. There seems to be a sort of complementary 
action between the skin and the internal mucous membranes, as well as 
between the skin and kidneys. This is sometimes well marked in gouty 
patients where the disappearance of an eruption from the skin is followed 
by asthma, and vice versa. It is also shown by the experiments of 
Rossbach (p. 225) ; and the effect of irritation of the stomach and nausea 
on the secretion of the skin has already been noticed. 

One of the best diaphoretics to cut short commencing catarrh is com- 
pound ipecacuanha powder. In fevers, with the exception of rheumatic 
fever, the skin is generally dry although the temperature is high, and 
diaphoretics are employed to increase the cutaneous secretion, and thus to 
lower the temperature. 

In exanthemata, after the eruption disappears from the skin, there is 
a tendency to inflammation of internal organs, and in order to prevent 
this diaphoretics arc used, those which act markedly on the vessels, or 
stimulating diaphoretics, being especially indicated. 

The advantage of a free supply of blood in chronic morbid conditions, 
sucl i as chronic ulcers has already been mentioned when speaking of 



ACTION OF DRUGS ON EXCEETION. 



381 



irritants (p. 301) ; and in chronic morbid conditions of the skin diapho- 
retics are sometimes employed to promote the cutaneous circulation. In 
diseases of the kidneys, when it is advantageous to lessen their functional 
activity, diaphoretics are employed in order to make the skin act vigor- 
ously ; and they are used also to assist the kidneys in removing the fluid 
which has already accumulated in the body in cases of dropsy. When 
the kidneys, though not diseased, are called upon to do excessive work — 
as in diabetes mellitus, or polyuria — diaphoretics are employed to aid 
them. Where an unnatural secretion of fluid is taking place from the 
intestine, as in cases of chronic diarrhoea, diaphoretics are also employed 
to divert secretion from the intestine to the skin and thus lessen the diar- 
rhoea. 

Antihydrotics or Annydrotics. 

These are substances which lessen the secretion of sweat : — 



Acids. 

Belladonna and Atropine. 

Hyoscyamus. 

Amarita muscaria and muscarine. 



Agaricus albus. 



Jaborandi and Pilocarpine. 

Nux vomica and Strychnine. 

Quinine. 

Picrotoxine. 

Ipecacuanha (compound powder). 

Zinc salts. 



These remedies may act (1) on the sweat glands themselves by les- 
sening the excitability either of the secreting cells or of the secreting 
nerves ; (2) on the sweat centres, by lessening their excitability or 



Motor nerves of thorax 

Motor nerves of diaphragm. 



Diaphragm 

Nerves to sweat glands. 




Respiratory centre — more 
readily stimulated by 
venous blood than the 
sweat centres in the 
spinal cord. 

Carotid artery and verte- 
bral arteries supply- 
ing the respiratory 
centre with blood. 



Sweat centres in spinal 
cord with arteries car- 
rying blood to them, 
and with nerves pass- 
ing to sweat glands. 



Fig. 118.— Diagram to illustrate the action of antihydrotics. The secretory nerves passing to the sweat 
glands from the sweat centres in the spinal cord have been represented as a single nerve for the 
sake of simplicity. 

removing the excitant; and (3) on the circulation. Belladonna in 
large doses paralyzes the ends of the secreting nerves, just as it does in 
the salivary glands, so that the sweat glands will not secrete even when a 



382 PHARMACOLOGY AND THERAPEUTICS. 

strong stimulation is applied to their nerves. As belladonna acts thus 
when locally applied, it may be used for local sweating in the form of 
extract or of solution of atropine painted on. or rubbed over, the surface. 
It is thus useful in cases of local sweating of the palms of the hands and 
soles of the feet. It may also be given internally to paralyze the ends of 
the secreting nerves, and thus to arrest the night sweats in phthisis. But 
in all probability its beneficial effect in the night sweats of phthisis it not 
dependent on its paralyzing action on the secreting nerves, for it is useful 
in doses which appear to be too small to produce this effect, and which 
also do not act immediately, but rather after some time. Its utility in 
such cases, therefore, is probably due to an effect on the nerve-centres, 
and especially to a stimulating action on the respiratory centre. 

The night sweats of phthisis are usually followed by great weak- 
ness and prostration, which has sometimes been attributed to the loss of 
salts and organic matter contained in the sweat. But the quantity of these 
is very small, and the same depression is not noticed when there is an 
increase of two or three ounces in the daily secretion of urine, although 
it will carry off quite as large a quantity of both salts and organic mat- 
ter. Xor is the same depression produced by the profuse sweating due 
to active exertion, nor even by the sweating in ague. The depression 
is not the consequence of the profuse sweat ; both are probably the con- 
sequence of one common cause. This cause I believe to be partial fail- 
ure of the respiration and consequent accumulation of carbonic acid in 
the system, which leads at the same time to stimulation of the sweat cen- 
tres and impairment of tissue change throughout the body generally. 

In healthy persons the respiratory centre is more sensitive to the 
stimulus of carbonic acid than other parts of the nervous system. Thus 
any increase in the venosity of the blood at once stimulates this centre, 
and through it the diaphragm and respiratory muscles of the thoracic 
wall, rendering the respiration more active, and increasing arterialization. 
Consequently, the blood does not become venous enough to stimulate the 
sweat centres. But when the respiratory centre is depressed by excessive 
reflex stimulation during the day in the process of coughing, and by the 
natural depression which occurs during sleep, it may respond less readily to 
the stimulus of venous blood. The amount of carbonic acid in the 
blood may thus accumulate to such an extent that the sweat centres are 
stimulated before the respiratory centre responds, and thus the profuse 
sweats which are so depressing to the patient may occur. 

It is probable that this is only part of the truth, and that there are 
other factors in the production of abnormally profuse sweats ; for in chil- 
dren suffering from rickets, the head perspires profusely during sleep, yet 
the mucous membranes are of a bright rosy color. Nevertheless, acting 
on this idea, I have given at night such substances as are powerful stimu- 
lants to the respiratory centre, like nux vomica and strychnine, and I 
have found that the sweating is usually arrested by them. A small dose 
is sometimes sufficient, but occasionally it must be steadily increased until 
as much as half a drachm of the tincture of nux vomica is given at once. 
The only disadvantage that I have noticed from this treatment is that the 
excitability of the respiratory centre sometimes persists during the day, 
and renders the cough more troublesome. I have tried to remedy this 



ACTION OF DRUGS ON EXCRETION. 383 

by combining strychnia with opium, and partially succeeded. If we now 
review the remedies used in the night sweating- of phthisis, we shall 
see that almost every one of them has a stimulant action on the 
respiratory centre. It is possessed in a marked degree by atropine 
and hyoscyamus. Ipecacuanha has this action also, and its combination 
with opium, in the form of Dover's powder, although it causes sweating 
in healthy persons, tends to restrain it in phthisical patients. Picrotoxine, 
salts of zinc, and pilocarpine, all stimulate the respiratory centre also, 
and we find that the last is useful in the night sweats of phthisis, although 
we would expect from its physiological action that it would be injurious, 
stimulating, as it does, the terminations of the secreting nerves in the 
sweat glands themselves. It is possible, however, that in addition to the 
stimulation of the sweat centres by venous blood, the night sweats of 
phthisis may be sometimes increased by the liig'li temperature of the 
patient, and in such cases quinine, as Murrell has pointed out, is likely 
to be most serviceable. 



Action of Drugs on the Bladder. 

The walls of the bladder consist of involuntary muscular fibre which 
expels the urine by its contraction. Around the neck of the bladder is 
a band of involuntary muscular fibre, the sphincter vesicae, which by its 
contraction closes the orifice and prevents the escape of urine. The 
sphincter vesicae receives its motor supply through the third, fourth and 
fifth sacra nerves. 

The nerve-centre for the movements of the bladder is situated in 
the spinal cord opposite the fifth lumbar vertebra in dogs, and the 
seventh in rabbits. This centre is able to regulate the retention and 
discharge of the urine by the bladder even when the spinal cord is divided 
between it and the brain, but the activity of the centre under normal 
conditions is modified by the brain, so that we may consider that there is 
a cerebral as well as a spinal centre for the bladder. The spinal centre 
may be set in action either reflexly, or by stimuli passing down from it to 
the brain. The cerebral centre may be set in action either reflexly or 
voluntarily. 

Usually when the pressure of the urine within the bladder is increased 
beyond a certain limit depending not only on the quantity of the water, 
but on the state of the contraction of the bladder itself, the neck of the 
bladder becomes slightly dilated, and a drop of urine exuding acts as a 
stimulus to the sensory nerves of the urethra, and thus calls reflexly into 
action the centre in the spinal cord by which at the same time the sphincter 
vesicae is inhibited, and the detrusor urinae stimulated. Reflex action 
may also be induced by stimulation of other nerves, as for example by 
the application of a wet sponge to the anus or perinaeum. The cerebral 
centre is usually called into action by the sensation of the bladder being 
full. It may be called into action voluntarily, although there is little 
urine in the bladder ; and also may be excited by emotion, such as fear. 

It maybe also excited reflexly through the sense of hearing. Boer- 
haave was accustomed when patients found difficulty in passing water, to 
make an attendant pour water from a height into a basin in the patient's 



384 PHARMACOLOGY AXD THERAPEUTICS. 

hearing. The splashing thus occasioned induced the patient to pass 
water, and a similar effect, as is well known, is produced on horses by 
whistling. Nervous agitation has often the contrary effect of producing 
retention of water. When it is desirable for a person to pass water — 
e.g., when a specimen of urine is wanted for examination — it is advisable 
to put him in a room by himself and turn on a tap within his hearing. 
The removal of the restraint exercised by the presence of another per- 
son, along with the stimulant action of the sound of falling water, rarely 
fails to produce the desired effect. Even the recollection of the sound 
of falling water will tend to cause evacuation of the bladder, and when 
there is difficulty in passing water the patient may sometimes obtain 
relief by thinking of a waterfall. Washing the hands in cold water 
also tends reflexly to cause evacuation of urine, and the effect of a wet 
sponge to the perineum has already been mentioned. 

Vesical sedatives are substances which lessen the irritability of 
the bladder, and thus remove pain, and lessen the desire to urinate. 
This desire may be excited not only by the presence of urine in the 
bladder, but by the irritation of calculi or inflammation of the mucous 
membrane of the bladder itself. When calculi are a source of irritation, 
carbonate of lime taken internally seems to lessen the irritability. In 
cystitis the irritation is diminished by the use of very hot water exter- 
nally, in a bidet or hip-bath. The irritability of the nerves may be 
diminished by opium, belladonna, and hyoscyamus, and by drinking 
freely of warm water, either alone, or in the form of an infusion or decoc- 
tion of some mucilaginous substance, e.g., linseed-tea or barley-water. 

In chronic inflammation the irritation may be diminished by astrin- 
gents, such as buchu, uva ursi, pareira brava, and alchemilla. Vesical 
tonics are substances which increase the contractile power of the mus- 
cular fibres in the bladder. They are therefore useful in two different 
conditions, for by strengthening the detrusor urinre they prevent reten- 
tion, and by strengthening the sphincter vesicae they prevent incon- 
tinence. 

Some of these remedies appear to act by increasing the stimulating 
power of the urine, so that the sphincter vesicae is consequently more 
firmly contracted — of this class is cantharicles. Others appear to alter 
the direction of reflex action — such are the passing of a bougie through 
the urethra once or twice a day, or the application of an injection of 
nitrate of silver, ten to thirty grains to the ounce, to the neck of the 
bladder. Others act on the nerve-centres, and apparently are useful 
sometimes by lessening the reflex susceptibility from the bladder, so 
that the detrusor urime is less called into action ; at other times by 
increasing the susceptibility of the nerve-centre, so that the sphincter 
vesicae is more firmly contracted — of the latter class is strychnia; to the 
former belong bromide of potassium, given at night. Belladonna, 
which is one of the most useful remedies in incontinence of urine, acts 
upon the nerve-centres, but whether it acts in the same way as strych- 
nine or as bromide of potassium, it is difficult to say. It is quite pos- 
sible that it lessens the sensibility of the bladder to changes in pressure 
-within it in somewhat the same way as it lessens the sensibility of the 
heart to changes in blood-pressure (p. 203). 



ACTION" OF DRUGS ON EXCRETION. 385 

Urinary Sedatrves and Astringents. 

When the urinary passages are healthy, the secretion of mucus 
from them is very slight, and the presence of urine in the bladder, or 
its passage along the urethra usually gives rise to no pain. Pain and 
scalding are sometimes caused by an abnormally acid urine, or by the 
presence of crystals of uric acid in it, even though the mucous mem- 
brane itself be healthy. In such cases the use of potash or lithia is 
indicated to restore the healthy character of the urine. 

When the bladder itself is irritable or inflamed, the secretion of 
mucus is increased and there is constant desire to micturate. There are 
here two indications to be fulfilled ; one is to lessen the irritability, and 
the other is to remove the inflammation. In lessening the irritability, 
belladonna seems to be especially useful, and to diminish the inflamma- 
tion astringents are employed. 

In inflammation of the urethra the same indications exist, and here 
also cubebs, copaiba, and sandal-wood oil are employed. It is, however, 
easier to apply astringents locally to the urethra than to the bladder, 
and consequently astringent injections are more frequently used : these 
are usually solutions of alum, sulphate or acetate of zinc, and acetate of 
lead. 

Finely-divided powders act also beneficially by keeping the inflamed 
walls of the urethra apart, and on this account a mixture of sulphate of 
zinc and acetate of lead, which gives a fine, white, insoluble precipitate 
of sulphate of lead, is more efficacious than either of the solutions 
employed alone. Kaolin or china clay, which is a completely inert 
powder, as well as bismuth and calomel, have also been used for a similar 
purpose. As it is found that the secretion in gonorrhoea frequently, if 
not always, contains microscopic organisms, the injection of antiseptics 
has been used; among these may be mentioned permanganate of potash, 
boracic acid, carbolic acid, sulpho-carbolates, sulphurous acid, as well as 
drugs having both an astringent and antiseptic action, like chloralum, 
perchloride and pernitrate of mercury, and chloride of zinc. 

The beneficial effects of copaiba in inflammation of the bladder and 
urethra are probably due to its antiseptic action. It is excreted in con- 
siderable quantities by the kidneys and renders the urine antiseptic, so 
that its decomposition and the appearance of bacteria in it are greatly 
retarded or completely prevented. The whole urinary passages from 
the glomeruli of the kidneys to the orifice of the urethra are thus washed 
out by antiseptic urine, which does not decompose, and which tends to 
destroy or remove any germs that may be present. Cubebs and terpenes 
have probably a similar action. 1 



1 Schmiedeberg, Arzneimittellehre, p. 121. 



25 



386 PHARMACOLOGY AND THERAPEUTICS. 

CHAPTER XVI. 

ACTION OF DRUGS ON THE GENERATIVE SYSTEM. 
Aphrodisiacs and Anaphrodisiacs. 

The sexual function is regulated by two nerve-centres, one of which 
is cerebral and the other spinal. The cerebral centre is the seat of 
the feelings and appetite which prompt the individual to seek sexual 
congress. 

The spinal centre regulates the condition of erection in the sexual 
organs which is necessary for coitus. These two centres may act inde- 
pendently of each other, e.g., when the spinal cord is cut, but in the 
normal condition they naturally influence each other, excitement of the 
spinal centre reacting on the cerebral centre so as to awaken sexual feel- 
ings, and excitement of the cerebral centre reacting on the spinal so as 
to produce erection of the genital organs. 

Erection is due partly to dilatation of the arteries in the erectile tis- 
sues of the genital organs, and partly to compression of the efferent veins. 
The blood being thus allowed to flow freely into the organs, and pre- 
vented from flowing out, distends them so as to render them turgid and 
more or less rigid. During the orgasm the turgidity is increased by par- 
tial stoppage of respiration, which, by rendering the blood venous and 
thus stimulating the vaso-motor centre, tends to raise the blood-pressure 
in the body generally, and in the erectile tissues particularly. 

Dilatation of the arteries in the genital organs and consequent erec- 
tion occurs on stimulation, either of the genital centre in the lumbar 
spinal cord or of the vaso- dilating nerves (nervi erigentes) which pass 
from it to the genital organs and end in a ganglionic plexus surrounding 
the arteries. 

The lumbar genital centre may be excited either reflexly by stimu- 
lation of the sensory nerves of the genital organs and adjoining parts, or 
by psychical stimuli transmitted to it from the brain. 

The exact seat of the cerebral genital centre has not been determined, 
but Eckhard has found that irritation of the crura cerebri can produce 
similar effects to stimulation of the nervi erigentes. 

The cerebral genital centre may be stimulated and sexual feelings 
aroused by impressions made on the nerves of special or general sense, 
e.g., on the eye, ear, nose, on the mammae, and general surface of the 
body, the genital organs and parts adjoining, as the bladder, prostate, 
and nates. Thus, sexual excitement may occur in consequence of the 
sight of persons or pictures, the reading or hearing licentious stories, or 
of irritation of the surface of the body either by gentle friction or by 
prurigenous irritation due to irritating articles of clothing, parasites, or 
skin diseases. Distention of the bladder has a somewhat similar effect, 
and the irritation consequent on an enlarged prostate is probably, in part 
at least, the cause of the great sexual excitement which sometimes occurs 
in elderly men. A very acid condition of the urine, such as is found in 
some gouty patients, may possibly have a similar action. Chlorate and 



ACTION OF DRUGS ON GENERATIVE SYSTEM. 



387 



nitrate of potash administered internally are said by Jacobi 1 to render 
the urine so irritating and to produce such sexual excitement as to lead 
to onanism. Ascarides in the rectum may cause excitement of the cere- 
bral genital centre and give rise to nocturnal emissions as well as pos- 
sibly to diurnal excitement, and in females they may cause even greater 



Optic nerves 

Auditory nerves 

Olfactory nerves 

Nerves of mammae and general surface, 



Nervi erigentes passing to the genital 
arteries 

Sensory nerves of the genital organs... 



prostate and bladder 
perineum and rectum 




— Sensory nerves of nates, and 
rectum. 



Fig. 119. — Diagram to illustrate the action of aphrodisiacs and anaphrolisiacs. The darkly-shaded 
spot indicates the genital centre in the brain, and the lighter spot the spinal centre in the lumbar 
portion of the cord. The direction in which impulses are conveyed along tbe nerves are indicated 
by the arrows. The nerves from the general surface have been represented as going to the cerebral 
centre, and acting through it on the spinal centre. It is probable, however, that several of them 
pass directly to the spinal centre, as represented in the case of the nerves of the nates. 

irritation by passing into the vagina. Irritation of the rectum from the 
presence of piles or fissure may also give rise to such great sexual excite- 
ment as to induce onanism or nymphomania. Faeces in the rectum, and 
perhaps in the colon, may also cause sexual excitement in some persons 
or increase it when present. 

Such sources of local irritation may sometimes be insufficient to affect 
the cerebral centre during waking hours, when the attention is otherwise 
engaged, but may do so powerfully during sleep, or when the cerebral 
functions are disturbed by cannabis indica, and they may then produce 
erotic dreams or seminal emissions. 

The lumbar centre is most readily excited by mechanical stimulation 
of the genital organs, but it may be also powerfully stimulated from the 
mucous membranes of the urinary passages, as is seen in the painful 
priapism which occurs in poisoning by cantharides. 

Stimulation of the lumbar centre without stimulation of the cerebral 
centre may occur from the presence of faeces in the rectum and perhaps 
in the colon, so as to give rise to seminal emissions during sleep unac- 
companied by any dreams of a sexual character. 

Aphrodisiacs. 

These are medicines which increase the sexual appetite. 

Irritation of the nates either mechanically alone by flogging or 



1 Medical Times and Gazette, 1876, vol. i., p. 177. 



388 PHARMACOLOGY AND THERAPEUTICS. 

mechanically and chemically combined by urtication or flogging with 
nettles has been used as an aphrodisiac. 1 

The sexual function requires, however, for its proper performance a 
healthy state of the body, and good, or at least fair, nutrition ; without 
these, mere reflex excitement of the genital centres is likely to prove 
inefficient for the propagation of the race. Tonics generally, such as 
iron, are therefore to be regarded as indirect aphrodisiacs. 

Strychnia has probably a double action, both increasing the general 
nutrition and rendering the genital nervous centres, both lumbar and 
cerebral, more susceptible to the action of stimuli. Its aphrodisiac 
action is sometimes an objection to its use as a tonic, for both it and nux 
vomica may cause seminal emissions which more than counter-balance 
its tonic action and weaken the patient. 

Cannabis indica has been regarded as an aphrodisiac, but the trials 
of it made in this country seem to show that it does not itself at least 
have any such action, and merely induces a condition of partial delirium 
in which Easterns may possibly have visions of a sexual nature, and, 
indeed, they try to give a sexual direction to the mental disturbance which 
the cannabis produces, by mixing with it musk, ambergris or cantharides. 

Cantharides act as an aphrodisiac, but their action is probably due 
to their irritating effect on the mucous membrane of the urethra, and its 
use in such doses as to have any aphrodisiac action is attended with 
danger. Blatta orientalis when used as a diuretic may have an aphro- 
disiac action like cantharides. 2 

Alcohol appears to excite the cerebral centre and increase the sexual 
appetite, while it partially paralyzes either the lumbar centre or the 
nervi erigentes, through which the centre acts on the genital organs and 
thus interferes with the proper performance of the generative act. 3 



Anaphrodisiacs. 

These are medicines which diminish the sexual passion. 
The agents employed as anaphrodisiacs are: — 

Ice. Conium. 

Cold baths, local and Camphor. 

general. Digitalis. 

Bromides of potassium and Purgatives. 

ammonium. Nauseants, and 

Iodide of potassium. Bleeding. 

Anaphrodisiacs may act locally on the genital organs, or may act 
upon the genital nerve-centres. 

The effect on the nervous system may be directly exerted on the 
nervous structures themselves, on the circulation, nutrition, and general 



1 Trousseau et Pidoux, Traite de Thcrapeutique. 

2 Buttenwieser, Der practische Arzt, Feb., 1882. 
:i Shakespeare, Macbeth, act ii., scene iii. 



ACTION OF DRUGS ON GENERATIVE SYSTEM. 389 

surroundings. Amongst the most powerful local anaphrodisiacs is the 
continuous application of cold by means of ice. Bromide of potassium 
possibly has also a local as well as a general action. 

When the lumbar portion of the cord is abnormally stimulated 
reflexly, the stimulus ought to be removed: thus, in warm countries, 
where smegma may accumulate around and irritate the glans penis, very 
careful washing is requisite and circumcision is an advantage. Both in 
warm and cold countries, circumcision, either general or partial, is useful 
if the prepuce be very long and its orifice much contracted. 

When the irritation appears to arise from the presence of very acid 
urine, or of crystals of uric acid irritating the bladder or urethra, as in 
gouty persons, potash or lithia should be employed to lessen the acidity 
of the urine, or to render it neutral. Where abnormal irritation of the 
genitals is present the urine should be examined for sugar as well as for 
uric acid, as the sugar may cause local irritation of the prepuce or vulva. 

Distention of the bladder ought also to be avoided, and in persons 
who suffer from seminal emissions, occurring in the morning, it is occa- 
sionally advisable that they should be awakened and empty the bladder 
an hour or more before their usual time of rising. 

If stone in the bladder is acting as an irritant, surgical treatment 
should be employed, but in cases where this is inadvisable, or where the 
irritation is dependent on enlarged prostate, general anaphrodisiacs must 
be used, such as bromide of potassium in large doses, care also being 
taken that the condition of the urine is not abnormally acid or alkaline. 
Ascarides in the rectum must be treated with anthelmintics. When 
irritation arises from piles the use of sulphur internally is often bene- 
ficial, though surgical interference may be necessary both for them and 
for fissure. 

When irritation arises from faecal accumulations in the rectum or 
colon, they should be removed and their return prevented by the careful 
use of aperients. 

As anything which tends to increase the flow of blood to the genital 
orgajis or the lumbar portion of the spinal cord heightens their excita- 
bility, care should be taken not only to avoid this, but also to direct as 
much as possible the current of blood to other parts of the body. Thus, 
warm and heavy clothing or pads about the hips or loins should be 
avoided, and a hard mattress should be used in the place of a feather bed. 
Sometimes patients suffer from emissions in consequence of lying on their 
back. This is probably due to the effect of warmth on the spinal cord, 
and in order to avoid it, a towel or girdle should be put around the loins 
with a knot tied in it, or some hard substance fastened on it opposite the 
spine, so that the person would, even during sleep, be prevented from 
lying on his back. Walking exercise is not so useful as exercise of the 
arms, as in rowing, gymnastics, or mechanical occupations, such as those 
of a carpenter or blacksmith, because, in walking, the current of blood 
passes towards the lower extremities and part of it may become directed 
to the pelvis. In the other occupations just mentioned, the current of 
blood is, on the contrary, directed to the upper extremities. Working a 
treadle, as in turning a lathe or sewing machine, is objectionable, both 
because the blood is directed towards the lower extremities generally and 



390 PHARMACOLOGY AND THERAPEUTICS. 

because it may become specially directed to the genitals by occasional 
friction of the clothes. 

Hard mental work has also a similar effect to that of bodily exer- 
cise. In addition to these measures, a meagre diet, and especially a 
vegetable diet, with the avoidance of stimulants, is of considerable service. 

Emmenagogues and Ecbolics. 

Emmenagogues are remedies which restore and regulate the 
normal menstrual flow when it is absent or deficient or irregular. 

Ecbolics are remedies which cause the expulsion of the contents 
of the uterus. 

In menstruation both ovaries and uterus become congested. An 
ovum is discharged, and a flow of blood occurs from the uterus. Dimi- 
nution or absence of the menstrual flow may be occasioned either by 
general or local conditions : thus great debility or anaemia may cause it, 
and it is very frequent indeed in the anaemia and debility which are con- 
sequent on the occurrence of slight consolidation in the lungs. 

A local cause may be deficient determination of blood to the ovaries 
and uterus, although no general anaemia exists. 

The remedies employed for these two conditions are termed indirect 
emmenagogues. To correct anaemia, iron, manganese, and cod-liver 
oil may be employed. 

In order to determine more blood to the uterus, warm foot-baths, 
warm hip-baths, mustard hip-baths, mustard stupes or poultices to the 
thighs and lower part of the abdomen, and leeches to the inside of the 
thighs or to the genitals, and aloetic purgatives, may be employed. 

It might at first seem from theoretical considerations that foot-baths 
could hardly have any action on the uterus, but warm foot-baths cause 
great dilatation of the arteries in the legs, and it is probable that this 
dilatation extends up the iliacs, so that more blood may be sent to the 
genitals as well. But in addition to this, it is not at all improbable that 
a close nervous connection exists between the vascular supply of the 
uterus and of the feet, for not only does the warm foot-bath tend greatly 
to restore, but cold and wet feet are amongst the most powerful agents in 
checking menstruation. 

Other substances, which seem to have a direct stimulating action on 
the womb itself, are called direct emmenagogues. It is not easy to 
see at present how they act ; we know, however, that when given in large 
doses they cause contraction of the womb, and then act as ecbolics. The 
chief emmenagogues are : — 

Indirect Emmenagogues. Direct Emmenagogues. 

( Hot foot. Ergot. 

Baths < Hot hip. Digitalis. 

( Mustard. Savine. 

TV,/ ^° genitals. Quinine. 

iieecnes ^ Tq thighg Assafoetida. 

f l>aths. Myrrh. 

Mustard^ Poultices. Guaiacum. 

( Stupes. Cantharides. 



ACTION OF DRUGS ON GENERATIVE SYSTEM. 



391 



Indirect Emmenagogues. 



IMrect Emmenagogues. 



{Continued.) 




{Continued. 


Purgatives, as aloes. 
Iron. 

Manganese. 
Cod-liver oil. 
Strychnine. 


Echolics. 


Borax. 
Rue. 



The involuntary muscular fibres of the uterus appear, like those of 
the ureter or of the frog's heart, to possess the power of rhythmical 
contraction, and may contract when entirely separated from the general 
nervous system. They are, however, controlled by the higher nerve- 
centres. There appears to be one centre, situated in the lumbar por- 
tion of the spinal cord, which is of itself sufficient to regulate all the 
movements, for they go on normally, even when the spinal cord has been 
completely divided above it. This centre may be reflexly stimulated 
and contractions of the uterus induced by irritation of the ovarian, 
crural or sciatic nerves. It may be also stimulated by the action upon 
it of drugs circulating in the blood, as ergotine, picrotoxine, or strych- 
nine, or by great venosity of the blood, due to asphyxia. 

There appears, however, also to be a second centre for the uterus, as 
for the male genital organs, in the "brain (vide p. 387), by which the 
lumbar centre may be excited, and in consequence of this, stimulation 
of the cerebellum, crura cerebri, corpora striata, and optic thalami, also 
give rise to uterine contractions. 

Y. Basch and Hofmann consider that the impulses pass to the uterus 
from the central nervous system, along two sets of nerves. One is com- 
posed of nerves passing from the inferior mesenteric ganglion to the 
hypogastric plexus. Stimulation of these causes circular contraction of 
the uterus, descent of the cervix and dilatation of the os. The other 
consists of branches passing from the sacral nerves across the pelvis to 
the hypogastric plexus, and representing the nervi erigentes. On stim- 
ulation of these the uterus contracts longitudinally ; the cervix ascends 
and the os closes. 

The mode of action of ecbolics has not been satisfactorily ascer- 
tained. Ammonia injected into the circulation appears to cause con- 
traction of the muscular fibres, for it causes contraction of the uterus 
even when all nervous connections have been divided. Ergot possibly 
acts in the same way, but it is possible also that it acts on the spinal 
centre. 

The chief ecbolics are : — 

Ergot. 

Savine. 

Quinine. 

Uses. — Ecbolics are used to accelerate the expulsion of the 
child when the passages are free but expulsive power is deficient, and to 
cause firm contraction of the uterus and so prevent haemorrhage 
after delivery. 



392 PHAKMACOLOGY AND THERAPEUTICS. 

Adjuncts. — Compression of the uterus by kneading, pressure over 
it by a pad, the hand dipped in cold water laid over the uterus, or a cold 
pad. Sternutatories have been used to supplement the expulsive power 
of the uterus, and, when necessary, operative interference must be had 
recourse to. 

Action of Drugs upon Milk. 

The milk glands somewhat resemble the salivary glands in the way 
in which they are affected by the central nervous system, and by the 
action of drugs upon them. The action of the central nervous system 
on the milk glands, however, has not been made out with anything like 
the same clearness as in the case of the salivary glands, experiments on 
animals having given not very definite results. It is chiefly inferred 
from the effect of mental emotions in checking or altering the secretion 
of the milk ; and from the effect of belladonna locally applied in check- 
ing the secretion. The amount of secretion appears to depend on the 
amount of blood-pressure in the gland, and gentle stimulation of the 
nipple increases both the flow of blood to the gland and the secretion 
of milk. It is uncertain whether there are definite secreting nerves 
affecting the gland cells apart from the vaso-motor nerves. 

The character of the milk depends to a great extent upon the feed- 
ing and exercise of the mother, and diet is the most important agent in 
regulating both the quality and the quantity of the milk. As Dolan 
points out, it not unfrequently happens that a wet nurse, when first she 
arrives, yields such milk that the child she is nursing thrives well, but 
the quality soon falls off. In place of much out- door exercise and plain, 
nutritious diet, she is fed luxuriously and gets little exercise. In order 
to restore the quality of the milk in such a case, the woman must be 
restored as far as possible to her previous conditions of diet and exercise. 

Many substances are excreted in the milk, such as ammonia and the 
aromatic oils to which vegetable substances belonging to umbellifera and 
crucifera owe their flavor, probably also all volatile oils are thus excre- 
ted. Amongst those which have actually been found to pass into the 
milk are the oils of anise, cummin, dill, wormwood and garlic, as well 
as turpentine and copaiba. The purgative principles of rhubarb, senna, 
scammony and castor-oil, pass into the milk. Opium, iodine and indigo 
do so also, and metals, such as antimony, arsenic, bismuth, iron, lead, 
mercury and zinc. Volatile oils, having an agreeable taste, do not appear 
to affect the secretion of milk directly, but appear to render it pleasant 
to children, so that they take the breast eagerly. When lactation is 
defective they may increase the reflex stimulus to the nipple by making 
the child suck more vigorously, and thus increase the quantity of milk. 
For this reason such volatile oils as anise and dill may be useful as 
galactagogues. Garlic, on the contrary, renders the milk disagreeable 
to children, so that they will not take it. Copaiba also renders the 
milk disagreeable. The nearest approach to a true galactagogue is jab- 
orandi, but it affects the gland only temporarily. Beer and porter stim- 
ulate the secretion for a short time, but they produce no proportionate 
benefit in the child, and nursing mothers are, as a rule, much better 
without alcohol, and should rather take milk instead. When the milk 



METHODS OF ADMINISTERING DRUGS. 393 

of the mother is deficient in saline constituents they may be supplied 
by giving the appropriate salts to the mother. 

Various physiological actions may be produced in the child by admin- 
istering drugs to the mother. The administration of acids to nursing 
mothers is generally to be avoided, as they are apt to cause griping in 
the child. Neutral salts as a rule pass into the milk and cause looseness 
of the bowels in the child. Senna, castor-oil, rhubarb, scammony, sul- 
phur, and probably jalap, act as purgatives to the child. Salts of potash 
administered to the mother will act as diuretics to the child. Turpentine 
administered to the mother also can be detected in the urine of the child ; 
and this is also the case with copaiba and iodide of potassium. Opium 
administered to the mother may act as a narcotic to the child, and mer- 
cury, arsenic and iodide of potassium, may all be given to nursing chil- 
dren by administration to the mother. 



CHAPTER XVII. 

METHODS OF ADMINISTERING DRUGS. 

Drugs may be used either for their local or general action, and 
sometimes for a combination of the two. Thus a solution of opium may 
be applied to the eye for its local effect in relieving irritation of the con- 
junctiva. It may be given by the mouth or injected under the skin to 
relieve pain and induce sleep, though the seat of the pain may be far 
removed, both from the point of injection and from the alimentary canal; 
or the opium may be applied in the form of a pessary in uterine disease 
to relieve pain, both by its local action on the part, and its general action 
on the system after absorption. 

In order to produce their general action drugs may be introduced 
into the system through the skin, subcutaneous cellular tissue, lungs, 
mucous membranes, especially that of the alimentary canal, serous mem- 
branes and veins. The same drug applied in the same quantity through 
different channels may have different effects; for not only may slower 
absorption give rise to difference in the amount present at any time in 
the blood, as already explained (p. 55), but a reflex effect upon the 
organism may be produced by the local action of the drug at the place 
of introduction. 

Application of Drug's by the Skin. 

There are three different methods of applying drugs to the skin which 
are well recognized, these are : — 

1. Epidermic, to the skin covered by epidermis. 

2. Endermic, to the skin denuded of epidermis. 

3. Hypodermic, to the subcutaneous cellular tissue. 



394 PHARMACOLOGY AND THERAPEUTICS. 

Epidermic Application. — Remedies are applied to the unbroken 
skin chiefly for their local action on the part to which they are applied, 
or their reflex action through the nervous system on more distant parts. 
The epidermic applications are comparatively rarely used as a means of 
introducing drugs into the system, for the epidermis opposes such an 
obstacle to absorption, that it takes place slowly and with great difficulty. 

In some of the lower animals, such as frogs, respiration takes place 
to such an extent through the skin that the animal will live for a long 
time after respiratory movements have ceased. Respiration also takes 
place through the skin in man, but to a very slight extent, the absorption 
of oxygen and the excretion of carbonic acid being only about 2iro~th part 
of that in the lungs. 

The skin is able to absorb other gases as well as oxygen, such as sul- 
phuretted hydrogen, carbonic acid, carbonic oxide, and the vapors of 
hydrocyanic acid, ether and chloroform. 

From the relief which persons who have been shipwrecked and have 
suffered from extreme thirst have received by bathing in sea-water, or 
putting on shirts wet with sea-water, it seems probable that the skin is 
able to absorb water, but this fact also shows that solids dissolved in the 
water are not absorbed by the skin. A good deal of discussion has taken 
place regarding the absorption by the skin of substances applied to it in 
a state of solution. Experiments on this point have usually been made 
with iodide of potassium, on account of the ease with which this salt can 
be detected in the urine. The results have generally been negative, but 
sometimes they have been positive. The general result is that the salt 
is never absorbed by the skin from the solution, and that in the cases 
where absorption has taken place, it has been due to the skin not having 
been washed after the bath, so that the iodide has crystallized on the 
surface, and has afterwards by friction of the clothes been rubbed into 
the sebaceous glands. It would appear that the fat in the skin as well 
as the epidermis presents an obstacle to the absorption of substances in 
solution, but when they are applied in such a form that they can readily 
mix with the sebaceous matter of the skin, they are tolerably readily 
absorbed, as for example when they are used in the form of ointment and 
well rubbed into the skin, so as to penetrate into the sebaceous follicles 
and also the sweat glands. They are also absorbed when dissolved in 
ether, and especially in chloroform, even when simply painted over the 
surface. Alcoholic solutions are not absorbed when painted on in this 
way, although they may be absorbed if rubbed well in. It has been sup- 
posed that the absorption of chloroform solutions is due to the chloroform 
mixing with the sebaceous matter. But if true at all, this is certainly 
not the complete explanation of the fact, for, as has just been mentioned, 
alcoholic solutions are not absorbed, although alcohol as well as chloro- 
form will dissolve sebaceous matter. Waller has also shown that chloro- 
form passes rapidly through the dead skin, carrying with it alkaloids 
dissolved in it. Its action is therefore to a great extent due to its pecu- 
liar endosmotic power. 

The vascularity of the skin greatly alters its absorptive power. In 
the frog, absorption usually occurs rapidly through the skin, so that if 
the hind legs be immersed for a few minutes in a solution of cyanide of 



METHODS OF ADMINISTERING DRUGS. 



395 



potassium, the salt is rapidly absorbed and can be detected in the mouth 
of the animal in a few minutes. But if the circulation be depressed by 
the previous administration of ether, curare, or any cardiac depressant, 
this absorption into the system does not take place ; for although the 
cyanide of potassium passes through the skin, yet, the subcutaneous cir- 
culation being feeble, it is not conveyed away from the point of local 
application into the system generally. 

The absorption of drugs may therefore be diminished by depression 
of the circulation either locally at the point of application or in the sys- 
tem generally. It may be rendered more rapid by increased circulation 
at the point of application. A general increase in the circulation usually 
accelerates the circulation in the different parts of the body, but does not 
necessarily do so, for the vessels of a part may remain contracted while 
the general circulation is more rapid than usual. 

A local increase in the circulation occurs from inflammation of a part, 
or from temporary irritation such as that produced by rubbing, or by the 
application of irritant substances. The use of friction, therefore, increases 
absorption not only by pressing the substances employed into the sweat 
glands and hair follicles but also by increasing the circulation, and this 
effect will take place to a still greater extent if the substances used have 
a tendency to cause dilatation of the vessels. 

The most common methods of applying drugs epidermically are 
baths, poultices, inunction, and friction. 



Baths. 

These may be either local or general. In general baths the 
whole of the body excepting the head is exposed to the action of various 
agents. According to the nature of the agent, baths may be divided as 
follows : — 









' (1) Ordinary full bath. 

(2) Affusions. 

(3) Spray. 






r's . 


(4) Sitz-bath 






o 


(5) Foot-bath. 

(6) Cold pack. 

(7) Compresses. 




A. Simple. - 


^ 


^ (8) Douches. 

' (1) Tepid bath. 
(2) Warm bath. 






. w H 


(3) Hot bath. 


I. Watee. - 




(4) Hot foot-bath. 








_ (5) Hot sitz-bath. 








(1) Sea-bathing. 


s 






(2) Common saline bath. Artificial sea- 
water made by dissolving bay-salt in 
water (1 lb. of salt in 30 gal. of 




B. Medicated. 


- 


water). 

(3) Acid bath. 

(4) Akalinebath. 

(5) Sulphurous bath. 

(6) Mustard bath. 

. (7) Pine bath (Fichtennadelbad). 




. 





396 PHARMACOLOGY AXD THERAPEUTICS. 

f A. Aqueous. (1) g . x f Russian. 

v y ^ ( Simple vapor. 

II. Vapoe. -{ (2) Medicated. Vinegar. 

_B. Volatilized drugs, e.g., Calomel. 

III. Air. Turkish bath. 

Cold Bath. — The effect of a bath depends very much upon its 
temperature. 

In a cold bath, the temperature of the water is at or below 70° F. 

The first effect of immersion in a cold bath is contraction of the ves- 
sels of the skin, accompanied by a feeling of chilliness and perhaps even 
of shivering. When the water reaches the level of the chest, the respira- 
tory centre becomes reflexly affected, and the respiration becomes 
gasping. 

After a few minutes the cutaneous vessels begin to relax, and the 
blood returning to the surface warms it. If the person now comes out 
of the bath, dries quickly and rubs vigorously, the brisk circulation in 
the skin gives rise to a pleasant feeling of warmth. 

The feeling of warmth, or at least of lessened coldness, will occur 
even if the bath be continued, but the increased circulation in the skin 
allows the blood to be much more rapidly cooled, and thus the tempera- 
ture of the body is much more quickly reduced. When the blood which 
has been thus cooled in the skin returns to the nerve-centres, it appears 
to stimulate the vaso-motor centre and produce a second contraction of 
the cutaneous vessels, accompanied by a greater and more persistent 
chilliness than before. 

The object of cold baths is usually: — 1st, either to have a tonic 
and bracing influence on the body; or 2dly, to abstract heat from the 
body in cases of fever. 

As a tonic the cold bath is often very efficacious, and not only gives 
a feeling of strength and comfort, but tends to prevent those who take 
it from catching cold so readily as they might otherwise do. The vessels 
of the skin are, as has already been mentioned, the regulators of tempera- 
ture, and contract when they are exposed to cold : thus protecting the 
internal organs from its chilling influence. But Rosenthal has found 
that when animals are kept for a long time in a warm chamber, their 
vessels lose to a great extent their contractile power, and thus the animal 
becomes much more readily chilled when exposed to cold. Cold baths, 
by training as it were the cutaneous vessels to contract, tend to • protect 
the organism from the injurious effects of accidental exposure. Besides 
this, however, the stimulation to the circulation which comes as an after- 
effect, tends to increase both the tissue change in the body, and the 
excretion of waste substances from it. In consequence of this cold bath- 
ing is usually followed by an increased appetite, so that the most favor- 
able conditions for the nutrition of the body are supplied by cold baths, 
viz., increased supply of food, increased tissue change, increased excre- 
tion of waste. 

Cold baths may therefore be looked upon as a most powerful tonic. 

But while cold baths are of great use to those with whom they agree, 
they may be productive of great harm when they are indiscreetly 



METHODS OF ADMINISTERING DRUGS. 397 

used. As a general rule it may be said that when they cause much dis- 
comfort during the bath, and especially if they cause chilliness afterwards, 
they do harm rather than good. This is more especially the case with 
children and with persons of feeble circulation. 

Rosenthal's experiments, already quoted, show us that there is a 
scientific basis for the popular notion of "hardening"" by exposure. 
But this process may be carried much too far, and instead of getting 
excitement of the circulation with all its attendant advantages, the effect 
of the bath may be to lower the temperature, depress the circulation, and 
greatly injure the nutrition. The risk of such injury may be much 
diminished by proper attention to the mode of giving the bath. In 
children or delicate persons it is better as a rule to avoid immersing the 
whole body, and especially to avoid putting the feet in cold water at the 
same time as the body. The best way is to let the person sit down in a 
sitz-bath with the feet out and quickly to dash the water over the face, 
chest, back, and arms. Then a large bath sheet is to be thrown around 
the body so as completely to envelop it, and to prevent its being chilled 
during the process of drying. For during the exposure of the body 
while the surface is still wet, the chilling process is going on by evapora- 
tion during summer, and by conduction by the cold air in winter. This 
may be seen markedly in persons of a feeble circulation who rise from 
the bath with a feeling of slight glow, but lose it completely and begin 
to feel chilly, if the process of drying is delayed. Instead of a bath 
sheet, a dressing-gown made of towelling may be used. For very deli- 
cate persons the water of the bath should be rendered tepid by the addi- 
tion of a little hot water, and the face may not be sponged until after 
the rest of the body has been dried and the clothes put on. 

Sometimes the vigorous use of a flesh-brush over the chest tends to 
assist the reaction, and if practicable a short though brisk walk is 
advisable just after the bath. It must not, however, be long, as other- 
wise exhaustion might set in, and the appetite instead of being increased 
would be diminished. 

Besides the tonic action which cold baths exert on the circulation 
and on the body generally, they appear to have a beneficial action in cer- 
tain disturbances of the respiration. 

The respiratory centre (p. -11), may be strongly affected reflexly by 
cold applied to the surface of the chest, as is shown by the gasping 
breathing, or inspiratory tetanus, observed when the cold water reaches 
the chest on walking slowly into it. 

Cold sponging as recommended by Binger in his excellent work on 
Therapeutics is exceedingly useful in laryngismus stridulus. It should 
be used two or three times a day whatever be the weather. If the child 
be hoarse, it should not be allowed to go out, but if there is no hoarseness, 
the fresh air, even if cold, will be advantageous. To arrest a paroxysm 
cold water should be dashed over the child. 

Binger also recommends it for a catch in the breath occurring in 
young children during the night, awaking them from sleep. 

By abstracting heat, cold baths are useful in fever in several 
ways. By reducing the temperature they tend to lessen the amount of 
tissue change which is already excessive, and they thus tend to husband 



398 PHARMACOLOGY AND THERAPEUTICS. 

the patient's strength, as well as to reduce the alterations of the tissues, 
such as fatty degeneration of the heart, which occur in consequence of a 
high temperature. By lessening the temperature also, they diminish the 
rapidity of the pulse, and by thus prolonging the cardiac diastole give 
more opportunity for the nutrition of the muscular wall of the heart. 

A high temperature, if it is remittent is better supported than a lower 
temperature which is continuous, and therefore Liebermeister, to whom 
we in a great measure owe the recent introduction of cold baths as a 
therapeutic measure, uses them with the object of increasing and prolong- 
ing the remissions in temperature which usually occur spontaneously in 
febrile diseases. 

There are several ways of employing cold baths to reduce temperature. 
One is that of cold affusion, in which the patient is put into a tub and 
four or five gallons of cold water thrown over him. Another is to place 
the patient in a bath at about 90° F. and gradually reduce the 
temperature, by the addition of cold water, to 80°, 70°, or even 60° 
F. The patient is kept in this from ten to twenty minutes, according to 
his strength and the height of the temperature. As the temperature 
continues to fall for some time after the removal of the patient from the 
water, the bath should not be continued so long as to lower it to the full 
extent required while he is in the bath, lest collapse occur afterwards. 

Instead of the bath being gradually cooled down, it may be used at 
once at a temperature between 60° and 90° according to the condition 
of the patient, and if the temperature be very high, the water must be 
cooled still more by means of ice, and its action aided by ice given by 
the mouth and rubbed or laid upon the surface of the body. This treat- 
ment may be adopted even although pneumonia be present, if the patient's 
life is threatened by an excessive rise in temperature. When the tem- 
perature rises again the bath should be repeated. 

Cold Pack. — The pack is a less efficient means of abstracting heat 
from the body, but it is useful in causing a different distribution of blood 
in the body. It is therefore sometimes very useful in lessening delirium 
and producing quietness and sleep. In employing it a wet sheet is wrung 
well out of cold water and wrapped tightly around the patient ; over this 
are wrapped one to three blankets. A little heat is abstracted at first by 
the cold of the sheet, but this is very little, and indeed it is asserted by 
some that cold packs instead of abstracting heat, prevent its escape. The 
skin soon becomes warm and frequently profuse perspiration is produced. 
A certain amount of heat is lost, though perhaps not very great, by the 
evaporation through the blankets. It is probable however that the pro- 
duction of heat is to a certain extent lessened, at least in restless patients, 
by their movements being mechanically restrained by the sheet, and also 
by the blood being withdrawn from the internal organs and muscles to 
the skin. As the pack restrains the movements in a most complete way 
and with a force against which it is in vain to struggle, while at the same 
time it is comfortable and soothing, it frequently induces sleep when 
narcotics have been useless. 

Cold sponging is sometimes a very useful means of abstracting 
heat in cases of fever, where the patient is weak and the temperature, 
thougli perhaps not going above 104° or 105° F., tends rapidly to regain 



METHODS OF ADMINISTERING DRUGS. 



399 



its former height after cooling, and where it seems inadvisable to subject 
the patient to the frequent movement in and out of bed required in cold 
baths. The loss of heat consequent on cold sponging is due partly to 
the application of the cold water, but it is due chiefly to the evaporation 
which takes place from the surface of the body. Consequently sponging 
with tepid or even with hot water will also reduce temperature. 

Cold Douches. 1 — In this form of bath a stream of water having 
considerable force is directed against a part of the body. The stream 
may either be unbroken, and to this the name douche is usually restricted, 
or it may be broken up by delivery through a rose into a number of 
minute streams so as to form a shower or rain bath. If the douche is 
large (one to two inches in diameter) it causes a great amount of shock 
and sometimes does much harm. Usually a stream of a quarter of an 
inch in diameter is quite sufficient for all purposes. Douches are chiefly 
applied to the spine, spleen, liver, joints, anus, and vagina. The spinal 
douche usually consists of a single stream, and may either be allowed 
to fall vertically upon the spine, the body being more or less inclined, 
or it may be delivered from a horizontal pipe with the body in an upright 
position. It is useful as a stimulant in melancholia, cerebral anaemia, 
and general debility. To avoid too great depression it is better to apply 
hot and cold water alternately, unless it is used immediately after a hot 
application such as a spinal pack. Douches to the liver and spleen 
have been found useful in chronic congestion and enlargement of these 
organs. The douche applied to stiffened joints appears sometimes to be 
of considerable service. 

The ascending douche is usually delivered through a rose, so as 
to form a shower, and it is directed against the perinreum while the patient 
is in a sitting position. It is useful in haemorrhoids and pruritus ani, 
and when used at a regular hour daily, first tepid and then cold, it is 
useful in constipation. 

The vaginal douche is used by the patient lying on her back with her 
knees drawn up and with the pipe in the vagina. It is useful in vaginal 
leucorrhoea and cervical catarrh, and in chronic subinvolution and hyper- 
plasia the hot douche at 105° F. to 110° F. twice a day for several 
minutes is of much service. 2 

Local Application of Cold. 

Sitz-Bath. — When a person sits down in a cold sitz-bath, or when 
he sits down in an empty bath and cold water is poured into it, until it 
covers the hips, the vessels of the parts exposed to the cold contract, and 
the blood is consequently driven into other parts of the body. It would 
appear however that not only do the vessels of the skin contract, but 
that also contraction of the intestinal vessels occurs reflexly through the 
splanchnic nerves : so that in consequence there is a feeling of warmth 



1 For a short and concise account of the various appliances used in hydro-thera- 
peutics, vide Paper on "Rational Hydro-therapeutics" by G. L. Pardington, M.D., 



Practitioner, Jan., 1884. 
2 Pardington, op. cit. 



400 PHARMACOLOGY AXD THERAPEUTICS. 

and fulness in the head, an increase in the volume of the arm as measured 
by the plethysmograph, and a rise of temperature in the axilla. 

A cold sitz-bath, when applied only from one to five minutes and 
followed by a brisk rubbing afterwards, tends to increase the amount of 
blood in the abdominal organs, to quicken the circulation in the liver 
and spleen, and to augment the activity of the movements of the intestine 
and bladder. It may therefore be used with advantage in constipation 
and in disorders of the bladder depending upon weakness, such as either 
difficulty in expelling the urine or difficulty in retaining it. 

In pregnancy, cold sitz-baths are sometimes useful, giving a feeling 
of comfort and strength, and lessening the sensations of dragging in the 
abdomen. 

Where any tendency to premature expulsion of the foetus exists they 
should be avoided, as the increased circulation which they cause in the 
pelvic organs might lead to abortion. 

When cold sitz-baths are continued for a long time, as from ten to 
thirty minutes, at a temperature from 8° to 15° C, the contraction of the 
abdominal vessels appears to be more permanent, and thus they may be 
employed for the purpose of lessening congestion in the intestine ; and 
may be used with advantage in cases of obstinate diarrhoea and congestive 
enlargement of the liver and spleen. 

The effect of a prolonged sitz-bath in lessening congestion of the 
abdominal organs is greatly increased if it be preceded by a wash-down 
with brisk friction, so that the blood may be attracted to the other parts 
of the surface as well as driven out of the abdomen by contraction of the 
intestinal vessels. 

Cold Foot-Batli. — Coldness of the feet not only causes discomfort 
to the person, but if it occurs at night, it may prevent sleep. Putting 
them in hot water may warm them temporarily, but will not do so per- 
manently, and a much better way is to put them in cold water, rub them 
briskly while in it, and then dry them thoroughly with a soft towel, 
giving them a rub afterwards with a rough bath-towel. 

Cold foot-baths are to be avoided during the menstrual period, as 
they have a very great power indeed to check menstruation and frequently 
bring on amenorrhcea. Their power to check the menstrual flow is popu- 
larly known, and sometimes great harm is occasioned by young women 
using them to check menstruation in order that they may be able to 
attend some party of pleasure. 




FlG. 120.— Tracings from the radial artery at the wrist: A before and B after the application of a cloth 
dipped in cold water round the arm. After Winternitz. 

Cold Compresses. — By the application of cold over the course of 
an artery, it can be made to contract, and the amount of blood to the 
district which it supplies may consequently be diminished. This is shown 
by the accompanying curve taken by Winternitz from the radial artery. 



METHODS OF ADMINISTERING DRUGS. 



401 



The first half of the curve (A) was taken before anything had been 
applied to the arm, the instrument being allowed to remain. Ice was 
next applied to the arm, and the second half of the curve (B) shows the 
contraction which it had produced in the artery. 

When the cold application is allowed to remain for a while, it gradu- 
ally acquires the temperature of the body, and if evaporation be prevented, 
it comes to have the same effect as warmth, but if constantly renewed, 
the contraction of the artery may be kept up. A similar contraction to 
that just noticed in the vessels of the arm may be produced in the vessels 
of the head by cold applications around the neck. This is shown by the 
fall of temperature in the auditory meatus. Cold may be applied to the 
neck either by a bag containing ice, or by an India-rubber bag, or coils 
of tubing, through which cold water may be kept constantly flowing. 

It may be applied to the neck in cases of tonsillitis. Cold to the 
head is frequently applied in delirium, meningitis, and severe cephalalgia. 
It may be applied either by a bag containing cold water or ice, or still 
more conveniently by a cap consisting of India-rubber tubing through 
which water constantly flows. 



Warm Baths. 

Tepid Baths.— These baths range from 85° F. to 65° F., or 
29° -4 C. to 18° • 3 C. They are chiefly used for cleansing purposes, and 
at the lower margin of about 65° F. they may be used for a somewhat 
tonic action in persons of feeble circulation. 

Warm Baths.— These range from 97° F. to 85° F., or 36°-l C. 
to 29° -4 C. When the water is above these temperatures it forms a 
hot bath. The warm water softens the epidermis, and is thus of much 
use in chronic skin diseases. It dilates the vessels of the surface of 
the body, and thus tends to lessen any internal congestion. At the 
same time it tends to induce perspiration. On this account the warm 
bath is useful in lessening pain depending on congestion of internal 
organs, and in preventing congestion from going on to inflammation. 
It is therefore very serviceable when there is a threatening of bronchitis, 
or gastro-intestinal catarrh, colic, etc. It tends to reduce the tempe- 
rature both by dilating the peripheral vessels and inducing perspira- 
tion, and is therefore useful in febrile conditions. By withdrawing 
blood from the brain it tends to induce sleep. 

Hot Baths.— These range from 97° F., or 36°-l C, upwards. A 
much higher temperature than can be endured at first can be borne if 
the temperature be gradually raised by the gradual addition of hot 
water to the bath while the body is immersed, and the bath may thus be 
raised as high as 110° F. Hot baths not only prevent loss of heat from 
the surface, but if above the temperature of the blood, actually impart 
heat to the body. The consequence of this is that the temperature of 
the body rises very rapidly, and therefore the respiration and pulse 
both become very quick. The peripheral vessels become still more 
dilated than in the warm bath, and the blood pours so rapidly through 
them that, in spite of the quick and powerful action of the heart, there 
may be a tendency to syncope when the head is raised. After remaining 
26 



402 PHARMACOLOGY AXD THERAPEUTICS. 

in such a bath from ten to twenty minutes, the patient must be carefully 
lifted out so as to avoid any risk of syncope, and should be wrapped 
in warm, dry blankets. The hot bath is a still more powerful agent than 
the warm bath in producing sweating, and is employed in cases of dropsy. 

Hot Foot-Batli. — A hot foot-bath has a general effect that can 
hardly be explained by the simple dilatation of the vessels in the feet, and 
consequent derivation of blood to them. It seems, indeed, to exert some 
reflex action on other parts of the body and causes a general feeling of 
warmth. It is very useful as an adjunct to vascular stimulants in relieving 
congestion and preventing inflammation, as in threatened catarrh, bron- 
chitis, etc. When the feet are put into a hot bath, we find that the femoral 
arteries become much dilated and pulsate much more vigorously than they 
did before. It is not improbable that this dilatation extends beyond the 
femoral to the iliac arteries, and that the supply of blood is increased in 
the pelvic organs as well as in the feet. In cases of amenorrhoea, espe- 
cially where it has been brought on by exposure to cold, hot foot-baths 
tend to restore the menstrual flow. They should be begun four or five 
nights before the period is expected, and continued during the time it ought 
to last. Their efficacy may be increased by the addition of a little mustard. 

Hot Sitz-Batlis. — These have a still greater tendency than hot 
foot-baths to increase the circulation in the pelvic organs, and they may 
be used either alone or with mustard in the manner just described in 
cases of amenorrhoea. 

Poultices. — Poultices are simply a means of applying heat and 
moisture to a limited portion of the surface of the body, and they con- 
sist essentially of some farinaceous substance made into a paste with hot 
water. The most common substances used are linseed meal, crushed 
linseed, bread, bran, oatmeal and starch. The most common basis of a 
poultice is either linseed meal or crushed linseed. The difference 
between the two is that the crushed linseed still retains the oil naturally 
present in the seed, whereas it has been expressed from the linseed meal. 
Crushed linseed, if fresh, forms an excellent basis for a poultice, but if 
kept long is apt to become rancid. In order to avoid this disadvantage, 
the British Pha ■macopoeia directs that linseed meal should be used, and 
that olive oil sh juld be added to the poultice. Oil is only wanted when 
the poultice is to be applied directly to a wound or sore. It is unneces- 
sary when the poultice is to be used for the relief of internal pain. In 
all cases, not only should the water with which the poultice is made be 
perfectly boiling, but the bowl in which it is to be mixed, the spoon 
with which it is to be stirred, and the tow or flannel in which it is to be 
laid, should all be as hot as possible. By adding the linseed meal to 
the water and constantly stirring, there is less chance of the poultice 
being knotty than if the water were added to the meal. If the poultice 
is intended to be applied to a wound, sore, boil, or carbuncle, it should 
be spread upon a piece of flannel or tow and applied directly to the 
skin, because the softening action of the water and oil it contains on the 
dermal tissues is required as well as the warmth. But where the poul- 
tice is used to relieve pain or congestion of the internal organs it ought 
not to be applied directly to the skin, but should be separated from it 
by something which conducts heat badly, such as flannel. The reason 



METHODS OF ADMINISTERING DRUGS. 403 

for this is that it is impossible to apply a very hot poultice directly to 
the skin on account of the pain it causes, whereas if a substance which 
conducts heat badly be interposed, the poultice can be applied boiling 
hot, the heat gradually passes through without becoming inconveniently 
great, and is retained for a much longer time. 



Medicated Baths. 

The addition of stimulating substances, such as salt, to the water 
increases the stimulation to the skin, and the amount of after-reaction. 

In sea-bathing the stimulating effect of the salt is further increased 
by the mechanical shock of the waves, and sometimes also by the friction 
of the fine sand of the beach. Sea-bathing also differs from baths in the 
fact that muscular exertion is combined with it either in simply moving 
about and retaining one's footing, or still more in swimming. 

Acid Batli. — This bath is made by mixing eight ounces of nitro- 
hydrochloric acid with a gallon of water at blood heat (98° F.). This is 
sometimes used as a foot-bath, but it is better applied as a compress. A 
flannel roller about a foot wide, and long enough to go twice round the 
body, should be soaked in the acidulated water, wrung thoroughly out, and 
rolled round the region of the liver ; a piece of oil-silk, large enough to 
cover it completely and leave a little margin over, should then be put 
over it. It may be worn for several days, being renewed every night, 
and it is chiefly useful in chronic disease of the liver. 1 

Alkaline Bath. — This is made by adding crystallized carbonate 
of soda to water in the proportion of about one drachm to each gallon. 
It is chiefly used in chronic skin diseases. 

Sulphurous Bath. — This may be made by dissolving sulphurated 
potash in water, about half a drachm to the gallon, or an imitation of 
Barege waters may be made by mixing sodium sulphide, sodium carbon- 
ate, and sodium chloride in the proportion of twenty grains of each to 
the gallon. These are chiefly useful in chronic scaly skin diseases, and 
in rheumatism. Much more benefit is usually obtained by a visit to sul- 
phur springs, such as those of Aix-les-Bains, Aix-la-Chapelle, Barege, 
Harrogate, or Strathpeffer, than from the use of sulphur baths at home. 

Mustard Bath. — This is made by adding mustard to water in the 
proportion of about half a drachm to a drachm and a quarter per gallon. 
It is a powerful stimulant, but must not be applied too long. It must 
be remembered that, while slight stimuli to the skin increase the fre- 
quency and energy of the cardiac contractions and the rapidity of the 
circulation, and raise the temperature, severe irritation of the skin les- 
sens the frequency of the pulse and the rapidity of the circulation, dilates 
the vessels and lowers the temperature. 2 The patient should never be 
allowed to remain more than ten minutes in the bath, and should be at 
once removed as soon as he feels either burning of the skin or icy coldness. 



1 Squire's Companion to the British Pharmacopoeia, 13th Ed. 

2 Naumann, Prager, Med. Jahrsch., 1863, i., p. 1, and 1867, i., p. 133 ; Heidenhain, 
Pfliiger's Archiv, Bd. iii., p. 504, and Bd. v., p. 77 ; Riegel, Pfliiger's Archiv, Bd. iv., p. 
350. 



404 PHARMACOLOGY AND THERAPEUTICS. 

Mustard baths are generally used in order to quicken the appearance of 
the eruption in exanthemata. 

Pine Bath. — This is made by adding a decoction of the shoots of 
pines to water, but it is more convenient to use the oleum pini sylvestris 
in the proportion of one minim to the gallon. These baths are used in 
rheumatism, gout, paralysis, scrofula, and skin diseases. 

Vapor Baths. 

In these the body is exposed to steam instead of being immersed in 
hot water. The effect is much the same as that of the hot bath. The 
so-called Russian bath consists of a room filled with steam and provided 
with benches at various levels. The higher the level the greater is the 
heat, and usually, excepting on the lower benches, it is only possible to 
breathe with any comfort by holding a sponge dipped in cold water before 
the nose. From this room the bather goes to another where he is 
drenched with cold water by a douche, and is then quickly dried, and 
allowed to rest for some time before dressing. These baths are chiefly 
used in chronic rheumatism. They are liable to the same objections as 
the hot bath, and to a still greater extent, for the inhalation of the hot 
steam produces greater difficulty of breathing, greater acceleration of the 
pulse, and greater tendency to syncope. Vapor baths, in which the 
body only is exposed to the action of the steam, and the head is left out, 
are much better. They are usually applied either by means of a kind of 
box in which the body of the bather is inclosed while the head remains 
outside, or else by introducing steam under the bedclothes, which are 
supported by a kind of cradle, while the bedclothes are tucked tightly 
round the patient's neck to prevent the escape of the vapor. The latter 
plan is very useful in cases of dropsy and uraemia, as it induces a copious 
perspiration and does not exhaust the patient nearly so much as a hot 
bath. In cases of acute rheumatism a vapor bath of vinegar has been 
recommended. 

Calomel Fumigation. — This is used as a means of inducing the 
general action of mercury. The patient is seated naked on a wicker- 
work chair, underneath which is put a stand holding a shallow cup con- 
taining calomel. The calomel is volatilized by means of a spirit-lamp, 
and a blanket or water-proof sheet being thrown round the patient so as 
completely to envelop himself, his chair, and the fumigating apparatus, 
the calomel fumes become condensed upon his skin in a fine state of divi- 
sion. It is absorbed with considerable rapidity, probably from becoming 
mixed with the sebaceous secretion from the skin, and the general action 
of mercury is quickly induced. 

Air Baths. 

Turkish Bath. — The Turkish bath usually consists of three rooms, 
although frequently there are more. The temperature of the first, or 
dressing-room, is moderate, that of the second is higher, and that of the 
third is higher still. In the first room, the bather, after undressing, 
winds one towel round his loins, and a second round his head in the form 
of a turban. If he has any tendency to cerebral congestion, the second 



METHODS OF ADMINISTERING DRUGS. 405 

one may be wet. He then passes into the second room, where he usu- 
ally waits a short time before passing into the third room. Some people,' 
however, go directly into the third room. In both the second and third 
rooms the bathers partake freely of cold water. A few minutes' stay in 
the warmest room is usually sufficient to make the bather perspire freely, 
and he then returns to the second or cooler room, where he may remain 
half an hour or more, according to circumstances. He may then be 
shampooed, the surface of the body being rubbed, the muscles kneaded, 
and the smaller joints extended. He is next washed with a lather of soap, 
and sluiced with basins of tepid or warm water. For some people it is 
most agreeable after this to be simply wrapped in warm towels and 
allowed to repose in the dressing-room. Others prefer to finish up with 
a cold douche before proceeding to the dressing-room. Here they remain 
resting for a considerable time before they again dress. Turkish baths 
are exceedingly useful in chronic rheumatism and gout, and in persons 
suffering from the effects of malaria. The chief objection to the Turkish 
bath is the length of time that it takes. In some persons it has a weak- 
ening effect, but in many others it has none. The chief precautions are 
not to stay too long in the hot room, and to leave it at once if giddiness 
or a feeling of tightness in the head comes on. If the skin perspires 
with difficulty, the necessity for caution in entering the hot room becomes 
still greater, and it is advisable rather to spend a longer time in the 
second room, and drink freely of water before entering the hotter room, 
if, indeed, this be entered at all on the first few times of taking the bath. 
Persons who suffer from a feeling of exhaustion after a Turkish bath 
should not take a cold douche nor a plunge into water after perspiring, 
but should simply allow themselves to cool very gradually, and should 
take some stimulant such as coffee or beef-tea while doing so. Persons 
who suffer from malaria also should spend a good while in the second 
room before attempting to enter the third, as the sudden application of 
heat to the skin and lungs seems to irritate the vaso-motor centres and 
cause chilliness or even shivering. 

Friction and Inunction. 

Friction of the skin causes first a temporary contraction of the ves- 
sels, followed by a more or less permanent dilatation, so that the skin 
continues red for a length of time after the irritation has ceased. This 
redness is accompanied by a warm glow from the increased circula- 
tion in the skin, and friction is therefore useful as an adjunct to cold 
baths. Besides this, friction along the extremities in an upward direc- 
tion tends to aid the flow of lymph, and thus to remove the products 
of waste from the muscles. 

The fascia covering a muscle forms a pumping apparatus for remov- 
ing waste products from the muscles. It consists of two layers, a b and 
e /, and between these are lymph spaces, some of which, x, are seen in 
transverse, and others, which appear black from the injection with which 
they are filled, are seen in longitudinal section. Each time the muscle 
contracts it becomes thicker, presses the two layers of fascia together, 
and drives the lymph from the spaces onwards into the lymphatics. 



406 



PHARMACOLOGY AND THERAPEUTICS. 



Each time the muscle relaxes the layers of fascia tend to separate, and 
lymph from the muscle, carrying with it the waste products, fills the 
spaces between the layers. The action of the muscle itself thus tends to 
remove the waste products which give rise to fatigue (vide Massage, p. 




Fig. 121. — Injected lymph spaces from the fascia lata of a dog, after Ludwig and Schweigger-Seidel. 
The injected lymph spaces are black in the figure. 

128), but after over-exertion their removal may be greatly aided by 
gentle but firm upward friction which will have a similar action on the 
fascia to the alternate compression and separation of its two layers, 
caused by the action of the muscle itself. 

Gentle firm friction thus lessens or may even remove entirely 
the feeling of fatigue and weight in the extremities after exertion. 
When applied to the nape of the neck, or along the spine — it is some- 
times useful in headache, in nervous irritability and in sleeplessness. 

When applied between the shoulders in persons suffering from flatu- 
lence, it appears to aid the expulsion of gas from the stomach. 

The effect of friction as a counter-irritant is greatly increased 
by the use of stimulating liniments. These are applied by pouring 
a little into the hollow of the hand and then rubbing it over the sur- 
face of the body, or else by soaking a piece of flannel in the lini- 
ment and rubbing the skin with it. Linimentum ammonise applied 
thus to the chest is useful in the bronchitis of children ; and linimen- 
tum camphorae compositum, B.P., or linimentum terebinthinge may be 
used in a similar way for adults. 

In chronic inflammation of joints, liniments may be applied in a 
similar way. Sometimes it may be advisable also in such cases to 
swathe the joint in a piece of flannel or lint, soaked in the liniment so 
as to procure more continuous application. 

Inunction. — Metallic salts are very slightly, if at all, absorbed 
from the skin when applied to it in watery solution, and wiped off with- 
out being allowed to dry. But when applied in the form of ointments a 
considerable absorption takes place. Advantage is taken of this in 
order to obtain the general action of mercury without its local effect on 
the intestinal canal. For this purpose mercurial ointment is rubbed on 
the skin, and especially on those parts where the epidermis is thin, as 
under the axilhe and on the inside of the thighs. 

Absorption also takes place, however, through the skin of the hands, 
and if the ointment is not rubbed on by the patient himself, but by 
another person, in whom the action of mercury is undesirable, it has 



METHODS OF ADMINISTERING DRUGS. 407 

been recommended that the latter should cover his hands with a piece 
of bladder thoroughly well oiled in order to prevent absorption. 

In children, instead of applying the mercurial ointment by inunc- 
tion, it is customary to smear the ointment on a piece of flannel, and 
to keep it applied to the abdomen of the child by means of a bandage. 



Endermic Application of Drugs. 

This method consists in applying the drug to the skin previously 
denuded of its epidermis or epithelial layer by blistering. The drug 
may be applied in the form of powder, solution, ointment, liniment, or 
plaster, but most frequently in the form of powder. The drug is more 
readily absorbed when applied in this manner than when applied over 
the epidermis. Cantharides may be used for the purpose of raising a 
blister, but a more convenient method is to fill a thimble with cotton- 
wool or lint soaked in the strongest liquor ammoniae, apply it to the spot 
and keep it on for five minutes. If the cuticle has not then risen in a 
blister, apply a poultice until it rises. Cut off the cuticle, place the 
powder on the denuded surface, and cover it with a piece of oil-silk fixed 
in position by two pieces of strapping crossed over it. This method was 
chiefly employed for the local application of morphine. It has now 
been almost entirely superseded by the hypodermic method, but may 
still be occasionally employed in cases where it is advisable to combine 
the counter-irritant action of the blister with the local sedative effect of 
the morphine. 

Hypodermic Administration of Drug's. 

This method, the introduction of which we owe to Dr. Alexander 
Wood, of Edinburgh, possesses great advantages. 

It consists in the injection of a solution of a remedy under the 
skin. Absorption takes place from the subcutaneous cellular tissue 
rapidly, and it is much less likely to be modified by altered conditions 
of the organism than absorption from the stomach and intestine. For in 
the intestinal canal there is not only the condition of the circulation to 
be taken into consideration, but the fulness or emptiness of the stomach 
and intestine, the condition of their epithelial covering and of their ner- 
vous supply, and the state of the liver. These conditions may not only 
delay but entirely prevent absorption. 

The advantages of the hypodermic method, therefore, are 1st, cer- 
tainty of effect, and 2d, rapidity of action. 

As absorption of a drug takes place so much more rapidly from the 
subcutaneous cellular tissue than from the stomach, a less quantity is 
excreted during the process of absorption, and consequently a smaller 
quantity of the drug is required (p. 56). 

But absorption does not take place with equal rapidity from all parts 
of the intercellular tissue. The vascularity of this tissue, and the rate of 
absorption from it, are greater on the temples and breast than on the 
back, and greater on the inner than on the outer surfaces of the arms 
and legs. 



408 PHARMACOLOGY AND THERAPEUTICS. 

As the liquids used for hypodermic injection are usually concen- 
trated solutions of powerful poisons, it is important that neither more 
nor less than the quantity previously determined upon should be admin- 
istered. The syringe consists of two parts : a glass barrel in which a 




1 15 \4 13 la U 



Fig. 122. — Syringe for hypodermic injection. 

piston plays air-tight, and a hollow needle which fits tightly on to the 
end of the syringe either with or without a screw. The bore of the 
needle being very fine it is apt to get choked by rust, or by crystals of 
the substance last employed for injection forming within it, and render- 
ing it impermeable and useless. In order to avoid this it should be care- 
fully washed with water each time it is used, and a small piece of thin 
wire kept constantly in it during the intervals of use. When the syringe 
has not been used for some time, the packing of the piston is apt to 
shrink, so that it will no longer either suck in or drive fluid out of the 
barrel efficiently. This may often be remedied to a great extent by soak- 
ing the syringe for a short time in warm water and driving the piston 
up and down in it. If this is insufficient the piston may be taken out, 
and sufficient thread wound round it to make it work. Care must be 
taken also that the needle fits tightly on the syringe, and that no leakage 
takes place at the junction. The liquid to be injected should contain 
no solid particles which may obstruct the needle, and if any such should 
be present, the fluid may be filtered through clean blotting paper. 

The exact quantity required, and no more, should then be drawn up 
into the syringe and injected. Some syringes have a small screw upon 
the piston, so as to stop its movement at any required point. With such 
a syringe the barrel may be filled quite full of the solution, and the 
required quantity injected by forcing the piston down until it is stopped 
by the screw. The advantage of this arrangement is that if any leakage 
should occur, the screw may be moved further up, and an additional 
quantity of solution injected without the necessity of withdrawing and 
reintroducing the needle under the skin. If all proper precautions be 
taken, however, the necessity for such a procedure will rarely arise. 

Convenient places for injection are the outside of the arm near the 
deltoid, the fore-arms, or the thighs. In order to avoid the risk of 
introducing the needle into a vein, the injection should not be made over 
a vein visible through the skin. The skin should be pinched up between 
the finger and thumb, the needle pushed directly through it, and then 
passed onwards a little way obliquely in the subcutaneous cellular tissue. 

Objections to Hypodermic Injections. — The chief objections 
are, (1) the pain caused at the time by the introduction of the needle, 
or by the drug itself after its injection, (2) the inflammation which either 
the needle or the drug may give rise to subsequently, (3) the scars which 
may be left by the frequent repetition of the injection, (4) the danger of 
communicating a specific or contagious disease, (/>) the danger of inject- 
ing the drug directly into a vein, and thus producing a dangerous or 



METHODS OF ADMINISTERING DRUGS. 409 

fatal effect from the too rapid entrance of the drug into the circulation. 
With a little care these untoward results may be almost entirely avoided. 
If the needle is well sharpened the pain of introducing it is very slight, 
and may be still further lessened by making the patient take several 
deep breaths in rapid succession before the injection is made. If the 
patient is excessively sensitive, partial or complete anaesthesia of the 
part may be produced by cold or by carbolic acid (p. 186). 

The solutions should always be perfectly free from solid particles 
and should be as neutral and bland as possible. Metallic salts have 
their irritating properties diminished or removed when combined with 
albumen or with an alkaline citrate or tartrate so as to form double salts. 

By washing the syringe and needle thoroughly out with carbolic 
acid, the danger of conveying any specific or contagious disease is ren- 
dered very slight, and it may be completely avoided by heating all parts 
of the syringe in a spirit-lamp before using them. The syringe employed 
by Koch in his experiments on the effects of micro-organisms in pro- 
ducing disease (Fig. 122) is admirably adapted for this purpose, as all 
parts of it can be readily heated, and the padding upon the piston which 
is more likely to retain infective matter than any other part of the 
syringe can be renewed each time that the instrument is employed. In 
order to prevent pain or inflammation being caused by the solution 
injected, care should be taken that its reaction is as nearly as possible 
neutral, and that the quantity should not be great. The smart which 
follows the injection is lessened by rubbing the finger gently over the 
part, so as to distribute the fluid in the subcutaneous tissue. If it is 
necessary to employ such large quantities as half a drachm or a drachm, 
as may be the case with ergot, it is better not to inject the solution under 
the skin, but into the substance of a muscle, such as the gluteus maximus. 

Cicatrices are not apt to follow injection if the precautions already 
mentioned have been taken, and if the injections are not made too fre- 
quently at the same point. 

Application of Drugs to the Eye. 

For inflammation of the lids, ointment is smeared between the edges. 

Cold water is applied to the conjunctiva for its tonic action, by 
keeping the eyes open and then dipping the face into a basin of water. 

Strong solutions like that of atropine are applied to the conjunctiva 
by dropping them into the outer canthus of the eye and allowing them 
to flow over the surface. If such a solution is to be applied frequently, 
it may be dropped into the inner canthus, and the head held so as to 
allow it to drop out of the outer canthus ; for when the reverse proce- 
dure is employed the atropine may pass down the lachrymal duct, and 
being absorbed may produce its general effect upon the system and 
cause symptoms of poisoning. 

Application of Drug's to the Ear. 

Astringent solutions are usually applied to the auditory meatus by 
injecting them in a gentle stream by means of a small syringe 
(Fig. 123). 



410 



PHARMACOLOGY AND THERAPEUTICS. 



Fig. 123. — Vulcanite syringe for injecting solutions into the ear. 

For the mode of injecting into the middle ear, special treatises on 
aural surgery must be consulted. 

Application of Drugs to the Nose. 

Drugs are applied to the nose in the form of powder, which may be 
taken in the same way as snuff by putting a little on the top of the 
thumb, holding it in front of the nose and strongly inspiring ; or the 
powder may be put on a small piece of card-board in which a pin-hole has 
been made just under the powder, or with a small perforated spoon like 
that used in Scotland for snuff. Sternutatories may be used in this way, 
and so may Ferrier's powder for soothing the mucous membrane in cases 
of commencing catarrh. 

Fluids may be applied by insufflation, the nose being simply 
immersed in them and strong inspiration being made. 

They may also be applied by the nasal douche. This consists 
simply of a long India-rubber tube to act as a syphon (Fig. 124). The 




Weight. 



Clip to stop the now " 

Conical nozzle ( 



Fig. 124.— Nasal douche. 

upper end of it is placed in a vessel filled with the solution to be applied, 
and it is prevented from falling out by a hollow lead weight attached to 
its upper end. At the lower end is a conical nozzle, which completely 
plugs the nostril. The tube being filled with the fluid by suction so that 
it commences to act as a syphon, the nozzle is placed in one nostril, and 
the head is held with the mouth open over a basin. In this position the 



METHODS OF ADMINISTERING DRUGS. 411 

posterior nares are cut off by the soft palate from the pharynx, and the 
solution passes up one nostril and out through the other, so that 
the nasal cavity is washed out and its mucous membrane acted upon by 
the solution which is employed. By altering the position of the head, 
both in insufflation and in washing with the douche, the part of the nose 
reached by the fluid will be changed. Thus when the head is held much 
forward, the anterior and upper part of the nose will be chiefly cleansed, 
when the head is held upright, the posterior and lower, and when the 
position is intermediate, the middle part of the nose will be most affected. 

Pure water is irritating to sensitive mucous membranes like that of 
the nose, and so instead of employing pure water it is much better to use 
a *5 to 1 per cent, solution of common salt, which is a bland non-irritating 
fluid. Such a solution may be made by adding a drachm of common 
salt to a pint of water. 

Fluids may also be applied to the nose in the form of spray, either 
directed simply into the nostrils, or by means of a catheter perforated 
with a number of minute holes, and introduced along the floor of the 
nasal fossae. The former may be used for applying astringent and deo- 
dorizing solutions, and the latter for the purpose of washing out the nose 
and removing hardened secretions. 

Application of Drug's to the Larynx. 

Solid powders may be applied to the larynx by insufflation. The 
insufflator used for this purpose consists of a tube curved at one end, and 
having at the other a piece of India-rubber tubing or an India-rubber ball, 
by which a powder may be blown through the tube near this end of the 

_^ T— C 



Fig. 125. — Insufflator for applying powders to the larynx. A, piece of India-rubber covering the open- 
ing in the insufflator, by which the powder is placed in it. B, India-rubber tube by which the pow- 
der is blown out of the insufflator into the larynx. C, curved end of insufflator for introduction 
into the pharynx. 

tube. There is a small opening in its side through which the powder 
may be introduced, and this is afterwards covered by a sliding ring or a 
piece of India-rubber tubing so as to prevent the powder from escaping. 
The bent part of the tube is carefully introduced into the mouth so as 
not to cause retching by touching the tongue or soft palate, and, when 
the end of it points down over the larynx, the patient is told to take a 
deep breath. At the moment of inspiration the operator forces the 
powder out of the tube into the larynx, either by blowing through the 



412 PHARMACOLOGY AIVD THERAPEUTICS. 

India-rubber mouth-piece or by compressing tbe India-rubber ball. Mor- 
phine applied by this method gives more relief than almost anything else 
in laryngeal phthisis. About one-sixth of a grain is sufficient, and in 
order to give it sufficient bulk it may be mixed with either starch or 
bismuth. 

Solutions may be simply applied by means of a sponge firmly tied to 
a piece of whalebone having the proper curve ; as the patient inspires 
this is pushed down the larynx. Doubts have been expressed as to 
whether the sponge does get through the larynx, but I have seen the 
cricothyroid membrane projected forwards by the sponge applied in this 
manner. 

Nitrate of silver applied in this way gives relief in cases of phthisis, 
but it is a very rough method, and the application of the solution by 
means of a brush with the aid of the laryngoscope is much to be preferred. 
When the sponge has not been firmly fixed it has been known to come 
off and fall into the trachea. 

Fluids may be applied by a brush to the larynx, the operator using 
the brush with one hand and holding the laryngoscopic mirror with the 
other, while the patient holds his tongue out himself. If the patient is 
made to take several deep breaths in succession a slight anaesthetic con- 
dition is produced which renders the operation much more easy. 

Caustics are best applied to the larynx by means of a caustic holder 
in which the caustic is concealed until it reaches the point of application 
when it can be projected by a touch of the finger, and again withdrawn 
at the wish of the operator. 

Liquid may be applied to the larynx in the form of spray, produced 
either by means of Richardson's apparatus or by a current of steam. 
The nozzle of the spray producer may be simply directed towards the 
pharynx, or the tongue and the cheeks may be protected from the spray 
by a cylindrical glass speculum. 

Application of Drugs to the Lungs. 

% 

Inhalations. — Vapors employed as inhalations act not only on the 
bronchial tubes but upon the larynx, pharynx, and nostrils. One of the 
commonest is that of simple hot water. A jug is filled about half full of 
boiling water and the head held over it, the steam being kept in by 
means of a napkin or towel thrown over the head and around the mouth 
of the jug. This application often gives great, though temporary, relief 
in nasal, laryngeal, and bronchial catarrh. 

Vapor may be medicated by the addition of various substances to 
it such as carbolic acid, tincture of benzoin, creasote, or pine oil. But 
in order to gain the full advantage of the admixture of these substances 
it is better that the inspired air should not merely play over the surface 
of the hot water, but be drawn through it, and for this purpose inhalers 
are employed. In these the air is inspired by means of a mouth-piece 
fitted with a valve. This valve prevents the air from passing into the 
mouth-piece, so that during inhalation it is sucked through a tube which 
dips under the water and passes into the mouth laden with the vapor. 
During expiration it passes readily through the valve just mentioned. 



METHODS OF ADMINISTERING DRUGS. 413 

In cases of bronchitis, the patient breathes much more easily when 
the air of the room is kept warm and moist, and this is effected by means 
of a bronchitis kettle. This is simply a tin kettle with a spout about 
three feet long which projects into the room, so that when the kettle is 
kept boiling briskly a constant current of steam is driven well out into 
the room. When this cannot be obtained a substitute may be extempo- 
rized by rolling a piece of brown paper into a tube, tying a piece of 
string around it at intervals so as to keep it in shape, and putting it over 
the spout of an ordinary kettle. In cases of tracheotomy it is usual to 
keep the air still warmer and moister by hanging sheets around the bed 
so as to convert it into a kind of tent, and then conveying the steam from 
a bronchitis kettle into it by means of an India-rubber tube, or keeping 
up a constant spray by one of Lister's steam spray producers. 

Smoke. — The attacks of difficulty of breathing which come on in 
cases of pure spasmodic asthma, in advanced kidney disease, or in emphy- 
sema, are frequently much relieved by inhaling the smoke which issues from 
burning touch-paper or from powdered stramonium. The touch-paper 
or stramonium may be simply laid on a plate, or may be placed at the 
bottom of a cup or jug, and the fumes inhaled. Datura is often used in 
the form of cigarettes made either from the leaves of the datura stra- 
monium or datura tatula. 

Application of Drugs to the Digestive Tract. 

Mouth and Pharynx. — Weak solutions are applied to the mouth 
in the form of washes with which the mouth is rinsed out. Stronger 
ones may be painted with a camel's hair brush inside the cheek, lips, 
gums, tongue or pharynx. Solutions may be applied to the pharynx by 
painting with a brush ; solid substances, as caustics, by rubbing. In 
using caustic, care must be taken that it is firmly attached to the caustic 
holder, and, in the case of nitrate of silver, that only a short point is used, 
as otherwise the caustic may fall off, or the stick of nitrate of silver may 
break and be swallowed. This is especially necessary in touching the 
throat in children. In cases of post-nasal or pharyngeal catarrh, solutions 
such as glycerin or tannin, &c, may be applied to the back of the soft 
palate and the posterior part of the nares by means of a camel's hair 
brush fixed on a wire which may be bent to any desired angle. 

Masticatories. — We sometimes give the patients solid pieces of 
a drug to chew. These are called masticatories. We use them for 
their action upon the mouth itself, e.g., pellitory, where we wish to 
increase the secretion of saliva; or where we not only wish to produce 
the effect upon the mouth, but the effect of the drug mixed with the 
saliva upon the stomach and intestines, as in the case of rhubarb. 

Gargles. — In gargling, a full breath is taken, the mouth is filled 
with the liquid which is to be applied to the pharynx, and the head 
being thrown back the fluid runs against the pharynx and is partly 
thrown up against the soft palate by the air which gradually escapes 
from the lungs. In cases where it is advisable for the fluid to reach the 
posterior nares, the patient should lie down flat, take a mouthful of the 
liquid, draw out the tongue as far as possible with a handkerchief, and 
gargle while in that position. By throwing the head suddenly forward 



414 PHARMACOLOGY AND THERAPEUTICS. 

the liquid may be brought through the nose. This method is useful 
both as a method of applying the liquid more thoroughly to the pharynx 
and as a training preparatory to rhinoscopic examination. 

Stomach. — Drugs are applied to the stomach in the form of solu- 
tions or draughts, pills, powders, or boluses, &c., which are swallowed. 

Powders may be very conveniently given in wafers. A thin wafer 
is moistened with water, and the powder being introduced, is folded up 
in it and swallowed. Another most convenient vehicle is oatmeal por- 
ridge, a little of which is put upon a spoon, and, a depression being made 
in it with the finger, the powder is put into it and covered over with por- 
ridge. The porridge should fill the front half of the spoon, and the back 
part should be filled with milk, which helps the child to swallow more 
easily. Powders are sometimes given to children in jelly, but this is too 
soft, and so also is the paste made of bread and milk, although this may 
be used when porridge cannot be readily obtained. Pills may be simply 
swallowed with water, or taken in jelly, but some people are unable to 
take them without choking, and children especially have much difficulty 
in swallowing them. This difficulty is readily got over by dividing the 
pill into four or more parts, and taking each part in a little oatmeal por- 
ridge. Custard puddings, or puddings made of corn flour or arrowroot, 
may be used instead of porridge, but are hardly so good. 

Stomach-pump. — In cases where the patient is unable to swallow 
from paralysis of the pharynx, constriction of the oesophagus, or narcotic 
poisoning, the stomach-pump may be used. . This consists of a large, 
double-acting syringe with a flexible tube attached. In using it care 
must be taken 1 (1) to have the tube well softened in hot water; (2) to 
keep its end directed towards the pharynx, and not bent too much for- 
ward, lest it enter the larynx; (3) not to use violence in introducing the 
tube, lest it should be driven into the mediastinum, or even through the 
walls of the stomach itself, into the peritoneal cavity ; (4) not to use vio- 
lence in working the syringe, lest the mucous membrane of the stomach 
should be drawn into the lower orifice of the tube and injured. 

In place of the stomach-pump the gastric syphon may sometimes 
be advantageously employed, especially for feeding. It consists of a 
piece of thick-walled, soft, and flexible India-rubber tubing. It is so soft 
and flexible that it can hardly by any possibility injure the oesophagus 
or stomach, and yet it is sufficiently firm to pass down without much 
difficulty. After it is in, an ordinary funnel is attached to the project- 
ing end, and water, beef-tea, or whatever substance one wishes to intro- 
duce into the stomach, is simply poured in, the funnel being kept at or 
above the level of the patient's mouth. When it is desired to empty 
the stomach, water is poured in, in the manner just described, and then 
the outer end of the funnel is held down as low as possible — the syphon 
action is thus reversed, and the fluid which has just been poured into the 
stomach again flows out of it. 



1 In cases of poisoning it may be absolutely necessary to use the stomach-pump, 
but in ordinary cases a tube should never be passed down the oesophagus until the 
absence of aortic aneurism has been ascertained by a careful examination of the 
patient's chest. 



METHODS OF ADMINISTERING DRUGS. 415 

Intestine. — Drugs are applied to the intestine by means of enemata 
or suppositories. Enemata are liquid injections into the rectum for the 
purpose of emptying the lower parts of the bowels when we do not wish 
to excite the whole bowel, or when we wish to cause as little movement 
as possible to the patient. They are also used for the purpose of adminis- 
tering nutriment when the patient is unable to swallow or to retain food 
given by the mouth. In using enemata for the purpose of inducing 
action of the bowels the quantity should be considerable — sixteen fluid 
ounces, or even more. When they are intended to be retained, the quan- 
tity is usually small — not more than two to four fluid ounces at most. 
In using the enema syringe care should be taken that it is first emptied 
of air and that it is not pushed forcibly into the bowel. The nozzle 
should not be directed too much backward, as if this be done, and espe- 
cially if force be employed, ulceration of the posterior wall of the rectum 
may be induced. Where enemata are given for the purpose of nutrition, 
a much larger quantity than four ounces may be retained by using the 
proper- method. A flexible, soft rubber tube should be passed for eight 
or ten inches up the intestine and the nutrient enema may then be 
slowly and gently introduced either by using a syringe or by simply 
pouring it into the tube by a funnel. By this method the fluid is intro- 
duced into the sigmoid flexure or descending colon, and if the patient 
can be propped somewhat so as to lie on his left side, none of it may 
descend into the rectum. In this case there will be little or no tendency 
to evacuate it and the whole may be readily absorbed. 

Suppositories are drugs made up into a conical shape by means 
of cacao-butter. When introduced into the rectum the cacao-butter 
melts, the drugs become spread over the surface of the mucous mem- 
brane of the rectum, and gradually absorbed. They are employed when 
we wish to get the local action of a drug upon the rectum, or the parts 
surrounding it, or when we wish to get the general action of a drug 
after its absorption without producing any local effect upon the stomach. 

Application of Drug's to the Urethra. — They are usually 
employed as lotions. The syringe used to inject them should not have 
a small thin nozzle, but should have a conical point such as that shown 
in Fig. 126, which fills up the opening of the urethra and allows the 
injection to be forced up to the neck of the bladder without any escaping. 



Fig. 126. — Vulcanite syringe for injecting solutions into the urethra. 

Application of Drug's to the Vag-ina and Uterus. — Lotions 
are usually either injected into the vagina with a syringe, or allowed to 
flow into it from a reservoir at some height above the patient. In either 
case, if it is desirable that the lotion should remain in contact with the 
vaginal walls or cervix uteri, the patient should lie on her back with the 
hips raised by a pillow. The syringe employed for the vagina is usually 
furnished with a shield to prevent it from being introduced too far, and 
it ought to have no central opening, but only openings at the side, as 
occasionally, when astringent and irritating fluids have been used with 



416 PHARMACOLOGY AND THERAPEUTICS. 

syringes having a central aperture, they have been forced into the cavity 
of the uterus, and have there produced uterine contraction and conse- 
quent pain. Sedative and astringent substances are often introduced in 
the form of pessaries or vaginal suppositories, in which the active 
substance is mixed with either cacao-butter or with gelatine and glyce- 
rine. Solids such as caustics are applied either to the vaginal walls 
or cervix directly through a speculum, and powders are applied on 
pledgets of cotton-wool. Tents, consisting of thin sticks of a porous 
substance, are introduced into the cervix itself for the purpose of dilat- 
ing it, and solutions may be injected into the uterine cavity itself by 
means of a syringe provided with a long nozzle. 



CHAPTER XVIII. 

ANTIDOTES. 



Antidotes are remedies which counteract the effect of poisons. 

Action. — Antidotes may act in two ways : they may either pre- 
vent the action of the poison on the body, or they may counteract 
its effects. Many of them, especially those which are employed in the 
case of mineral poisons, form chemical compounds with the poisons 
which are almost insoluble and therefore inert. 

Some of these compounds, though nearly insoluble, will nevertheless 
be gradually dissolved and absorbed if left too long in the stomach, and 
therefore it is advisable to remove them by means of emetics or by the 
stomach-pump or stomach-syphon as soon as possible. Indeed, it is 
advisable in all cases of poisoning-, when the substance has been 
taken into the stomach, to empty the stomach at once before pro- 
ceeding to administer the antidote. The only possible exception is 
when a highly corrosive substance has been taken which may have par- 
tially dissolved the wall of the stomach and rendered it extremely liable 
to rupture during emesis, or on the introduction of a stomach-tube. If 
the poison has been absorbed, we must try to counteract its poisonous 
action on the respiration, circulation, or temperature, by giving sub- 
stances which will tend to produce an opposite effect. 

The more common poisons with their antidotes are given in the 
following table: — 

Poisonous Gases. 

Sulphuretted hydrogen . Chlorine cautiously inhaled. 

Chlorine ] 

I ir* imine L Steam inhalations. 

Iodine vapor .... J 

Vapor of ammonia . . Vapor of vinegar. 



ANTIDOTES. 



417 



Poisonous Gases— continued. 



Carbon monoxide 



Nitrous oxide 



Coal gas . . . . . 
Charcoal fumes . . 
Carbonic acid (choke 

damp) 

Marsh gas 

Fire damp 



{Fresh air and artificial respiration. 
Transfusion. 



Artificial respiration, with the tongue drawn 
forward, and with intermittent pressure 
over the cardiac region if the heart is 
failing. 



Artificial respiration. 

Alternate warm and cold douche to the head 

and chest. 
Friction. 
Mustard plasters over surface. 



Acids — 

Sulphuric . . 

Hydrochloric . 

Nitric . . . 

Phosphoric . . 



Oxalic acid .... 

Bin-Oxalate of potash 
(salts of lemon or salts 
of sorrel) . . . . 

Tartaric acid .... 

Acetic acid .... 



Acids. 

Alkalies — 

Bicarbonate of soda or potash. 

Magnesia. 

Chalk or whiting. 

Plaster from the wall. 

Soap. 

Milk. 

Eggs beaten up. 

Olive or almond oil. 



Chalk or whiting, or plaster from the wall, 
with water. 



Hydrocyanic acid . . «j 



Alternate cold and warm affusions. 

Artificial respiration. 

Injection of atropine (2 to 4 min. liquor 
atropise), repeated every half hour. 

Per- and proto- salts of iron, with magnesia, 
are recommended to render the acid insol- 
uble, but it acts so quickly that there is 
usually no time for their application. 



Caustic potash or soda 
Caustic lime . . . 
Caustic ammonia 
Carbonate of soda or pot 

ash 

27 



Alkalies. 

Vinegar. 
Lemon juice. 
Other dilute acids. 
Milk. 
Oil. 



418 



PHARMACOLOGY AND THERAPEUTICS. 



Aconite 



Alcohol 



Alkalies — continued. 

f Spirits. 

Ammonia. 
. Warmth. 

Digitalis. 

Atropine. 

Coffee. 

Cold douche to head. 



^.ntesthetics • ! 

Chloroform, ether, etc. '. f Artificial respiration, inversion, etc. 



Antimony 



Arsenic 



Atropine 



Baryta salts 



If vomiting does not occur, wash out the 
stomach with water first; then with tannic 
or gallic acid; then give milk and white 
of egg as demulcent to stomach. 

Wash out the stomach with large draughts of 
warm water, either by stomach-pump, or, 
if the arsenic itself does not cause vomit- 
ing, by using sulphate of zinc. 

Give magnesia, or still better, freshly precipi- 
tated oxide of iron made by precipitating 
a solution of perchloride of iron with car- 
bonate of soda. Dialyzed iron is also very 
useful. 

Give stimulants and coffee; inject caffeine 
subcutaneously ; arouse from stupor, as in 
opium poisoning, and, if necessary, arti- 
ficial respiration. Give cautiously physo- 
stigma. 

J Give Epsom or Glauber salts or dilute sul- 
[ phuric acid. 



Belladonna, vide Atropine. 

Burnett's Disinfecting Fluid, vide Metallic Salts. 



Calabar bean . 
Cannabis Indica 

Cantharides 



f Stimulants. 

\ Atropine. 

I Artificial respiration, if necessary. 

Vide Morphine. 

Large quantity of demulcent drinks. 

Barley water. 

Gruel. 

Linseed tea. 

Avoid oils and fats. 



ANTIDOTES. 



419 



Carbolic acid . . 
Cherry laurel water 



Alkalies — continued. 

Saccharated lime. 
Stimulants. 



Chloral 



Bichromate of potash 
Colchicum . . . . 



Conium 



Quinia 



Copper .... 
Corrosive sublimate 
Creasote . . . 



Croton oil . . . 



Curare 



Cyanide of potassium 
Digitalis . . . 



Ergot 



Vide Hydrocyanic acid. 

Keep patient warm. 

Arouse him. 

Give him coffee per rectum. 

Liquor strychnine, 4 minims, subcutaneously, 
repeated every 10 to 20 minutes, if neces- 
sary. 

Same as Acids. 

f Tannic or 
-i Gallic acids. 
[ Stimulants. 

f Tannic acid, 
j Stimulants. 
I Coffee. 

Tannic or 
Gallic acids. 
Strong tea or coffee. 
Stimulants warmed. 
Artificial respiration. 

Vide Metallic Salts. 
Vide Metallic Salts. 
Vide Carbolic Acid. 

Demulcents. 
Stimulants. 

Artificial respiration. 

If there is a wound, ligature above it if pos- 
sible, and incise and suck strongly. The 
ligature should be loosened from time to 
time, and again tightened, so as not to let 
too much poison into the blood at once. 

Vide Hydrocyanic acid. 

f Strong tea. 
I Tannin, 
i Stimulants. 
Aconite, 5 mins. of the tincture subcuta- 
neously. 
I Keep perfectly quiet, lying in bed. 

Tannin. 
Stimulants. 



420 



PHARMACOLOGY AKD THERAPEUTICS. 
Alkalies — continued. 
Vide Arsenic. 



Insect powder .... 

{Atropine. 
Stimulants. 
Artificial respiration. 

Hyoscyamus .... Vide Atropine. 

f Stimulants. 

Laburnum \ Coffee. 

[ Alternate hot and cold douches to chest. 

Lead Vide Metallic Salts. 



Lobelia 



Metallic salts . 



Morphia 



Mushrooms 

Nitro-benzol . 
Nitrite of Amyl 

Nitro-glycerin 



Tannin. 
Stimulants. 

Strychnia hypodermically (5 mins. liq. 
strychniae). 

White of egg freely to form insoluble com- 
pound : then wash out stomach to remove 
it : afterwards demulcents. 

Poultices to surface, and morphia if neces- 

L sai 7- 

Warm coffee after the stomach is emptied. 

Ammonia. 

Arouse by flicking with a towel, or by gal- 
vanic battery, and keep awake by walking 
about and renewal of stimulation if neces- 
sary. 

2 to 4 mins. liq. atropine, subcutaneously. 

Artificial respiration, if necessary. 

2 to 4 mins. liq. atropine, subcutaneously : 

repeat if necessary. 
Castor oil. 
Stimulants. 

f Stimulants. 

\ Alternate douche. 

[ Artificial respiration. 

f Cold to head. 

\ Ergotin. 

I Atropine, subcutaneously. 



Oil of Bitter Almonds . Vide Hydrocyanic acid. 
Opium Vide Morphine. 



Phosphorus 



f Sulphate of copper. 

\ Oil of turpentine, old and oxidized. 

[ Avoid oils and fats. 



ANTIDOTES. 



421 



Physostigma . . . 

Picrotoxine . . . 

Pilocarpine . . . 
Eat paste .... 

Savin . . . . . 



•I 



Snake-bite 



Stramonium . . . 
Strychnia . . . 

Tobacco . . . . 
Turpentine (oil of) . 
Veratrine . 



Alkalies — continued. 

' Stimulants. 
Atropine. 
Chloral. 
Strychnine. 
Artificial respiration. 

Chloral. 

Bromide of potassium. 

Atropine. 

Vide Phosphorus. 

f Epsom Salts. 
{ Demulcents. 

Ligature limb, cut out part with penknife 

and sear with hot iron. 
Alcoholic stimulants. 
Ammonia. 
Artificial respiration. 

Vide Atropine. 

' Chloroform. 
Tannin. 

Bromide of potassium. 
Chloral. 

Tannin. 

Stimulants, warm. 
[ Strychnine. 

Demulcents. 
Sulphate of magnesia. 

f Stimulants. 

\ Coffee, warm. 

[ Recumbent posture. 



422 PHARMACOLOGY AND THERAPEUTICS 

CHAPTER XIX. 

ANTAGONISTIC ACTION OF DRUGS. 

The idea that one drug might be made to counteract the deadly 
effects of another is a very old one, and in the middle ages alexiphar- 
mics and mithridates were used as antidotes. Of late years, however, 
the subject has been investigated experimentally, and a more accurate 
knowledge of it obtained. Amongst the first of these experimental 
researches were those of Preyer, on the antagonism of atropine and 
hydrocyanic acid; of Schmiedeberg and Koppe on the antagonism of 
muscarine and atropine; and of Fraser on the antagonism between 
physostigma and atropine. 

Although the fact is undisputed that we are occasionally able by the 
administration of one drug, to prevent the appearance of certain symp- 
toms which would otherwise have certainly been produced by another 
previously administered, it is by no means certain that the one simply 
counteracts the effect of the other. 

Some regard the effect of one drug in counteracting another as a 
case of chemical combination or substitution, the second drug either 
becoming added on to a compound of the first with some of the tissues, 
or else displacing it from such a compound with the tissues. Others, 
again, think that no chemical action of this sort takes place, but that 
each drug acts upon the tissue or tissues by itself, one, for example, 
exciting and the other paralyzing. 

In favor of the first view may be mentioned the analogy between 
the action of poisons and the formation of acid-albumen and alkali- 
albumen, either of which can be changed into the other by excess of 
alkali or of acid respectively. 

The objection is a very natural one that the doses of alkaloids 
required to produce marked physiological action are so extremely small 
that one can hardly fancy any chemical action being the cause of their 
physiological action. I have, however, on one occasion, by the addition 
of a single drop of liquor potassse, converted a milky-looking fluid, con- 
sisting of the nuclei of fowl's blood corpuscles suspended in water and 
measuring 90 cc, into a solid jelly-like mass, a result more ' striking 
than if a similar quantity injected into a frog had induced rigor in every 
muscle. Even such a result is infinitely less delicate than the color 
reactions by which alkaloids are detected. 

Some of the best-marked examples of antagonism in regard to invol- 
untary muscular fibre are those observed by Ringer in the frog's heart, 
and they strongly support the view which he advocates of chemical 
substitution. As already mentioned, calcium salts and veratrine greatly 
prolong the cardiac systole; but this prolongation is at once removed, 
and the systole rendered normal by a small quantity of a potash salt. 
The salts of potash alone render the systole short and weaker, and then 
normal, but this action again is neutralized by calcium. 

A similar condition has been observed by Cash and myself in the 
voluntary muscles of the frog. The contraction of the gastrocnemius is 
prolonged to a slight extent by calcium, and to a great extent by veratrine, 



ANTAGONISTIC ACTION OF DRUGS. 423 

and also by barium salts. This contraction is quickly reduced to the 
normal by the addition of a small quantity of potash. 

There is no very well-marked case of antagonism in which one drug 
is able to restore power to motor nerves which have been paralyzed by 
another drug : such antagonism, however, has been observed in regard 
to the vagus. By small doses of atropine this may be paralyzed ; by a 
dose of physostigma administered afterwards the inhibitory power may 
again be restored ; and by a further dose of atropine it may be again 
paralyzed. This action has been denied by Rossbach, but in experiments 
on the subject by myself, I have obtained this effect in such a marked 
degree that I have no doubt regarding it. It is possible that the different 
results obtained may be due partly to the animal employed, partly to 
the dose, partly to the preparations of the drug, and partly to the tem- 
perature at which the experiments are made. 1 In my experiments the 
vagus was irritated, and I ascertained that the stimulation was strong 
enough to stop the heart. A very small quantity of atropine was then 
injected, and the same stimulus was repeated. After enough atropine 
had been gradually injected to abolish the inhibitory action of the vagus 
completely, some physostigma was then injected into the jugular vein, and 
the irritation again repeated with the effect of stopping the heart as at 
first. 

The antagonism of certain drugs upon the frog's heart has received 
much attention. In considering this subject care must be taken to dis- 
tinguish between experiments made with the ventricle alone, containing 
involuntary muscular fibres but no ganglia, and the whole heart, in which 
both muscle and ganglia are contained. The experiments on veratrine, 
calcium, and potassium, already alluded to, were made with the ventricle 
alone ; those which are now to be considered have reference to the whole 
heart. Atropine appears to have the power not only of destroying the 
inhibitory action of the vagus upon the heart, but of antagonizing those 
drugs which inhibit the heart and render its beats slower, or stop them 
altogether, such as muscarine, physostigma, pilocarpine and phytolacca. 
Digitalin and saponin have a mutually antagonistic power, so that when 
the frog's heart has been stopped by either of them, the other will restore 
its pulsations. A limited antagonism also exists between muscarine, 
aconitine, and digitalin ; when the heart has been stopped by digitalis, 
muscarine and aconite will restore its movements. Digitalin will also 
restore the pulsations in a heart which has been arrested by aconite. 
Physostigmine, camphor, and other drugs which stimulate the muscular 
fibre of the heart will remove the still-stand caused by muscarine. 

Another very important antagonism is that between drugs acting on 
the respiratory centre and spinal cord. The mode of action of these 
drugs is difficult to explain on account of our imperfect knowledge of 
the physiology of the structures on which they act. Chloral lessens the 
excitability of these structures, strychnine increases it. These drugs 
have to a certain extent an antagonistic action, so that a fatal dose of 



1 My experiments were made on rabbits during the summer. The preparation 
of physostigma employed was a glycerin extract of the bean, and the preparation of 
atropine used was the Liquor Atropine, B.P. 



424 PHAKMACOLOGY AND THERAPEUTICS. 

strychnine may be so antagonized by chloral as to prevent death ; and a 
small quantity of strychnine may prevent death from chloral. Atropine 
has an exciting action on the respiratory centre somewhat like strych- 
nine, though very much less marked ; and atropine also will antagonize 
chloral. It has also an antagonistic action to aconite, which has a 
peculiar depressing influence on the respiratory centre. 

The sedative action of chloral enables it to antagonize picrotoxine, 
which has a stimulant action on the brain, causing convulsions. Opium 
and belladonna have to a certain extent an antagonistic action to one 
another. The first point which appeared to indicate an antagonistic 
action was their different effect on the pupil; but probably the point in 
which they chiefly antagonize one another is their action on respiration, 
atropine acting as a stimulant and morphine as a depressant to the 
respiratory centre. 

The alkaloids of tea, coffee, and allied substances, viz., theine, or 
caffeine, cocaine and guaranine, are antagonistic to morphine. These 
alkaloids in small and moderate doses increase the irritability of the brain, 
spinal cord, heart, and vaso-motor system, and in large doses paralyze 
them. Morphine and these alkaloids to a certain extent counteract one 
another, so that a lethal dose of one may be prevented from causing 
death by administering the other. 

The antagonism of drugs is also marked in regard to their action on 
the glandular system ; thus the excessive salivation produced by physo- 
stigma, pilocarpine, and bromal may be arrested by atropine, which also 
arrests the excessive secretion from the skin caused by pilocarpine, and 
the secretion from the mucous membrane of the lungs produced by 
bromal. 

The following table shows the most important examples of antagonism. 
The lethal and antagonistic doses have only been ascertained for a few. 
When the remark a not antagonistic" occurs in the table, it means that 
the second drug mentioned will not prevent death from a lethal dose of 
the first, although the first will prevent death from a lethal dose of the 
second. 



Aconitine 



Alcohol . . 

Ammonium 

chloride . 

Atropine . . 



.} 



Barium . ; . 

u 

Bromal-hydrate 

Brucine . . . 

Calabarine . . 

Carbolic acid . 

Chloral . . . 



Chloroform 
Cocaine . 
Codeine . 
Digitalin 



Gelsemium 

u 

Morphine 



Muscarine 
Opium . 



Physostigma 



Saponin . 
Strychnin 



Thebaine 



Atropine .... 
Digitalin .... 
Strychnine . . . 
Strychnine . . . 

Chloral .... 
Aconitine .... 

Bromal hydrate 

Chloral-hydrate 
Hydrocyanic acid . 
Jaborandi .... 
Muscarine . . . 

Morphine .... 

Physostigmine . . 
Phytolacca. . . . 
Pilocarpine . . . 
Quinine .... 
Sodium sulphate . 
Potash salts . . . 
Atropine .... 

Chloral 

Chloral 

Chloral 

Ammonium chloride 
Atropine ... . 
Brucine .... 
Calabarine . . . 
Carbolic acid . . 
Codeine .... 
Physostigma . . . 
Picrotoxine . . . 
Strychnine . . . 
Thebaine .... 
Amyl nitrite . . . 
Morphine .... 

Chloral 

Aconitine .... 
Muscarine . . . 
Saponin .... 

Opium 

Atropine .... 
Atropine .... 
Caffeine .... 
Chloroform . . . 
Cocaine .... 
Daturine .... 
Hyoscyamine . . 
Nicotine .... 
Physostigma . . . 
Atropine .... 
Atropine .... 
Gelsemium . . . 
Veratrum viride . 
Atropine .... 
Chloral .... 
Morphine .... 
Digitalin .... 
Alcohol .... 
Chloral. .... 
Hydrocyanic acid . 
Nicotine .... 
Nitrite of amyl . . 
Chloral 



Lethal 
dose.— I. 






Lethal 
dose.— II. 






7 



Antidotal 



Tio th - 
60V h ' 



not 
antagonistic 

not 
antagonistic 



not 
antagonistic 



426 PHARMACOLOGY AND THERAPEUTICS. 

CHAPTER XX. 

DOSAGE. 

The circumstances which affect dosage have already been discussed 
(p. 54). In practice we reckon the dose according to age, making 
allowances, however, for the size and sex of the patient. Various tables 
have been drawn up for this purpose. One in common use is Dr. Young's. 
It is to convert the age into a fraction by adding twelve to it and using 
the number thus obtained as the denominator, the age itself being the 
numerator. Thus, if a child's age be three years, the denominator will 
be 3 + 12=15, and the numerator will be 3. The dose for the child 
will therefore be 3 + 3 1 2 = -^ = i- of that for an adult. For a child five 
years old it will be 5 _f ± 2 = -f=-, which is between one-third and one-fourth 
of that for an adult. If the child is large for its years, we would give 
one-third ; if small, we would rather give one-fourth. 

Another rule, proposed by Dr. Cowling, is to divide the number of 
the patient's next birthday by twenty-four. Thus, for a child three years 
old, the fraction representing the dose would be -£$ = \\ for a child five 
years old, ^ = \. 

The rule which I should propose as being more convenient for the 
metric system is a modification of Dr. Cowling's. If we assume that 
the body has attained its full growth at twenty-five years of age instead 
of twenty-four, we get the proportion by dividing the number of the next 
birthday by twenty-five. Thus, for a child three years of age, the pro- 
portion would be -gt- = nearly \ ; for a child five years of age, -^ = between 
4- and \. This number does not lend itself readily to fractions such as 
the preceding, but it is very easy to divide by twenty-five by simply 
multiplying by four and dividing by 100. When the metrical system is 
used, all that is necessary is to multiply the full dose by the number of 
the child's next birthday, then by four, and remove the decimal point 
two places to the left. Thus, if the full dose for an adult be 1 gramme, 
the dose for a child of three will be 1 *q* 4: = '160 gramme or 16 centi- 
grammes. If the full dose for an adult be "3 gramme, the dose for a 
child of three will be ' 8 ^ X4 = '048, or 48 milligrammes. If the full 
dose be 1 gramme, the dose for a child of five will be ^{j* 4 = *240 
gramme or 24 centigrammes. If the full dose be -3 gramme, the dose 
for a child of five will be '3Xgim.X6 _X4 = .079 gramme or 72 milligrammes. 
To put it more shortly, the number of grammes in the full dose multiplied 
by the child's next birthday and by four, gives the result in centigrammes. 
The number of decigrammes multiplied in the same way gives the result 
in milligrammes. 



SECTION II. 



GENERAL PHARMACY. 






CHAPTER XXI. 
PHARMACEUTICAL PREPARATIONS. 

Pharmacy includes both the general preparation of drugs from crude 
natural products and their combinations with other substances, so as to 
render them either more effectual or more easily administered. 

The great rule for the administration of medicines is (1) curare, (2) 
cito, (3) tute, et (4) jucunde — that they shall not only (1) cure, but that 
they shall do so (2) quickly, (3) safely, and (4) pleasantly. According 
to this rule many prescriptions contain four ingredients, viz.: (1) the 
substance which is to cure, or the basis; (2) the adjuvant to help it; 
(3) the corrective to prevent any bad effects ; and (4) the vehicle to make 
it pleasant to take. This rule, however, is carried out not only in written 
prescriptions, but in those also which have been adopted by the profession 
at large, as a means of saving labor and time in the routine of practice, 
and embodied in the Pharmacopoeia as useful preparations. 

Formerly we were dependent for our medicines chiefly on the crude 
products of the animal, vegetable, and mineral kingdoms. As chemistry 
advanced various inorganic compounds were discovered and added to the 
Materia Medica, and as our knowledge of this science becomes greater 
and our power of preparing various organic bodies increases, we find that 
such bodies are becoming more and more introduced into medicine. As 
examples of these, we may take carbolic acid, chloral, chloroform, ether, 
hydrocyanic acid, iodoform, nitrite of amyl, salicylic acid, and kairin. 

We seem now on the verge of discovering the mode of preparation of 
many organic alkaloids, and when this has been done, the vegetable 
Materia Medica will be less important than it is now, inasmuch as it is 
probable that, by using artificial alkaloids, prepared always under similar 
conditions, we may obtain purer products and greater constancy of action 
than we can at present from the natural active principles. 



428 GENERAL PHARMACY. 

Recent discoveries have shown that plants generally contain active 
principles so closely associated that the mixture was regarded as a pure 
alkaloid, and yet these drugs have very different and sometimes opposite 
physiological actions. Thus ordinary conine usually contains pure conine 
and methyl-conine, the former of which paralyzes the motor nerves, while 
the latter paralyzes the spinal cord. Extract of physostigma, and sup- 
posed pure physostigmine, or eserine, have been found to contain two 
active principles, viz., physostigmine having a paralyzing action, and 
calabarine having a tetanizing action on the spinal cord. 

The power which chemistry now gives us also of modifying the chem- 
ical constitution of organic bodies and therewith their physiological action, 
will almost certainly enable us to treat disease much more perfectly than 
we can at present. For such modified drugs, however, we must be 
indebted to the chemist. He will prefer to operate on substances which 
have been already prepared by himself rather than on crude drugs 
obtained from plants. But at present we are still dependent on the vege- 
table kingdom for a large number of our most useful remedies. In plants 
they are associated as a rule with quantities of woody tissue which is 
quite inert and indigestible, and which would interfere very much both 
with their easy administration and with their action. 

Sometimes the crude drug is given in the form of a simple powder, 
without any admixture, as in the case of guaiac given in tonsillitis, where 
it is advisable to have the local action of the drug on the throat, as well 
as its general action on the system. Sometimes the powder may be 
readily given by enveloping it in a wafer, and swallowing it with a 
little water, and at other times it is made up with saccharine, and more 
or less adhesive substances, into the form of a confection or bolus ; 
or suspended in water by means of mucilage in the form of a mixture. 
Usually however the active parts of the drug are extracted by means of 
solvents, and either given in solution, or in the solid form, after the 
solvents have been evaporated. There are a number of preparations 
according to the solvents used, and the mode in which they are applied. 
Probably the most convenient arrangement is not to take the groups of 
preparations according to the solvents or mode of preparation, but alpha- 
betically for the sake of reference. 

The letters U.S.P. stand for the United States Pharmacopoeia of 1883, 
and B.P. for the British Pharmacopoeia of 1874. When the letters 
U.S.P. or B.P. precede the name of a class or of a substance, they indi- 
cate that it is contained in the corresponding pharmacopoeia only, but 
not in the other. They succeed the name or are omitted when the class 
or substance occurs in both pharmacopoeias. When there are differences 
between things bearing the same name in the United States and British 
Pharmacopoeias, the letters U.S.P. are placed after the descriptions of 
that contained in the United States, and B.P. after that of the British 
Pharmacopoeia. 

U.S.P. Abstracta. Abstracts. — These are dry powdered ex- 
tracts. They are twice the strength of the crude drug, and about twice 
the strength of the corresponding fluid extracts. They are prepared by 
extracting the active principles from 200 parts of the crude drug by per- 
colation with the strong or diluted alcohol, mixing the percolate with 



PHARMACEUTICAL PREPARATIONS. 



429 



some sugar of milk, letting it dry, and then adding sufficient sugar of 
milk to make up the product to 100 parts. They are eleven in number. 



DOSE. 

Abstractum Aconiti *j-l gr. 

" Belladonnse 5-I gr. 

" Conii 1-3 grs. 

" Digitalis J-l gr. 

" Hyoscyami 2-3 grs. 

" Ignatise J-lJgr. 



DOSE. 

Abstractum Jalapee 5-15 grs. 

Nucis Vomicse %-2 grs. 

Podophylli 5-10 grs. 

" Senegse 1-3 grs. 

" Valerianae 10-20 grs. 



Aceta. Vinegars. — These are solutions of medicines in vinegar 
or acetic acid. In the U.S. P. there are four; in the B.P. there are 
three. 



u.s.p. DOSE. 

Acetum Lobelise 30-60 min. 

" Opii 10-15 min. 

" Sanguinarise 3-4 fluid dr. 

Scilla3 15-60 min. 



B.P. 



DOSE. 



Acetum 



Cantharidis 

Scillse 15-60 min. 



Alkaloidea. Alkaloids. — These are organic bases which may be 
regarded as compound ammonias. 

Like ammonia they all contain nitrogen, and form salts with acids. 
Most of them contain oxygen in addition to nitrogen, carbon, and hydro- 
gen, and occur as crystalline solids. Some, e.g., conine, nicotine, spar- 
teine, contain no oxygen, and occur as oily liquids. They generally 
have a powerful physiological action. They occur in many exogenous 
plants, but only veratrine and substances nearly allied to it have been 
obtained from the class of endogens and muscarine from thallogens. 
They occur in the plants in combination with acids. The alkaloids 
themselves are generally soluble in alcohol, but sparingly soluble in 
water. Their salts are more soluble in water. The general plan of pre- 
paring them is to precipitate them by ammonia from an aqueous solution 
either of the salt originally present in the plant, or of one formed by 
treatment with an acid. In the B.P. the names of alkaloid all terminate 
in "ia," like ammonia, e.g., quinia, strychnia. Neutral principles have 
the termination "in," e.g., santonin, digitalin. Chemists have now gen- 
erally returned to the older nomenclature, and assign the termination 
" ine" to alkaloids, e.g., strychnine, quinine. To neutral principles they 
give the termination " in," e.g., santonin, digitalin. This terminology 
has been followed in the U.S.P. 



U.S.P. 

Apomorphina (Apomorphine). 

Atropina (Atropine). 

Caffeina (Caffeine). 

Ciuchonidinse Sulphas (Sulphate of Cin- 

chonidine). 
Cinchonina (Cinchonine). 
Codeina (Codeine). 
Hyoscyaminae Sulphas (Sulphate of Hyos- 

cyamine). 
Morphina (Morphine). 



B.P. 

Aconitia (Aconitia). 

Atropia (Atropia). 

Beberiae Sulphas (Sulphate of Be- 

beria.) 
Morphiae Hydrochloras (Hydrochlo- 

rate of Morphia). 
Quinise Sulphas (Sulphate of Quinia). 
Strychnia (Strychnia). 
Veratria (Veratria). 



430 GENEEAL PHARMACY. 

U.S.P. 

Physostigminas Salicylas (Salicylate of 

Physostigmine). 
Pilocarpine Hydrochloras (Hydrochlorate 

of Pilocarpine). 
Peperina (Peperine). 
Quinidinae Sulphas (Sulphate of Quini- 

dine). 
Quinina (Quinine). 
Strychnina (Strychnine). 
Veratrina (Veratrine). 

Chinoidinum (Chinoidin or Quinoidin), U.S.P., is a mixture of bases. 



Along with the alkaloids may be mentioned several neutral prin- 
ciples which resemble alkaloids in having a powerful physiological 
action. 

U.S.P. B.P. 

Chrysarobinum (Chrysarobin). Digitalinum (Digitalin). 

Picrotoxinum (Picrotoxin). Santoninum (Santonin). 

Salicinum (Salicin). 
Santoninum (Santonin). 



Aquae. Waters. (15 in U.S.P. and B.P.) — One is simply water, 
another distilled water. The others in the B.P. are water containing 
small quantities of volatile oils in solution, with the exception of two, 
aquae chloroformi and aquae laurocerasi, which contain chloroform and 
prussic acid respectively instead of a volatile oil. Two waters are pre- 
pared by simply dissolving the substances in them in the cold ; these are 
aqua camphorae and aqua chloroformi. All the rest are prepared by dis- 
tillation. Two are prepared by distilling the volatile oils with water ; 
these are peppermint and spearmint waters. All the rest are prepared 
by distilling the plant in a retort with water and continuing the process 
until a certain quantity is distilled over. 

In the U.S.P. aqua ammonias, aqua ammoniae fortior, and aqua chlori 
consist of solutions of ammoniacal and chlorine gases in water. One, the 
aqua creasoti, consists of a solution of one part of creasote in 100 of 
water. 

The others consist of volatile oils in water. Only two, aqua aurantii 
florum and aqua rosae, are prepared by distilling the flowers with 
water. The others are prepared by thoroughly distributing the requi- 
site quantity of volatile oil through a quantity of cotton, and dissolving 
it in water, by allowing the latter to percolate through. Camphor is 
dissolved in alcohol before adding it to the cotton. 

Waters are chiefly used as vehicles. 

The dose of all those in the B.P. with one exception is from half an 
ounce to two ounces. This exception is aquae laurocerasi, which is not 
used as a vehicle, but is on the contrary a powerful drug containing 
hydrocyanic acid, and the dose of it is very small, 5-30 minims. 

Aqua anethi is a favorite remedy for flatulence in children, and in 
them it is given in a dose of a teaspoonful or more. 



PHAEMACEUTICAL PREPARATIONS. 



431 



Aqua 



u.s.p. (15). 



DOSE. 



Destillata 

Ammoniae 10-30 minims. 

Ammoniae Fortior.. 
Amygdalae Amarae .2 drachms. 

Anisi J-2 oz. 

Aurantii Flor uni ... " 

Camphorae " 

Chlori u 

Cinnamonii |-2 fluid oz. 

Creasoti 1-4 drachms. 

Foeniculi 1-2 fluid oz. 

Menthae Piperitae.. " 

Menthae Viridis.... 
Rosae " 



Aqua 



B.P. (15). 



DOSE. 



Destillata 

Anethi ^-2 oz. 

Aurantii Floris '' 

Camphorae " 

Carui " 

Chloroformi " 

Cinnamoni " 

Fceniculi " 

Laurocerasi 5-30 minims. 

Menthae Piperitae ...£-2 oz. 

Menthae Viridis " 

Pimentae " 

Rosae " 

Sambuci '' 



B.P. Cataplasmata. Cataplasms or Poultices. (6.) — These 
are used as a means of applying externally moisture and warmth, and in 
certain cases medicaments, to parts of the body. They consist of linseed 
meal or of bread crumb, made into a paste with hot water. In one, cata- 
plasma conii, hemlock leaf is added to relieve pain; in another, cataplasma 
sinapis, mustard is used to stimulate the skin ; and in the cataplasma 
carbonis, cataplasma fermenti, and cataplasma sodse chloratae, wood char- 
coal, yeast, and chlorinated soda respectively, are added for the purpose 
of removing foetor or acting as disinfectants. 

Cataplasma Carbonis. 
" Conii. 

" Fermenti. 

Lini. 
" Sinapis. 

" Sodae Chloratae. 

U.S.P. Cerata. Cerates. — These are ointments containing wax. 
The admixture of wax with oil or lard in cerates renders them harder 
than ointments, though they are softer than plasters. They can be 
spread on linen or leather, at ordinary temperatures without requiring 
heat like plasters, and they can be applied to the skin without melting 
and running like ointments. 



Ceratum. 



TJ.S.P. 

Camphorae. 

Cantharidis. 

Cetacei. 

Extracti Cantharidis. 

Plumbi Subacetatis. 

Eesinae. 

Sabinae. 



Chartse. Papers. — Charta epispastica or cantharidis, and charta 
sinapis consist of irritating substances spread upon paper, and used for 
the purpose of producing rubefaction or vesication. Charta potasii 
nitratis consists of bibulous paper soaked in a solution of nitrate of potash 
and dried, and is used for burning to give relief in asthma by inhalation 
of the fumes. 



432 GENERAL PHARMACY. 

U.S.P. (3). B.P. (2). 

Charta Cantharidis. Charta Epispastica. 

" Potassii Nitratis. " Sinapis. 

" Sinapis. 

Collodia. Collodions. — In these collodion is used as a solvent 
and means of application. 

U.S.P. B.P. 

Collodium. Collodium. 

" cum Cantharide. " Flexile. 

" Flexile. 

" Stypticum. 

Confectiones. Confections, Electuaries or Conserves. — 
These are soft pastes which contain the drug mixed with sugar or honey, 
and are convenient forms of administering drugs, which would be 
unpleasant to take alone, and would be too bulky for pills. In two of 
them, the confection of dog roses, and of red roses, the drug is of itself 
inert, and the confection is used only as a vehicle ; in the others, the 
drug is active, and the confection is used as a mode of administering it. 
The dose of all is 1 to 2 drachms, with the exception of the confection 
of opium (B.P.) and of scammony (B.P.). 

U.S.P. (2). DOSE. B.P. (8). DOSE. 

Confectio Rosse Confectio Opii 5-20 grs. 

" Sennse 1-2 dr. " Piperis 

" Rosse Caninae .. 

" Rosse Gallicse.. 

" Scaninionii 10-30 grs. 

li Sennse 

" Sulphuris 

" Terebenthinse. 

Decocta. Decoctions. — These are made by boiling the drug with 
water, and then straining while hot. Usually the boiling is continued 
from ten to twenty minutes, in order to dissolve out the active part of 
the drug ; prolonged boiling frequently alters it, and may render it inert. 

U.S.P. (2). DOSE. B.P. (14). DOSE. 

Decoctum Cetrariae ad lib. Decoctum Aloes Conipositum.^-1 fl. oz. 



Sarsaparilke Com- 

positum 4-6 fl. oz. 



Cetrariae ad lib. 

Cinchona? Flavie....l-2 fl. oz. 

Granati Radicis " 

Hoematoxyli " 

Hordei ad lib. 

for external 



Papaveris 

1 t use 

Pareiroe 1-2 fl. oz. 

Quercus " 

Sarsse 2-10 fl. oz. 

Sarsic Compositum. " 

Scoparii 2-4 fl. oz. 

Taraxaci " 

Ulmi " 



PHARMACEUTICAL PREPARATIONS. 



433 



U.S. P. Elixiria. Elixirs. — These are diluted tinctures rendered 
agreeable by aromatics and sugar. The only one in the U.S. P. is used 

as a vehicle. 

; 

TJ.S.P. (1). 

Elixir Aurantii (Simple Elixir). 

Emplastra. Plasters. — These consist of adhesive substances 
spread upon leather or cloth, so as to stick to the part of the body to 
which they are applied. 

Lead plaster is one of the most important, as it forms a basis for 
other plasters. It is also used for covering slight wounds and excoria- 
tions. Resin plaster is more adhesive, and is used to hold the edges of 
wounds together and to apply pressure. Two others, emplastrum bella- 
donna and emplastrum opii, contain narcotic substances with the inten- 
tion of lessening pain locally. The others are used for the purpose of 
affording mechanical support or gentle stimulation, and emplastrum can- 
tharidis (B.P.) is used as a vesicant. 



b.p. (14). 

Ammoniaci cum Hydrargyro. 

Belladonna?. 

Calefaciens (warming). 

Cantharidis. 

Cerati Saponis. 

Ferri. 

Galbani. 

Hydrargyri. 

Opii. 

Picis. 

Plumbi. 

Iodidi. 
Resinee. 
Saponis. 



u.s.p. (17). 

Emplastrum Ammoniaci ( Ammoniac ) . Emplastrum 

" " c. Hydrargyro " 

(ammoniac with mercury). " 

" Arnicas (Arnica). " 

" Asafoetidse (Asafoetida). " 

" Belladonnas (Belladonna). " 

" Capsici (Capsicum). " 

" Ferri (Iron). " 

" Galbani (Galbanum). " 

" Hydrargyri (Mercurial). " 

" Icthyocollae (Court). " 

" Opii (Opium). " 

" Picis Burgundicse (Burgundy " 

pitch). " 

" Picis Canadensis (Hemlock 

pitch). 

" Picis cum Cantharide (warm- 

ing). 

" Plumbi (Diachylon). 

" Resinse (adhesive). 

" Saponis (soap). 

B.P. Enemata. Injections, Enemas, or Clysters. — These 
are preparations for injection into the rectum. When the quantity 
injected is large, and especially if cold, it is usually returned almost 
immediately ; therefore, when we wish to get it retained, a small quan- 
tity only, and warm, must be employed. The vehicle in most injections 
is starch mucilage. In the enema of aloes 10 ounces, and in those of 
Epsom salts and of turpentine, 15 ounces of the vehicle are used, and 
these enemata are employed for the purpose of evacuating the bowel. 
In the case of the enema opii which we wish to be retained the quantity 
is only 2 ounces. This is used both as a local and general sedative, in 
order to relieve pain in or about the pelvis, or to produce the general 
action of opium after its absorption, in eases where medicines cannot be 
retained by the stomach, or when it is inadvisable to administer them by 
the mouth. The enema asafcetidae is perhaps the most powerful remedy 
28 



434 GENERAL PHARMACY. 

we possess in cases of tympanitic distention of the bowels. As it is used 
for the purpose of exciting the contraction of the bowels and the expul- 
sion of flatulence, but not of simply evacuating the rectum, an interme- 
diate quantity is used, viz., 4 ounces. Asafoetidsfcontains a gum as well 
as a resin, and therefore no mucilage is required to suspend it, and water 
only is required in preparing it. 

The enema of tobacco is now rarely used on account of the danger 
from collapse ; but formerly, before the introduction of chloroform, it was 
frequently employed in order to cause muscular relaxation and aid in the 
reduction of hernia. 

b.p. (6). NONE IN U.S.P. 

Enema Aloes (aloes 40 grains, carbonate of potash 15 grains). 

" Magnesias Sulphatis (sulphate of magnesia 1 oz., olive oil 1 fi. oz.). 

" Opii (tincture of opium \ fl. dr.). 

" Terebinthinse (oil of turpentine 1 fi. oz.). 

" Asafoetidae (asafcetida, 30 gr., water 4 A. oz.). 

" Tabaci (leaf tobacco 20 gr., water 8 fi. oz.). 

B.P. Essentise. Essences. — These are strong solutions of 1 
part volatile oil in 4 of rectified spirit. They are used as carminatives, 
and are usually given in the form of a few drops on a piece of lump 
sugar or with a little hot sugar and water, in order to remove flatulence. 

B.P. (2). DOSE. 

Essentia Anisi 10-20 m. 

" Menthae Piperita 10-20 m. 

Extracta. Extracts. — Extracts consist of the soluble parts of 
plants reduced to the consistence of a thick paste by extraction and 
evaporation. The plan of treatment adopted in order to extract the 
soluble parts, and leave behind the woody fibre and other inert constitu- 
ents varies, according as the plant is fresh or dry. 

From fresh plants, green extracts (B.P.) are obtained by evaporation 
of the fresh juice after removal of the coagulable albumen. From dried 
plants the active principles are removed by treatment with cold or boil- 
ing water, with spirit, ether, or acetic acid, and the solutions thus 
obtained are evaporated to a consistence suitable for making pills, or else 
to dryness. 

Where the active principles are of a resinous or alkaloidal nature, 
and are more soluble in pure than in dilute spirit, alcohol or rectified 
spirit is used; in other cases dilute alcohol or proof spirit is employed. 
Where the drug contains more than one active substance and one is 
more soluble in spirit, and the other in water, both spirit and water are 
used. In order to prevent extracts which, when freshly prepared, are 
of a proper consistence for making pills, from becoming too dry and 
hard by keeping, the U.S.P. in several instances directs them to be mixed 
with 5 per cent, of glycerine. 

U.S.P. (31). DOSE. B.P. (29). DOSE. 

Extractum Aconiti \-\ gr. Extractum Aconiti 1-2 gr. 

" Aloes Aquosum 2-10 gr. " Aloes Barbadensis 2-6 gr. 

" Arnica; Radicis 3-5 gr. " " Socotrinae " 

" Belladonna; Alco- ) , " Anthemidis 2-10 gr. 

holicum /* gn " Belladonnas \-\ gr. 



PHARMACEUTICAL PREPARATIONS. 



435 



U.S.P. (31). 



DOSE. 






Extractum Cannabis Indicse i gr. 

Cinchonae 10-30 gr. 

Colchici Radicis 1-2 gr. 

Colocynthidis J-l gr. 

" Com- 1 

positum j & 

Conii Alcoholicum ^-1 gr. 

Digitalis £ gr. 

Ergotae 5-15 gr. 

Euonymi 1-3 gr. 

Gentianae 10-30 gr. 

Glycyrrhizae Purum... 

Haematoxyli 10-30 gr . 

Hyoscyami Alco- \ 12 

holicum j s 

Iridis 1-2 gr. 

Juglandis 5-10 gr. 

Krameriae 10-20 gr. 

Leptandrae 20-30 gr. 

Malti 1-4 dr. 

Mezerei 

Nucis Vomicae ^-2 gr. 

Opii j-1 gr. 

Podophylli 1-3 gr. 

Physostigmatis T V -i gr. 

Quassiae 1-2 gr. 

Rhei 5-10 gr. 

Stramonii J-4 gr. 

Taraxaci 20-60 gr. 



B.P. (29). DOSE. 

Extractum Calunibae 2-10 gr. 

" Cannabis Indicse J-l gr. 

" Colchici J-2 gr. 

" " Aceticum " 

" Colocynthidis Com- 1 o -1 n 

positum J " ^ r * 

" Conii 2-6 gr. 

" Gentianas 2-10 gr. 

Glycyrrhizae 10-30 gr. 

" Haematoxyli " 

" Hyoscyami 5-10 gr. 

" Jalapa3 5-15 gr. 

" Krarueriae 5-20 gr. 

" Lactucae 5-15 gr. 

Lupuli 

' Mezerei iEthereum.... 
" Nucis Vomicae 2-2 gr. 

Opii 

" Papaveris 2-5 gr. 

" Pareirae 10-20 gr. 

" Physostigmatis T V? gr. 

" Quassiae 3-5 gr. 

" Rhei 5-15 gr. 

" Stramonii £-§ gr. 

" Taraxaci 5-30 gr. 



Fluid u.s.p. oe Liquid b.p. Extracts. — These are made like watery 
extracts, excepting that instead of evaporating the infusion, decoction 
or alcoholic solution (U.S.P.) to a solid paste, it is only reduced to a 
small bulk, and in the B.P. some spirit is added to it in order to prevent 
decomposition. 



U..S.P. (79). DOSE. 

Extractum Aconiti Fluidum §-1 m. (0*03-0'06 c.c.) 

" Arnicae Radicis Fluidum 5-10 m. (0'3-0'6 c.c.) 

" Aromaticum " 10-20 m. (0'6-l'25 c.c.) 

" Aurantii Amari " 15-30 m. (0'9-l'9 c.c.) 

Belladonnae " 1-2 m. (0'06-0\L2 c.c.) 

Brayerae " |-1 fl. oz. (15-30 c.c.) 

Buchu " 30-60 m. (1-9-38 c.c.) 

Calami " 5-15 m. (0-3-0'9 c.c.) 

Calumbae " 15-30 m. (09-19 c.c.) 

" Cannabis Indicae " £-1 m. (0-03-0-06 c.c.) 

Capsici " ^-1 m. (0-03-0-06 c.c.) 

Castanet " 1-2 fl. dr. (3'75-7'5 c.c.) 

Chimaphilae " 1 fl. dr. (3'75 c.c.) 

Chiratae " J fl. dr. (P9 c.c.) 

Cimicifugae " |-1 fl. dr. (l'9-3'75 c.c.) 

Cinchonae " J-2 fl. oz. (7*5-60 c.c.) 

" Colchici Radicis " 2-8 m. (0-12-0*5 c.c. 

" Colchici Seminis " 2-8 m. (0'1 2-0*5 c.c. 

Conii " 5 m. (03 c.c.) 

Cornus " 30 m. (1*9 c.c.) 

" Cubebae " 10-40 m. (0.6-25 c.c.) 

" Cypripedii " 15 m. (0-9 c.c.) 

" Digitalis " 1-2 m. (0'06-0'12 c.c.) 

" Dulcamarae " 30-60 m (19-3-75 c.c.) 



436 



GENERAL PHARMACY. 



u.s.p. (79). 

Extractum Ergotae 

Erythroxyli 

Eucalypti 

Eupatorii 

Frangulae 

Gelsemii 

Gentianae 

Geranii 

Glycyrrhizae 

Gossypii Radicis 

Grindeliae 

Guaranae 

Hamamelidis 

Hydrastis 

Hyoscyami 

Ipecacuanha? 

Iridis 

Krameriae 

Lactucarii 

Leptandrae 

Lobeliae 

Lupulini 

Maticae 

Mezerei 

Nucis Vomicae 

Pareirae 

Pilocarpi 

Podophylli 

Pruni Virginianae 

Quassiae 

Rhei 

Rhois Glabrae 

Rosae 

Rubi 

Rumicis 

Sabinae 

Sanguinariae 

Sarsaparillae 



DOSE. 

,f-t jul. ur. (19-15 c.c.) 
.20-60 m. (1-25-3-75 c.c.) 
.5-10 m. (0-3-06 c.c.) 
.20-60 in. (1-25-3-75 c.c.) 
10-20 m. (0-6-1-25 c.c) 
.2-3 m. (012-0-18 c.c.) 
.10-30 m. (0-6-1-9 c.c.) 
.30-60 m. (1-9-3-75 c.c. 
.30-120 m. (1-9-7-5 c.c. 
.30-60 m. (1-9-3-75 c.c.) 
.30-60 m. (1-9-3-75 c.c.) 
.1-2 fl. dr. (375-7-5 c.c.) 
.30 m. (1-9 c.c.) 
.1-2 fl. dr. (3-75-7-5 c.c.) 
.5 m. (03 c. c.) 
.15-30 (0-9-1-9 c.c.) 
.5-10 m. (0-3-06 c.c ) 
.10-60 m. (0-6-3-75 c.c.) 
.5-30 m. (0-3-1-9 c.c.) 
.20-60 m. (1-25-3-75 c.c.) 
.10-20 m. (0-6-1-25 c.c.) 
.10-15 m. (0-6-0-9 c.c.) 
.30-60 m. (1-9-375 c.c.) 
.for external use. 
.3-5 m. (0-18-0-3 c.c.) 
.1-2 fl. dr. (375-7-5 c.c.) 
.15-30 m. (0-9-1-9 c.c.) 
.5-15 m. (0-3-0-9 c.c.) 
.30-60 m. (1-9-3-75 c.c.) 
.5-10 m. (03-0-6 c.c.) 
.5-30 m. (03-19 c.c.) 
.for external use. 
.1-2 fl. dr. (375-7-5 c.c.) 
.H fl. dr. (1-9-3-75 c.c.) 
.1 fl. dr (3-75 c.c.) 
.3-8 m. (0.18-0-5 c.c.) 
.3-5 m. (0-18-0-3 c.c.) 
.2-4 fl. dr. (7.5-15 c.c.) 



Sarsaparillae Compositum Fluidum 30-60 (19-3-75 c.c.) 



Scillse 

Scutellariae 

Senegae 

Sennae 

Serpentariae 

Spigelian 

Stillingiae 

Stramonii 

Taraxaci 

Tritici 

Uvx- Ursi 

Valerianae 

Veratri Viridis 

Viburni 

Xanthoxyli 

Zingiberis 



.1-3 m. (0-12-0-18 c.c.) 
..30-60 in. (1-9-3-75 c.c.) 
..1-5 m. (006-03 c.c.) 
..1-4 fl. dr. (3-75-15 c.c.) 
..20-30 m. (1-25-1-9 c.c.) 
..1-2 fl. dr. (3-75-7'5 c.c.) 
..15-45 in. (0-9-2-8 c.c.) 
..1-2 m. (006-0-12 c.c.) 
.1-3 fl. dr. (3-75-11-25 c.c.) 
.3-6 fl. dr. (1125-22-5 c.c.) 
..30-60 m. (19-3-75 c.c. 
.lfl. dr. (3-75 cc.) 
.1-2 m. (006-0-12 c.c.) 
..30-60 m. (1-9-3-75 c.c.) 
..30-60 m. 1-9-3-75 c.c.) 
..10-20 m. (06-1-25 c.c.) 



B.l\ (8). DOSE. 

Extractum P>elae Liquidum 1-2 fluid drachms. 

Cinchona; Flavae Liquidum 10-XU minims. 



Ergotae 

Filicis 

Glycyrrhizae 

Opii 

Pareirae 

Sarsa? 



K»-3ii minims. 
.15-60 minims. 
.60- 120 minims. 
.10-40 minims. 
.o-2 fluid drachms. 
.2-4 fluid drachms. 



PHAEMACEUTICAL PREPARATIONS. 437 

b.p. Fresh or Green Extracts — These extracts have already been enu- 
merated among the others. In preparing them, the juice obtained 
from the fresh leaves, flowering tops or fruits, of the plant, by pres- 
sure, is heated to 130° F. to coagulate the green coloring matter. 
This is then filtered off and laid aside. The filtrate is next heated to 
200° so as to coagulate the albumen ; this is filtered out and thrown 
away. The filtrate is then evaporated at a temperature not exceeding 
140° to a thin syrup. The coloring matter is then added to it, and the 
whole evaporated to a proper consistence. In the case of extracts of col- 
chicum and taraxacum there is no chlorophyll to separate, as the juices 
are obtained by expression from the colchicum corm and the taraxacum 
root, and not from flowering tops. Consequently the juice is at once 
heated to the boiling point to coagulate the albumen, and after this has 
been filtered out the filtrate is evaporated at a temperature of 160°. In 
the case of green extracts, the preservation of the green color is usually 
regarded as a sign that they are good. It certainly indicates that the 
first and the last parts of the process have been conducted with care, as 
too high a temperature destroys the green color. It is therefore probable 
that the whole process may have been carefully done ; but this is not cer- 
tain, for the juice may have been exposed to a high temperature, and thus 
injured during its evaporation after the chlorophyll has been removed and 
before it has been again added. 

The green extracts of the B.P. are (8): — 

Extractum Aconiti. Extractum Colchici Aceticum. Extractum Lactucse. 

Belladonnas " Conii. " Taraxaci. 

" Colchici. " Hyoscyami. 

Glycerita, U.S. P. ; Glycerina, B.P. Glycerines. — These are 
solutions of soothing, astringent, or antiseptic substances in glycerine. 
Glycerine being thick and adhesive, they form most useful local applica- 
tions, either to the skin or mucous membranes. 

Those in the B.P. contain one part of the drug by weight to four of 
glycerine by measure, excepting in the case of starch, which being very 
light and bulky, is used in only half this proportion, i.e., one ounce of 
starch to eight ounces of glycerine. In the U.S. P. the starch is in the 
proportion of 1 to 9, i.e., 10 per cent. The glyceritum vitelli contains 
45 parts fresh yolk of egg to 55 of glycerine. 

TJ.S.P. (3). B.P. (6). 

Glycerinum. Glycerinum. 

Glyceritum Amyli. " Acidi Carbolici. 

" Vitelli. " " Gallici. 

" " Tannici. 

" Amyli. 

" Boracis. 

Infusa. Infusions. — These are prepared by simply pouring boil- 
ing water on the drug and allowing it to stand for a short time and then 
straining. 

There are two exceptions to this rule, calumba and quassia, which are 
prepared with cold water. The reason for using cold water in the case 



-138 GENERAL PHARMACY. 

of calumba is that the root contains a quantity of starch, and if hot water 
be used, this is extracted and renders the infusion liable to decompose, 
especially in hot weather. 

I have been unable to find any definite reason assigned for using cold 
water in the preparation of infusion of quassia, excepting that cold water 
is sufficient to dissolve the active principle. 

In the only instance in which I have seen an infusion made with hot 
water used, it caused vomiting, so that perhaps an infusion made with 
hot water has a more irritating action than that made with cold. 

Infusions of chiretta and cusparia are made with water at 120° 
instead of boiling water, as they are more agreeable when prepared in this 
way. 

The infusions of substances not specified in the U.S. P. are directed 
by it to be prepared by taking ten parts of the substance in coarse pow- 
der and 100 of boiling water. These are to be put into a vessel with a 
tight cover, and allowed to stand for two hours. The infusion is then 
strained, and enough water passed through the strainer to make the pro- 
duct weigh 100 parts. 

All the infusions both of the U.S. P. and B.P. are strained, with the 
exception of the infusion of cusso or brayera. 

TJ.S.P. (5). DOSE. B.P. (28). 

Of all not specified 1-2 fl. oz. 

Infusum Brayerae (Cusso) 10 oz. Infusum Anthemidis 1-4 fl. oz. 

" Cinchonae 2 oz. " Aurantii 

" Digitalis % oz.* " " Compositum 

" Pruni Virginianae...2-3 oz. " Buchu 1-4 fl. oz. 

" Sennas Compositum, 4 fl. oz. " Calumbae 

" Caryophylli 

" Cascarillae 

" Catechu 

" Chiratse 

" Cinchonae Fluidum.. 

" Cuspariae 

" Cusso (Brayera an-) . Q a ^„ 
thelmiutica) }4-8fl.oz. 

" Digitalis 1-4 fl. dr. 

" Dulcamarae 

" Ergotae 

" Gentian* Compos- 1 
itum I 

" Kramerine 

" Lini 

" Lupuli 

" Maticrc 

" Quassia; 

Rhei 

" Rosa* Acidum 

" Senega* 

" Senna? 

" Serpentaria* 

Uvae Ursi 

Valeriana- 

* This infusion is about twice the strength of the B.P. The dose is usually stated 
at \ oz. twice a day, but in many cases this dose would probably prove too large, 
and it is safer to begin with a smaller dose, and gradually push it as the patient 
will stand it. 



PHARMACEUTICAL PREPARATIONS. 439 

B.P. Injectio Hypodermica. Hypodermic Injection. — 
There is only one, that of acetate of morphia, used simply for injecting 
under the skin. It is 10 times stronger than the liquor morphiae ace- 
tatis, and contains 40 grains to the fluid ounce or 1 grain in 12 minims. 

B.P. DOSE. 

Injectio Morphise Hypodermica 2-3 minims. 

Linimenta. Liniments or Embrocations. — These are prepara- 
tions for rubbing or painting on a part of the body in order to produce 
local stimulation or relieve pain. The basis of most of those in the United 
States Pharmacopoeia is cotton-seed oil, and of those in the British Phar- 
macopoeia olive oil. 1 Camphor is added to most of the liniments in the 
B.P. for its local stimulant action, and also that its strong smell may les- 
sen the risk of the liniment being used internally. There are four excep- 
tions in the B.P., the liniments of ammonia, lime, croton oil, and iodide 
of potassium with soap. With the exception of the liniment of lime all 
these contain very strong smelling substances, namely, ammonia in the 
corresponding liniment, cajuput oil in the croton oil liniment, and oil of 
lemon in the iodide of potassium and soap liniment. 

Camphor is not contained in the liniments of the U.S. P., with the 
exceptions of the liniments of belladonna, camphor, chloroform and soap. 

Soap is used to give a lubricating quality to two liniments in the 
U.S. P., viz., chloroform and soap, and to four in the B.P., viz., opium, 
iodide of potassium with soap, soap and turpentine. In the compound 
mustard liniment, whose composition is nearly the same in the U.S. P. 
and the B.P., castor oil is used as a lubricant along with alcohol. In one, 
the turpentine liniment of the U.S. P., the lubricating substances are lard 
and yellow wax. 

One liniment in the U.S. P., belladonna, and three in the B.P., 
aconite, belladonna, and iodine, are really exceedingly strong solutions of 
active principles in spirit with camphor added for the purposes already 
mentioned. 

The liniments last mentioned contain no fatty substances as lubricants, 
nor does the linimentum cantharidis (U.S. P.), nor the croton oil liniment 
of the B.P., compound camphor liniment (B.P.). Croton oil liniment 
(B.P.) is a solution of croton oil with cajuput oil in spirit. The compound 
camphor liniment is a mixture of strong solution of ammonia with rectified 
spirit, camphor and oil of lavender. 

The linimentum cantharidis (U.S. P.) is a solution of the active princi- 
ples of cantharides in turpentine. The difference in composition between 
the ordinary camphor liniment (B.P.), which is simply a mixture of 
camphor and olive oil, and the compound camphor liniment, should be 
carefully borne in mind. The linimentum terebinthinse aceticum (B.P.) 
consists of oil of turpentine and acetic acid mixed with ordinary camphor 
liniment. But if any one thinking to increase its efficacy should add to 
it compound camphor liniment, the acetic acid and ammonia would 
neutralize one another more or less completely, and the activity of both 
liniments would be to a great extent destroyed. 

1 1 have been told that a great deal of what is sold as olive oil in Great Britain 
is really cotton-seed oil. 



uo 



GENERAL PHARMACY. 



U.S. P. 

Linimentum Ammonia?. 



B.P. 

Linimentum Aconiti. 



Belladonna?. 

Caleis. 

Camphora?. 

Cantharidis. 

Chloroformi. 

Plumbi Subacetatis. 

Saponis. 

Sinapis Compositum. 

Terebinthina?. 



Ammonia?. 

Belladonna?. 

Caleis. 

Camphora?. 

Camphora? Compositum. 

Chloroformi. 

Crotonis. 

Hydrargyri. 

Iodi. 

Opii. 

Potassii Iodidi cum Sapone. 

Saponis. 

Sinapis Compositum. 

Terebinthina?. 

Terebinthina? Aceticum. 



Liquores. Solutions. — These are solutions of active substances 
in water, either alone or with the aid of other solvents. 



U.S. P. 



DOSE. 



Liquor Acidi Arseniosi 2-8 m. 

" Ammonii Acetatis j-l^ oz. 

" Arsenici et Hydrar- \ - 1n 

gyri Iodidi |5-lUm. 

" Caleis 2-4 fl. oz. 

" Ferri Acetatis 2-10 m. 

" Chloridi " 

" " Citratis 10 m. 

" rt 2£r. *}««•■»• 

" Nitratis 5-20 m. 

" Subsulphatis 3-6 m. 

" Tersulphatis ... 

" Gutta-Percha? 

" Hydrargyri Nitratis 

" Iodi Compositus 5 m. 

" Magnesii Citratis 6-12 fl. oz. 

" Pepsini £-2 fl. oz. 

" Plumbi Subacetatis 

" Subacetatis 
Dilutus... 
" Potassii 10-60 m. 

" Arsenitis 5 m. 

" Citratis £-2 fl. oz. 

" Soda? 10-60 m. 

" Soda? Chlorata? 30-60 m. 

" Sodii Arseniatis 3-8 m. 

" " Silicatis 

" Zinci Chloridi 



b.p. (39). 



DOSE. 



Liquor Ammonia? 10-30 m. 

" " Acetatis 2-6fl.dr. 

Citratis " 

" " Fortior 3-10 m. 

" Antimonii Chloridi 

" Arsenicalis 2-8 m. 

" Arsenici Hydrochlo- \ « 

ricus j 

" Atropia? 1-2 m. 

" Atropia? Sulphatis " 

" Bismuthi et Ammo- | iifl a t 

nia? Citratis J 2 " 

" Caleis 1-4 fl. oz. 

" Caleis Chlorata? 

" " Saccharatus 15-60 m. 

" Chlori 10-20 m. 

" Epispasticus 

" Ferri Perchloridi 10-30 m. 

" " " Fortior 
<; " Pernitratis " 

'* Persulphatis 

" Gutta-Percha 

" Hydrargyri Nitratis 

Acidus 

" Hydrargyri Perchloridi £-2 fl. dr. 

" Iodi 

" Lithia? Effervescens 5-10 fl. oz. 

" Magnesia? Carbonatis....l-2 fl. oz. 

11 Citratis 5-10 fl. oz. 

" Morphia? Acetatis 10-60 m. 

Hydrochlo- \ 

ratis j 

" Plumbi Subacetatis 

" " Dilutus.. 

" Potassa? " 

11 " Effervescens 5-10 fl. oz. 

" " Permanganatis..l-4 fl. dr. 

" Soda? 10-60 m. 

" " Arseniatis 5-10 m. 

" " Chlorate 10-20 m. 

" Effervescens 5-10 fl. oz. 

" Strychnia' 5-10 m. 

" Zinci Chloridi 



PHARMACEUTICAL PREPARATIONS. 441 

U.S. P. Massae. Masses. — These simply consist of substances 
mixed together to a consistence suitable for making pills. 

Massa Copaibse. 

" Ferri Carbonatis. 
" Hydrargyri. 

Mellita. Honeys. — In these preparations honey is used as a 
vehicle. Oxymel and oxymel scillse of the B.P., which contain acetic 
acid, may be regarded as belonging to this class. 

U.S.P. B.P. 

Mel Despumatum. Mel Boracis. 

" Kosae. " Depuratum. 

Oxymel. 

Scillse. 

Misturse. Mixtukes. — These usually consist of insoluble sub- 
stances simply mixed with water or suspended in it by the aid of gum or 
other viscid substances. In almond (U.S.P and B.P.), chalk (U.S.P. 
and B.P.), guaiac (B.P.), and compound glycyrrhiza (U.S.P.) mix- 
tures, gum is added. In the ammoniacum (U.S.P. and B.P.), asafoetida 
(U.S.P.), and compound iron (U.S.P. and B.P.) mixtures, gum is con- 
tained in the ammoniacum, asafoetida, and myrrh used in their preparation 
respectively. 

In scammony mixture (B.P.) the scammony resin is simply suspended 
in milk. In egg flip or brandy mixture (mistura spiritus vini gallici) 
(B.P.) and chloroform mixture (U.S.P.), yolk of egg forms the basis of 
the mixture. 

The magnesia and asafoetida, 1 and rhubarb and soda mixtures of the 
U.S.P. contain insoluble substances mixed with water without the addi- 
tion of any viscid substance; in the creasote mixture (B.P.) the syrup 
may be looked upon as viscid and tending to keep the ingredients mixed, 
but the aromatic iron, compound gentian, and compound senna mixtures 
of the B.P., and the acetate of iron and ammonia (U.S.P.) mixture, are 
simply solutions and not mixtures in the usual sense. 

U.S.P. (11). DOSE. B.P. (11). DOSE. 

Mistura Ammoniaci £-1 fl. oz. Mistura Ammoniaci \-\ A- oz. 

" Amygdalae 1-2 fl. oz. " Amygdalae 1-2 fl. oz. 

" Asafoetidse ^-1 fl. oz. " Creasoti " 

" Chloroformi " " Cretan " 

" Creta3 1-2 fl. oz. " Ferri Aromatica " 

" Ferri Composite " " Composita " 

" " etAmmonii ) l1fl " Gentianae |-1 fl. oz. 

Acetatis f 2_1 n ' oz " " Guaiaci £-2 fl. oz. 

Glycyrrhizae Com- \ L " Scammonii. 



posita J 2 ' Sennae Composita 1-2 fl. oz. 

Magnesise et Asafce- \ oft " Spiritus Vini Gallici.... 

tidas r um> 

Potassii Citratis J fl. oz. 

Rhei et Sodae ^-1 dr. 



1 In this mixture there is no gum, for although it is contained in crude asafoetida 
it is not contained in the tincture of asafoetida used in this preparation. 



442 GENERAL PHARMACY. 

3Iueilagines. Mucilages. — These are thick solutions, partial or 
complete, of gurn or starch, which are convenient for suspending heavy 
powders in mixtures. 

u.s.p. (5). b.p. (3). 

Mucilago Acaciae. Mucilago Acaciae. 

" Cydonii. " Amyli. 

" Sassafras Medullar " Tragacanthse. 

" Tragacanthse. 
Ulmi. 

Olea. Oils. — These are divided into fixed and volatile. The fixed 
are obtained by simple expression ; the volatile by distillation excepting 
in the case of oil of lemons, which, being contained in distinct vittse in 
the rind, may be expressed instead of being distilled. 

Fixed Oils. 

U.S.P. (11). DOSE. B.P. (9). DOSE. 

Oleum Adi pis Oleum Amygdalae 1-4 fl. dr. 

" Amygdalae Expressum.... 1-8 fl. dr. " Crotonis (croton oil) fl min. 

" Gossypii Se minis " Lini 

" Lini " Morrhuae 1-8 fl. dr. 

" Morrhuae 2-4fl. oz. " My risticae Expressum.... 

" Olivae " Olivae " 

" Phosphoratum 1-5 min. " Phosphoratum 5-10 min. 

" Eicini 1-8 fl. dr. " Ricini 1-8 fl. dr. 

" Sesami " Theobromae 

" Theobromae 

" Tiglii (croton oil) |-1. min. 

Volatile Oils. 

U.S.P. DOSE OF EACH. 

Oleum ^thereum 1-5 m. unless otherwise mentioned. 

" Amygdalae Amarae |-1 min. (0-016-0-06 c.c.) 

" Anisi 5-15 min. (0'3-0'9 c.c.) 

" Aurantii Corticis 

" Florum 

" Bergamii 

Cajuputi 5-20 min. (03-1 25 c.c.) 

Cari 1-10 min. (006-06 c.c.) 

Caryophvlli 2-6 min. (012-036 c.c.) 

Chenopodii 4-8 min. for a child (025-05 c.c.) 

" Cinnamomi 1-3 min. (006-018 c.c.) 

" Copaibie 10-15 min. (06-09 c.c.) 

" Coriandri 

Cubebie 10-12 min. at first (0*6 or 072 c.c.) 

gradually increased. 

" Erigerontis 10 min. 4 fluid drachm (06-018 c.c.) 

Eucalypti 10-15 min. (06-09 c.c.) 

" Fo3niculi 5-15 min. (03-09 c.c.) 

" Gaultherine 

Hedeoma: (penny royal) 2-10 min. (012-06 c.c.) 

Juniperi 5-15 min. (03-0-9c.c.) 

" Lavandulae 1-5 min. (006-03 c.c.) 

Florum 

" Limonis 

Menthoe Pi]»crit;r 2-6 min. (012-036 c.c.) 

" Viridis 2-6 min. (006-036 c.c.) 



PHARMACEUTICAL PREPARATIONS. 443 

U.S.P. DOSE OF EACH. 

Oleum Myrcise 1-5 m. unless otherwise mentioned. 

" Myristicse 2-3 min. (012-0-18 c.c.) 

" Picis Liquidse 

" Pimentse 3-6 min. (0*18-0-35 c.c.) 

" Rosse 

" Rosmarini 3-6 min. (0-18-0'36 c.c.) 

" Rutae 2-5 min. (012-0-3 c.c.) 

" Sabinse 2-5 min. (012-0 "3 c.c.) 

" Santali 20-30 min. (1'25-1'9 c.c.) 

u Sassafras 3-5 min. (018-0'3 c.c.) 

" Sinapis Volatile 

" Succini 5-15 min. (03-0'9 c.c.) 

" Terebinthinse 5-30 min. (03-l'9 c.c.) 

" Thymi 

" Valeriana3 4-5 min. (0'24-0'3 c.c.) 

§ Volatile Oils. 

B.P. (22). DOSE OF EACH. 

Oleum Anethi 1-5 m. unless otherwise mentio 

" Anisi 

" Anthemidis 

" Cajuputi 

11 Carui 

" Caryophylli 

" Cinnamomi 

" Copaibse 5-20 min. 

" Coriandri 

" Cubeba3 5-20 min. 

" Juniperi 1-10 min. 

" Lavandulae 

" Limonis 

" Mentha3 Piperita? 

" Viridis 

" Myristica3 

" Pimenti 

" Rosmarini 

" Rut83 

" Sabinas 

" Sinapis For external use only. 

" Terebinthinas 10-20 m. as diuretic, 2-6 n. dr. as 

anthelmintic. 

U.S.P. Oleata. Oleates. — Solutions of bases in oleic acid. They 
are more readily absorbed by the skin than ointments. 

U.S.P. 
Oleatum Hydrargyri. 
" Veratrinse. 

U.S.P. Oleoresinse. Oleoresins. — These are, as their name im- 
plies, mixtures of volatile oil and resin. They are extracted by treating 
the crude substance with stronger ether, and removing the ether partly 
by distillation and partly by evaporation. Their advantage is that they 
remain in a liquid or semi-liquid state, and are stable, not requiring alco- 
hol to prevent decomposition. 

U.S.P. DOSE. 

Oleoresina Aspidii ?-l fl. dr.(r9-3*75 c.c.) 

" Capsici i-1 min. (0"015-006 c.c.) 

Cubebse 5-30 min. (0*3-l*9 c.c.) 

Lupulini 2-5 gr. (013-033 gm.) 

" Piperis H min. (0'015-0-06 c.c.) 

" Zingiberis T V1 min. (0'006-0'06 c.c.) 



444 GENERAL PHARMACY. 

Oxymel, vide Mellita. 

Pilulae. Pills. — Pills are small round masses which can be con- 
veniently swallowed. They are rarely made of a greater weight than 
five grains, as they then become too bulky to be swallowed easily. Those 
of the U.S. P. are four grains each. In their composition the old rule 
of curare, cito, tute et jucunde, has been pretty strictly followed, 
and most of them in addition to the basis contain an adjuvant, corrective, 
and vehicle. To prevent them sticking together they are generally 
shaken with some dry powder, such as lycopodium, carbonate of magnesia, 
flour, starch, or liquorice powder. Sometimes they are gilt or silvered 
by shaking them while freshly prepared, and without the addition of any 
dusting powder, along with gold or silver leaf in a hollow spherical 
wooden box. Recently a coating of firm gelatine has been used, and 

sometimes pills are coated with sugar. 

« 

U.S.P. DOSE. 

Pilulae Aloes 1-5 pills. 

" Aloes et Asafoetidae 2-5 pills. 

11 " et Ferri 1-3 pills. 

" " etMastiches 1 pill. 

" et Myrrhae 3-6 pills. 

" Antimonii Compositae 1-2 pills. 

" Asafcetidae 1 pill. 

" Catharticae Compositae 1-3 pills. 

" Ferri Compositae 2-6 pills. 

" Iodidi 1 pill. 

" Galbani Compositae 2-4 pills. 

" Opii.' 1 pill. 

" Phosphori 1-2 pills. 

" Rhei 1-6 pills. 

" " Compositae 2-4 pills. 

B.P. DOSE. 

Dose 5-10 grs. with the exception of those mentioned. 

Pilula Aloes Barbadensis 

" Aloes et Asafcetidae 

" et Ferri 

" " et Myrrhae 

" " Socotrinae 

" Asafoetidae Composita 

" Cambogiae Composita 

" Colocynthidis Composita 

" " et Hyoscyami 

" Conii Composita 

" Ferri Carbonatis 

" Iodidi 3-8 grs. 

" Hydrargyri 3-8 grs. 

" Hydrargyri Subchloridi Composita 

" Ipecacuanhas cum Scilla 

" Phosphori 2-5 grs. 

" Plumbi cum Opio 2-5 grs. 

" Quiniai 2-10 grs. 

" Rhei Composita 

" Saponis Composita 2-5 grs. 

" Scammonii Composita 5-15 grs. 

" Scilla- Composita 

Pulvercs. Powders. — The officinal powders contain two or more 
substances triturated and mixed together. The fineness of powders is 



PHARMACEUTICAL PREPARATIONS. 445 

ascertained by the size of the meshes of the sieve through which they 
pass. 

TJ.S.P. (9). DOSE. 

Pulvis Antimonialis 3-8 grs. (0-2-0 '52 gm.) 

" Aromaticus 10-30 grs. (0-65-195 gm.) 

" Cretse Compositus 10-30 grs. (065-1-95 gm.) 

" Effer vescens Compositus One powder. 

" Glycyrrhizse Compositus 30-60 grs. (l'95-3*9 gm.) 

" Ipecacuanha? et Opii 5-15 grs. (0 33-1 gm.) 

" Jalapse Compositus 30-60 grs. (l'95-3'9 gm.) 

" Morphinse Compositus 10 grs. (0"65 gm.) 

" Rhei Compositus 30-60 grs. (1-95-3-9 gm.) 

b.p. (15). DOSE. 

Pulvis Amygdalae Compositus 60-120 grs. 

" Antimonialis 3-10 grs. 

" Catechu Compositus 20-40 grs. 

" Cinnamomi Compositus 3-10 grs. 

" Cretse Aromaticus 10-60 grs. 

" " Aromaticus cum Opio 10-40 grs. 

" Elaterii Compositus h-5 grs. 

'' Glycyrrhizse Compositus 30-60 grs. 

k ' Ipecacuanha? Compositus 5-15 grs. 

" Jalapse Compositus 20-60 grs. 

" Kino Compositus 5-20 grs. 

" Opii Compositus 2-5 grs. 

" Rhei Compositus 20-60 grs. 

" Scammonii Compositus 10-20 grs. 

" Tragacanthse Compositus 20-60 grs. 

Resina. Resins. — These are brittle, amorphous solids, consisting 
of an acid or mixtures of acids formed by the oxidation of terpenes which 
are volatile hydrocarbons having the formula C 10 H 16 . Resins are insoluble 
in water but soluble in spirit. They melt when heated and solidify again 
on cooling. They dissolve in alkalies, forming a kind of soap. They 
frequently occur in plants along with unoxidized volatile oils as oleo- 
resins. Resins may be obtained from oleo-resins, e.g., turpentine, by 
simple distillation, when the volatile oil distils over and resin remains. 
They may be got by heating the part of the plant in which they are 
contained, e.g., guaiac resin. They may be prepared by dissolving 
them out of the plants by means of alcohol and removing the alcohol by 
distillation, or precipitating them by throwing the strong tincture into 
water. Resins are of an acid nature, and the addition of a little mineral 
acid to water causes them to be precipitated more readily. 

U.S.P. B.P. 

Resina Copaibae. Resina. 

" Jalapse. " Guiaci. 

" Podophylli. " Jalapse. 

" Scammonii. " Podophylli. 

Guaiaci Resina. " Scammonise. 

Spiritus. Spirits. — With the exception of rectified and proof 
spirit, these are alcoholic solutions of volatile oils or ethers. The dose 
is \ to 1 fluid drachm, except where otherwise mentioned, and except in 
the case of brandy, rum, and whisky, the doses of which vary very much, 
according to the purpose for which they are used. 



446 GENERAL PHARMACY. 

U.S.P. (22). DOSE. 

Spiritus iEtheris 1-3 fluid drachms (3*75-11*25 c.c.) 

" " Compositus $-2 fluid drachms (TO-7'5 c.c.) 

" Nitrosi 30-60 min. (1*9-3*75 c.c.) 

" Ammonia? 10-30 min. (0*6-1*9 c.c.) 

11 " Aromaticus 30-60 min. (1*9-3*75 cc.) 

" Anisi 1-2 fluid drachms (3-75-75 c.c.) 

Aurantii 1-2 fl. dr. (3*75-7*5 c.c.) 

" Camphora? 5-60 min. (0*3-3*75 c.c.) 

Chloroformi 10-60 min. (0 6-3*75 c.c.) 

" Cinnamonii 10-20 min. (0*6-1*26 c.c.) 

" Frumenti (Whisky) 

Gaultheria? 10-20 min. (0*6-1*25 c.c.) 

" Juniperi 30-60 min. (1*9-3*75 c.c.) 

" Compositus 2-4 fluid drachms (7*5-15 c.c.) 

" Lavandulae 30-60 min. (1*9-3*75 c.c.) 

" Limonis 

" Mentha? Piperita? 10-20 min. (0*6-1*25 c.c) 

Viridis 30-40 min. (1*9-2*5 c.c.) 

" Myrcia? (Bay Rum) 

" Myristica? 1 fluid drachm (3*75 c.c.) 

■* Odoratus (Cologne- Water)... 
" Vini Gallici 

B.P. (16). DOSE. 

Spiritus iEtheris 

" Nitrosi £-2 fluid drachms. 

" Ammonia? Aromaticus 

" '* Foetidus 

" Armoracia? Compositus 1-2 fluid drachms. 

" Cajuputi 

" Camphora? 10-30 min. 

" Chloroformi 10-60 min. 

" Juniperi \-l\ fluid drachms. 

■' Lavandula? 

" Mentha? Piperita? 

" Myristica? 

" Rectificatus 

" Rosmarini 10-60 min. 

" Tenuior 

" Vini Gallici 

Suppositoria. Suppositories. — These are small conical masses for 
introducing drugs into the rectum. They are used either to produce a 
local action on the rectum itself, or on the adjoining pelvic organs, such 
as the uterus or the bladder ; or to introduce certain drugs into the body 
when we wish to avoid any local action on the stomach. 

Thus the morphia suppositories may be used for their general action 
in inducing sleep, or for their local action in soothing pain or irritation 
in the rectum or pelvic organs, or to check diarrhoea. The compound 
lead suppository may be used in diarrhoea for its local action on the 
rectum, and likewise for its general action in checking bleeding from 
the lungs, etc. The same may be said of the mercurial suppository. 
The others are more intended for local action. 

B.P. (7). 

Suppositoria Acidi Carbolici cum Sapone. 
" " Tannici. 

" cum Sapone. 
Hydrargyri. 
" Morphia?. 

" cum Sapone. 
" Plumbi Composita. 



PHARMACEUTICAL PREPARATIONS. 447 

In the U.S. P. no special suppositories are named, but a formula is 
given for their preparation. The quantity of the medicine required, 
brought to a proper consistency if necessary, is to be mixed with a small 
quantity of oil of theobroma by rubbing together, and then sufficient oil 
of theobroma previously melted and cooled to the temperature of 35° C. 
(95° F.) is to be mixed thoroughly with it, and immediately poured into 
suitable moulds cooled by ice. In the absence of moulds the mass is to 
be divided into parts of a definite weight, which are to be made into a 
convenient form for a suppository. Unless otherwise specified, they 
should weigh fifteen grains or one gramme. 

B.P. Succi. Juices (8). — These consist of the fresh juices of the 
plant which are mixed with a sufficient quantity of spirit to prevent them 
from decomposing, except in the case of lemon, mulberry, and buckthorn 
juice, to which no alcohol is added. 

B.P. (8). 

Succus Belladonnse. Limonis Succus. 

" Conii. Mori " 

" Hyoscyami. Rhamni " 

" Scoparii. 
" Taraxaci. 

Syrupi. Syrups. — These are strong solutions of sugar ; many of 
them contain flavoring or coloring matters, and are used to make medi- 
cines more agreeable to the eye or palate. 

In the case of iodide of iron and phosphate of iron the sugar prevents 
oxidation, and thus preserves the preparation from decomposition. 

U.S.P. DOSE. 

All 1 fluid drachm except those specially marked. 

Syrupus Acacise 

" Acidi Citrici 

" Hydriodici 1-4 fl. dr. (3 75-15 c.c.) 

Allii 1 fl. dr. (375 c.c.) 

Althsese 1-4 fl. dr. (375-15 c.c.) 

" Amygdala? 

" Aurantii 

" Florum 1 fl. dr. (3'75 c.c.) 

" Calcii Lactophosphatis 2-4 fl. dr. (7 "5-15 c.c.) 

Calcis , 1 fl. dr. (375 c.c.) 

Ferri Bromidi H fl. dr. (19-315 c.c.) 

" " Iodidi 15-30 m. (09-19 c.c.) 

" Quininae et Strych- \ . fl , ,».„- ) 

ninse Phosphatum [ 1 fl " dr - ^ 7& c ' c ^ 

Hypophosphitum 1-2 fl. dr. (3-75-7"5 c.c.) 

cum Ferro...l-2 fl. dr. (3 '75-7 "5 c.c.) 

" Iuecacuanhse I (Emetic) \-\ oz. (15-30 c.c.) 

Ipecacuannae j ( Expectorailt ) 30 . 6 o m . (19-375 c.c.) 

" Kramerise \ fl. oz. (15 c.c.) 

Lactucarii 2-3 fl. dr. (7 -5-11 '25 c.c.) 

" Limonis ,.. 

Picis Liquidse ....1-2 fl. dr. (3 "75-7 '5 c.c.) 

" Pruni Virginianse \ fl. oz. (15 c.c.) 

Ehei 1 fl. dr. (3'75 c.c.) 

" " Aromaticus 1 fl. dr. (3*75 c.c.) 

Kosae 1 fl. dr. (375 c.c.) 

Eubi 1-2 fl. dr. (3*75- 7*5 c.c.) 

" Ida^i 



448 



GENERAL PHARMACY. 



U.S.P. 



DOSE. 



Syrupus Sarsaparillse Compositus. ...\ fl. oz. (15 c.c.) 

Scillse lfl. dr. (3 "75.) 

11 " Compositus (Expectorant) 20-30 m. (1-25-1-9 c.c.) 

" Senegas 1-2 fl. dr. (375-7.5 c.c.) 

Senna? 1-4 fl. dr. (375-15 c.c.) 

" Tolutanus 

" Zingiberis lfl. dr. (3'75c.c.) 



b.p. (18). 



DOSE. 



Syrupus. 



All 1 fluid drachm except those specially marked. 



Aurantii 

Aurantii Floris 

Chloral £-2 fluid drachms. 

Ferri Iodidi \-l fluid drachm. 

" Phosphatis 

Hemidesmi 

Limonis 

Mori 

Papaveris 

Rhamni 

Rhei 1-4 fluid drachms. 

Rhoeados 

Rosse Gallicae 

Scillse \-\ fluid drachm. 

Sennse 1-4 fluid drachms. 

Tolutanus 

Zingiberis \-\ fluid drachm. 

Tincturse. Tinctures. — These are solutions of active principles 
in spirit. Rectified spirit, or alcohol, is used whenever the active prin- 
ciple is more soluble in strong than in dilute alcohol, as in the case of 
alkaloids, such as veratrum viride; resins, such as asafoetida, benzoin, 
and Indian hemp ; oils, such as cubebs, lavender, tolu, orange peel, larch 
bark, and ginger; and other substances, such as chloroform, acetate of 
iron, perchloride of iron, iodine, kino. 

Aromatic spirit of ammonia is used in the ammoniated tincture of 
guaiac, of valerian, and of opium (U.S.P. and B.P.). In the case of 
guaiac and valerian the active principles have an acid character, and so 
ammonia tends to dissolve them more completely. In both of them, 
however, as well as in ammoniated tincture of opium, the ammonia has 
got a stimulating action of its own, which tends to aid the effect of the 
other substances. 

Tinctures of fresh herbs (Tincturae Herbarum recentium) when not 
otherwise directed, are, according to the U.S.P., to be prepared by 
macerating fifty parts of the fresh herb bruised or crushed in a hundred 
parts of alcohol for fourteen days, then expressing the liquid, and filtering. 



U.S.P. DOSE. 

The usual dose is £-2 fl. dr. unless otherwise mentioned. 

Tinctura Aconiti 1-3 m. (006-018 c.c.) 

" Aloes (As laxative) \-\ fl. dr. 

" (As purgative) 2-4 fl. d 

" et Myrrhu; 1-2 fl. dr. (375-7-5 c.c.) 

" Arnicie Florum 10-30 m. (0*6-1 *9 c.c.) 

" Radicis 20-30 m. fl'25-1'9 c.c. 

" Asafoetida; 30-60 m. (19-3-75 c.c. 



PHAEMACEUTICAL PREPARATIONS. 449 

U.S.P. DOSE. 

Tinctura Aurantii Amari 1-2 fl. dr. (3'75-7'5 c.c.) 



29 



Dulcis. 

Belladonnse 15-30 m. (0*9-1*9 c.c.) 

Benzoini 20-30 m. (1*25-1 9 c.c.) 

" Coinposita £-2 fl. dr. (1*9-7 5 c.c.) 

Bryonia? 1-2 fl. dr. (375-7'5 c.c.) 

Calendula? 

Calumba? 1-4 fl. dr. (3*75-15 c.c.) 

Cannabis Indica? 30 m. (1*9 c.c.) 

Cantharidis 3-10 m. (0*07-0*30 c.c.) 

Capsici 30-60 m. (l"9-3*7 c.c.) 

Cardamomi 1 fl. dr. (3*75 c.c.) 

" Composita 1-2 fl. dr. (3*75-7-5 c.c.) 

Catechu Composita £-3 fl. dr. (P9-1125 c.c.) 

Chirata? 1-2 fl. dr. (3-75-7-5 c.c.) 

Cimicifuga? 1-4 fl. dr. (375-15 c.c.) 

Cinchona? 1-4 fl. dr. (375-15 c.c.) 

" Composita 1-4 fl. dr. (375-15 c.c.) 

Cinnamomi 1-4 fl. dr. (3*75-15 c.c.) 

Colchici £-2fl. dr. (1*9-7*5 c.c.) 

Conii 30 m. (1*9 c.c.) to be increased. 

Croci 1-3 fl. dr. (3-75-11-25 c.c.) 

Cubeba? 1-2 fl. dr. (3*75-7 "5 c.c.) 

Digitalis 10-20 m. (0'6-l'25 c.c.) 

Ferri Acetatis 20-60 m. (1*25-3*75 c.c.) 

u Chloridi 10-30 m. (0*6-1*9 c.c.) 

Galla? 1-3 fl. dr. (3 '75-11 '25 c.c.) 

Gelsemii 10-20 m. (0*6-1 '25 c.c.) 

Gentiana? Composita 1-2 fl. dr. (3*75-7*5 c.c.) 

Guaiaci 1 fl. dr. (3*75 c.c.) 

" Ammoniata 1-2 fl. dr. (3 *75-7 *5 c. c. ) 

Herbarum recentium 

Humuli 1-3 fl. dr. (3-75-11*25 c.c.) 

Hydrastis 30-60 m. (1*9-3*75 c.c.) 

Hyoscyami 60 m. (3*75 c.c.) 

Ignatia? 15-20 m. (0*9-1*25 c.c.) 

Iodi 5-15 m. (0*3-0*9 c.c.) 

Ipecacuanha? et Opii 10 m. (0*6 c.c.) 

Kino 1-2 fl. dr. (3*75-7*5 c.c. 

Krameria? 1-2 fl. dr. (3*75-7*5 c.c/ 

Lavandula? Composita 30-60 m. (1 9-3 75 c.c. 

Lobelia? 30-60 m. (1*9-3*75 c.c. 

Matica? 1 fl. dr. (3*75 c.c.) 

Moschi £-2fl. dr. (1*9-7*5 c.c. 

Myrrha? 15-30 m. (0*9-19 c.c. 

Nucis Vomica? 20 m. (1*25 c.c.) 

Opii 11m. (0*65 c.c.) or 22 drops. 

" Camphorata 1-4 fl. dr. (3*75-15 c.c.) 

" Deodorata 11m. (0*65 c.c.) 

Physostigmatis 20-40 m. (l*25-2'5 c.c.) 

Pyrethri 

Quassia? 1 fl. dr. (3*75 c.c.) 

Rhei 1-2 fl. dr. (3*75-7*5 c.c.) 

" Aromatica KL fl dr. (P9-3-75 c.c.) 

" Dulcis 2-3 fl. dr. (7*5-11*25 c.c.) 

Sanguinaria? 30-60 m. (1*9-3*75 c.c.) 

Saponis Viridis 

Scilla? 10-20 m. (0*6-1*25 c c. 

Serpentaria? 1-4 fl. dr. (3*75-15 c.c. 

Stramonii 20-30 m. (1*25-1*9 c.c. 

Sumbul 20-60 m. (1*2-3*7 c.c.) 

Tolutana 1-2 fl. dr. (3*75-7*5 c.c.) 

Valeriana? 1-4 fl. dr. (3*75-15 c.c.) 

" Ammoniata 30-60 m. (1-9-3*75 c.c.) 



450 GENERAL PHARMACY. 

U.S.P. DOSE. 

Tinctura Vanilla? 

" Veratri Viridis 3-8>iin. (0-18-0-5 c.c.) 

" Zingiberis 8-40 m. (0'5-2'5 c.c.) 

b.p. (68). DOSE. 

The usual dose is ^-2 fl. dr. unless otherwise mentioned. 

Tinctura Acouiti 1-10 min. 

" Aloes 

" Arnica? 

" Asafoetida? \-l fluid drachm. 

" Aurantii 

" " Recentis 

" Belladonna? 5-20 min. 

" Benzoini Composita ^-1 fluid drachm. 

" Buchu 

" Calumbse 

" Camphorse Composita 15 min.-l fluid drachm. 

" Cannabis Indica? 5-20 min. 

" Cantharidis 5-20 min. 

" Capsici 5-20 min. 

" Cardamomi Composita 

" Cascarilla? 

" Castorei ...^-1 fluid drachm. 

" Catechu 

" Chirata? 

" Chloroformi Composita 10-60 min. 

" Cinchonse Composita 

11 Cinchona? Flava? 

" Cinnamomi 

" Cocci 

" Colchici Seminum 10-30 min. 

" Conii 10-60 min. 

" Croci 

Cubeba> 

" Digitalis 5-30 min. 

" Ergota? 10-60 min. 

" Ferri Acetatis 5-30 min. 

" " Perchloridi 5-30 min. 

Galla? 

" Gentiana? Composita 

" Guaiaci Ammoniata |-1 fluid drachm. 

" Hyoscyami f-1 fluid drachm. 

" Iodi 5-20 min. 

" Jalapa? 

" Kino 

11 Krameria? 

" Laricis 15-30 min. 

" Lavandula? Composita 

" Limonis 

Lobelia? 10-30 min. 

" " ^Etherea 10-30 min. 

" Lupuli 

" Myrrha- 30-60 min. 

" Nucis Vomica' 10-30 min. 

" Opii 5-40 min. 

" " Ammoniata 30-60 min. 

" Pyrethri 

" Quassia- 

Qninia' , 

" " Ammoniata 

" Rhei (Stomachic) ]-2 fluid drachms. 

" (Purgative) 4-8 fluid drachms. 

" Sabina- 10-60 min. 



PHARMACEUTICAL PREPARATIONS. 451 

B.P. (68). DOSE. 

Tinctura Scilla? 10-30 min. 

" Senega? 

" Senna? 1 fluid drachm to 4 fluid oz. 

" Serpentaria? 

" Stramonii 10-30 min. 

" Sumbul 10-30 min.- 

" Tolutana 10-30 min. or more. 

" Valerianae 

" '' Ammoniata %-l drachm. 

" Veratri Viridis 5-20 min. 

" Zingiberis 10-60 min. 

" " Fortior 5-20 min. 

U.S. P. Triturationes. Tkiturations. — These are intimate 
mixtures of substances with sugar of milk. Each contains 10 per cent, 
of the active substances. A general formula for their preparation is given 
in the U.S. P., although only one is named. According to this formula 
10 parts of the substance and 90 parts of sugar of milk are to be weighed 
out separately. The substance, reduced to a moderately fine powder if 
necessary, is mixed in a mortar with about its own bulk of sugar of milk 
and they are triturated together. Fresh portions of the sugar of milk are 
added from time to time until the whole has been added, and the tritura- 
tion is continued until the substance is intimately mixed with the sugar 
of milk and finely comminuted. 

U.S.P. 

Trituratio Elaterini. 

Trochisci. Lozenges. — These are small, flat, and hard, so that 
they can be readily carried about and melt slowly in the mouth. They 
are thus convenient for giving drugs which are intended to act upon the 
mouth or throat locally, or to be readily carried about and taken at times 
and in places where more bulky preparations would be inconvenient. 
Thus we have lozenges of chlorate of potash which are useful for soreness 
of the mouth and tongue ; tannic acid and catechu which are useful in 
relaxed sore throat and hoarseness ; ipecacuanha with morphia, and with 
opium, which are useful in coughs ; bicarbonate of soda, useful before 
meals in dyspepsia or after meals in acidity ; bismuth for irritability of 
the stomach; and reduced iron for debility. Bismuth, morphia and 
opium, are also useful in diarrhoea. In many cases it happens that 
although patients can take potions before, after, or with their morning 
and evening meals, they are unable to do so in the middle of the day 
when they are absent from home and engaged in various avocations. 
For such cases lozenges form a useful means of administering medicine. 

U.S.P. (16). B.P. (10). 

Trochisci Acidi Tannici. Trochisci Acidi Tannici. 

" Ammonii Chloridi. " Bismuthi. 

" Catechu. " Catechu. 

" Creta?. " Ferri Redacti. 

" Cubeba?. " Ipecacuanha?. 

" Ferri. " Morphia?. 

" G-lycyrrhiza? et Opii. " Morphiae et Ipecacuanha?. 

" Ipecacuanha?. " Opii. 

" Krameria?. " Potassa? Chloratis. 

" Magnesia?. " Soda? Bicarbonatis. 



452 



GENERAL PHARMACY. 

U.S.P. (16). 

Trochisci Menthae Piperita. 

" Morphinae et Ipecacuanha?. 
" Potassii Chloratis. 
" Sodii Bicarbonatis. 
" Santoninatis. 
11 Zingiberis. 



Ungueiita. Ointments. — These are soft admixtures of medicines 
with fatty substances for external application. The basis of many of 
them is lard, either alone or mixed with benzoin in order to preserve it 
from rancidity, or mixed with white wax in the form of ointment (ungu- 
entum U.S. P.). In the B.P. simple ointment, which consists of white 
wax and almond oil, forms the basis of several ointments. 

The semi-solid substances, obtained from American petroleum, form 
a useful basis for ointments, as they do not become rancid. They consist 
of hydrocarbons chiefly of the marsh-gas series. There are two chief 
varieties, one softer, having a melting point about 40° C. (104° F.), the 
other 51° C. (or 121° F.). They are obtained by distilling off the 
lighter and more volatile portions from American petroleum. They are 
known under different names. Petrolatum (U.S. P.) cosmoline, unguen- 
tum petrolei, and vaseline. 



U.S. P. (25). 



B.P. (34). 



Acidi Carbolici. Unguentum Aconitiae. 


Acidi Gallici. ' 


Antimonii Tartarati. 


" Tannici. 


Atropiae. 


Aquae Rosae (cold cream) . ' 


' Belladonnae. 


Belladonna?. 


' Cadmii Iodidi. 


Chrysarobini. ' 


Cantharidis. 


Diachylon. 


Cetacei. 


Gallae. ' 


Creasoti. 


Hydrargyri. 


Elemi. 


" Ammoniati. ' 


Gallae. 


" Nitratis. ' 


' " cum Opio. 


" Oxidi Flavi. c 


' Hydrargyri (blue ointment) 


" Rubri. 


' Ammoniati. 


Iodi. 


' " Compositum. 


Iodoformi. ' 


' " Iodidi Rubri. 


Mezerei. 


1 u Nitratis. 


Picis Liquidae. 


1 " Oxidi Rubri. 


Plumbi Carbonatis. ' 


' " Subchloridi. 


" Iodidi. ' 


Iodi. 


Potassii Iodidi. 


1 Picis Liquidae. 


Straruonii. ' 


Plumbi Acetatis. 


Sulphuris. 


{ " Carbonatis. 


" Alkalinum. ' 


Iodidi. 


Veratrinae. ' 


' " Subacetatis Compos- 


Zinci Oxidi. 


itum. 




Potassae Sulphuratae. 




Potassii Iodidi. 




Resins. 




' Sabina?. 




' Simplex. 




' Sulphuris. 




Iodidi. 




' Terebinthinae. 




1 Veratriae. 




Zinci. 



PHAKMACEUTICAL PREPARATIONS. 453 

B.P. Vapores. Vapors, Inhalations. — These are prepara- 
tions for applying volatile drugs to the air-passages for the purpose of 
deodorizing, disinfecting, stimulating or soothing. The drug is mixed 
with water and the vapor inhaled. If the drug is not readily volatile, 
warm water is used, as in the vapor creasoti, or the water is warmed 
during inhalation, as in the vapor iodi. 

B.P. (5). 
Vapor Acidi Hydrocyanici. 
" CMori. 
" Coniae. 
" Creasoti. 
" Iodi. 

The vapors of chlorine, creasote, and iodine may be used for 
deodorizing in cases of ozoena or in cases of chronic bronchitis with 
offensive sputa. 

Antiseptic inhalations, such as those of creasote and iodine, as well 
as non-officinal inhalations of iodoform and oil of pine, have been recently 
used in the treatment of phthisis with the object of destroying the 
tubercle bacillus. For this purpose a special form of inhaler is used, 
which fits over the mouth and nose. It contains a sponge which is 
soaked with the drug to be inhaled either pure or dissolved in spirit or 
water. 

They are probably also useful even in simple catarrh by destroying 
organisms which may have found their way into the air-passages and 
occasion or keep up inflammation. The vapors of hydrocyanic acid 
and conium are useful for the purpose of allaying irritability, as in 
spasm of the glottis, violent coughing or spasmodic asthma. 

Vina. Wines. — These are made in the same way as tinctures, 
strong white wine (U.S. P.) or sherry or orange wine (B.P.) being 
employed instead of spirit. 

U.S.P (14). DOSE. 

Vinum Album 

" Album Fortius 

u A1n . a f Stomachic, 1-2 drachms. 

Aioes I Purgative, H fluid oz. 

" Antimonii Expectorant, 10-30 min. 

" Aromaticum 

" Colchici Radicis 10 min.-l fluid drachm. 

" Seminis 30 min. -2 fluid drachms. 

" Ergotse 1-4 fluid drachms. 

" Ferri Amarum 2-4 fluid drachms. 

" Citratis 1-4 fluid drachms. 

" *p— {iSi-sV^r 

" Opii 15-20 min. 

" Rhei 1-4 fluid drachms. 

" Rubrum 

B.P (10). DOSE. 

Vinum Aloes 1-2 fluid drachms. 

" Antimoniale 5-30 min. as expectorant. 

5-1 fluid oz. as emetic. 

" Colchici 10-30 min. 



454 GENERAL PHARMACY. 

B.P. (10). DOSE. 

Vinum Ferri 1-4 fluid drachms. 

" Citratis 1-4 fluid drachms. 

Ipecacuanhse 5-40 min. as expectorant, 

1-8 drachms as emetic. 

Opii 10-40 min. 

Quiniae £-1 fluid oz. 

Rhei 1-2 drachms. 

Xericam 



SECTION III. 



INORGANIC MATERIA MEDICA. 



CHAPTER XXII. 



HYDROGEN, OXYGEN, OZONE, CARBON, SULPHUR, AND 
THE HALOGENS. 

Although the officinal substances included in this chapter differ 
widely from each other in many respects, yet their relations to oxygen 
form a connecting link between them. Sulphur belongs to the same 
chemical group as oxygen. The chief action of charcoal is its power of 
oxidizing organic substances by means of oxygen which it has condensed 
in its pores. The halogens probably owe their disinfecting properties in 
great measure to their power of liberating oxygen from water in the pres- 
ence of organic matter which they thus oxidize and destroy. 

HYDROGEN (H ; 1). Not officinal. 

Preparation. — By adding diluted hydrochloric or sulphuric acid to 
granulated zinc — 

Zn + 2HC1 = ZnCl 2 + H 2 . 

Uses. — It is of little or no use as a remedy, and is only used as a test. 

It is very frequently employed in testing for arsenic, antimony, or 
sulphur. When in its nascent condition it has active chemical affinities, 
and readily unites with these substances, forming sulphuretted, arseniu- 
retted, or antimoniuretted hydrogen. 

OXYGEN (0 ; 16). Not officinal. 

Preparation. — By heating chlorate of potash with peroxide of 
manganese — 

2KC10 S = 2KC1 -f 30 2 . 

(455) 



456 INORGANIC MATERIA MEDICA. 

Peroxide of manganese merely aids the decomposition of the chlorate 
of potash, and takes no part in the reaction. 

Properties. — Oxygen is a colorless gas without smell, slightly 
heavier than common air. It forms rather more than a fifth by volume 
of the atmosphere. 

Physiological Action. — Oxygen applied to the unbroken skin has 
but little action, but when applied to a wound it increases the circulation 
in it, and acts as a stimulant. When inhaled by healthy persons it 
causes a slight feeling of warmth in the mouth, extending downwards 
over the front of the body. In some people it appears to cause nervous 
symptoms somewhat like those produced by nitrous oxide. 

In animals, excess of oxygen produces tetanic symptoms almost like 
those of strychnine, and death. This effect is produced by a pressure of 
three atmospheres, and it is evident that it is due to the oxygen and not 
to the simple increase in atmospheric pressure only, because when ordi- 
nary air is used a pressure of three atmospheres has no such action, and 
a pressure of twenty -five atmospheres is requisite to produce this effect 
(Bert). 

It has been thought by some that when oxygen has been once breathed it 
loses something which enables it to support life. The reason of this belief 
is that animals soon die which are kept in a confined space, from which 
the carbonic acid formed during respiration is absorbed by lime or baryta, 
and its place supplied by fresh oxygen. Professor Seegen, however, has 
found that the death in such cases is not due to the removal of anything 
from the oxygen, but to actual poisoning by products of tissue waste. In 
some experiments he noticed that the air in which the animal had been 
confined for a while, although its chemical composition was correct, had 
a disagreeable smell, and the animal after its removal soon died of pneu- 
monia. When the air which the animal was breathing was extracted 
from one end of the compartment, made to pass through a red-hot tube, 
and introduced at the other end so that any organic matter formed dur- 
ing respiration was consumed, the animal could be kept for almost any 
length of time without injury to its health. 

Uses. — Oxygen has been applied to the surface in atonic, scrofulous, 
and syphilitic ulcers, and in cases of senile or other gangrene. It has 
more especially been employed in cases of respiratory disease such as 
emphysema, bronchial dilatation, phthisis, and gangrene of the lung, in 
asphyxia from noxious vapors or anaesthetics, and in spasmodic asthma. 
It seems to be chiefly of use in the latter disease. It has been employed 
also in cases of difficulty of breathing, of cardiac disease, and of anaemia 
from loss of blood or suppuration. It has been employed also in condi- 
tions where oxidation seems to be deficient, as in gout and diabetes, where 
sometimes the sugar disappears from the urine during its inhalation. 
Oxygen has also been used in the treatment of epilepsy and spasm. 

It has been strongly recommended by Bert in paralysis occurring in 
divers, due to their sudden ascension from a great depth to the surface. 
When submerged at a considerable depth the pressure of the air causes 
both nitrogen and oxygen to be absorbed by the blood ; when they return 
to the surface the oxygen enters into combination, but the nitrogen is set 
free in the blood-vessels, forming minute bubbles, which act as emboli, 



HYDROGEN, OXYGEN, OZONE, CARBON, ETC. 



457 



obstructing the circulation in the nerve-centres and in the lungs, thus pro- 
ducing paralysis and dyspnoea. The nitrogen diffuses as readily into an 
atmosphere of oxygen as into an absolute vacuum ; and therefore when 
animals, in which such a state has been artificially induced, have been 
made to breathe pure oxygen, bubbles of nitrogen disappear from the blood, 
the circulation is speedily restored to its normal condition, and the paraly- 
sis and dyspnoea disappear. 

Its inhalation has been recommended in cases of cholera. 

OZONE. Not officinal. 

When an electric spark is passed through air a peculiar smell is 
noticed ; this is due to the formation of ozone. The electricity in pass- 
ing through the air appears to break up the molecules of ordinary oxygen 
(Fig. 127), and the atoms which are thus dissociated join together so as 








Fig. 127.— Diagram to illustrate the formation of ozone by electricity, a represents oxygen through 
which a spark is passing ; b, after it has passed. The double rings are intended to represent mole- 
cules of oxygen, each containing two atoms. As the electric spark passes through the oxygen it 
breaks up the first molecule, carrying one atom on to join the second molecule of oxygen, and 
form one of ozone. The atom which is left joins another molecule of oxygen, and also forms 
ozone. (After Lockyer.) 

to form ozone. It is also formed by the slow oxidation of phosphorus 
(Fig. 128), and is formed also by protoplasm (p. 78). Two atoms are 
present in a molecule of oxygen and three in that of ozone. When elec- 
tricity is passed through a quantity of oxygen, contained in a tube over 



4 


^ 






■H 


A 


8-rr 


$, 


K^ / 


\rz\ 


V" \ 


1 


H5 


- 


A 


dPf 




t 


pp& 






V 


rv 





n> r^Q>0^ ^ 




QQd ^2>pC 


) 


°-TpV-0 Zj 


uo 


* 99-4 


%*$; 


9 




c Nfer°n 




mwmm 


% 



Fig. 128.— Diagram to represent the formation of ozone by the oxidation of phosphorus, a, during 
oxidation ; b, after oxidation. The phosphorus in uniting with oxygen splits up the molecules. 
Some of the atoms combine with the phosphorus to form phosphoric acid. Others reunite to form 
oxygen, and others form ozone (3P -J- 150 2 = 3P0 5 + 60» + U 3 ). 



458 INOEGANIC MATERIA MEDICA. 

mercury, so as to convert a portion of it into ozone, it becomes condensed 
in bulk and acquires much greater chemical activity. On warming it 
again to about 300° C. the molecules of ozone become again dissociated, 
ordinary oxygen is formed, the gas then returns to its original bulk, and 
it loses its active properties. Ozone has a most powerful oxidizing prop- 
erty, attacking metals and forming oxides, and destroying organic sub- 
stances, such as paper and caoutchouc. It has a curious action upon 
albumen, already described (p. 69), and decomposes blood. As might be 
expected, it is exceedingly poisonous to low organisms, and is fatal also 
to the higher animals. 

Its effect appears to be due in a great measure to its having such a 
powerful irritant and even destructive effect on the albuminous tissues of 
the respiratory passages, that it causes reflex depression of the heart and 
interferes with the ordinary respiration in the lungs. It thus diminishes 
instead of increasing oxidation. In animals it causes sometimes quick- 
ness and sometimes slowness of the respiration (vide p. 215), and pro- 
duces excitement followed by exhaustion and sometimes convulsions. 

When it is present only in small quantity in air, it may be inhaled 
without any disagreeable effects, and is, according to Binz, a decided 
soporific. 

Uses. — It has been recommended in cases similar to those already 
mentioned under oxygen ; and also in infectious diseases, and in diph- 
theria, where it is likely to be useful by destroying low organisms, which 
produce the disease. 

PEROXIDE OF HYDROGEN (H 2 2 ; 34). Not officinal. 

Preparation. — It is generally prepared by treating barium di-oxide 
with dilute sulphuric acid (Ba0 2 + H 2 S0 4 = H 2 2 + BaS0 4 ) and 
filtering off the aqueous solution from the sulphate of barium which is 
precipitated. 

Properties. — When the watery solution thus obtained is evaporated 
it forms a transparent oily liquid, but it is generally employed in the form 
of a 10 to 15 per cent, solution in water or in ether. The ethereal solu- 
tion is commonly known by the name of ozonic ether. The ethereal solu- 
tion is generally more stable than the aqueous solution, which, especially 
if kept in a badly-stoppered bottle, soon decomposes into water and 
oxygen. 

Action and Uses. — Peroxide of hydrogen has a powerful oxidizing 
effect upon organic substances, readily giving off an atom of oxygen in 
much the same way as ozone. It has therefore been used for the same 
purposes as ozone. It destroys bacteria, and is a powerful antiseptic. 1 
When mixed with the secretion from chancre it destroys its infective 
power ; and it has been employed as a local dressing for chancres, and 
also as an application for diphtheritic sore throat. Curiously enough, 
although when mixed with blood or with albumen it becomes decomposed 
almost immediately, it appears to be tolerably stable in the body, and is 
Baid to have been found in the urine after it has been taken by the mouth. 



1 Professor Dewar. Cambridge, unpublished experiments. 



HYDROGEN, OXYGEN, OZONE, CARBON, ETC. 459 

Its internal administration has been recommended in rheumatism, 
scrofula, diabetes, and cardiac disease. 

CARBON (C; 12). 

This element is employed in medicine in the form of animal and 
vegetable charcoal. 

Carbo Lig-ni, U.S. P. and B.P. Wood Charcoal. — Charcoal 
prepared from soft wood, U.S. P. Wood charred by exposure to a red 
heat without access of air, B.P. 

Preparation. — It is prepared either by burning the wood under 
turf, or in retorts, so that the hydrogen and oxygen are driven off and 
charcoal alone remains. If too much air be allowed to have access, the 
charcoal itself becomes burnt, and too large a proportion of ash comes to 
be present. 

Characters. — In black, brittle, porous masses, without taste or 
smell, very light, and retaining the shape and texture of the wood from 
which it was obtained. When pulverized it forms a fine black powder. 

Impurities. — Too much ash. 

Tests. — When burned at a high temperature with free access of air 
it leaves not more than two per cent, of ash. 

Dose. — 20-60 grains. 





Officinal Peepaeatiox. 


U.S.P. 


B.P. 


None. 


Cataplasma Carbonis 



B.P. Cataplasma Carbonis. Chaecoal Poultice. — Powdered charcoal 1 ; 
bread 4 ; linseed-meal 3 ; boiling water 20. Mix the water, bread, and linseed-meal, 
then add half the charcoal and sprinkle the remainder on the surface. By simply 
sprinkling a part of the charcoal on the surface of the poultice it is not wetted, and 
its disinfectant power not destroyed. 

Action. — Charcoal has the power of absorbing gases and of con- 
densing them within its pores. Amongst others it absorbs oxygen 
readily. The oxygen thus condensed has an oxidizing action akin to 
that of ozone, and the charcoal parts with it readily when brought into 
contact with oxidizable substances, whether these substances be in solu- 
tion or in the form of gas, but especially the latter. Thus it oxidizes 
and decomposes sulphuretted hydrogen very readily, and also quickly 
oxidizes and destroys decomposing organic substances. It thus acts as 
a deodorizer and disinfectant. It only possesses this power, however, 
when it is dry, and loses it when it is wet. For this reason the whole 
of it is not mixed with the poultice in the cataplasma carbonis, a part of 
it being merely sprinkled on the surface. Its oxidizing power is 
destroyed completely only when the charcoal is thoroughly saturated 
with water, and this occurs with difficulty even when it is thrown into 
water. Consequently its oxidizing power may still be exerted in fluids 
to which it has been freshly added. 

Uses. — It is employed as a deodorizer and disinfectant in traps 
•through which sewer gases may pass, and in a respirator for persons 
exposed to sewer gas or other noxious emanations. As a poultice it is 



460 INORGANIC MATERIA MEDICA. 

employed for foetid and phagedenic ulcers and gangrene. It forms a 
useful tooth-powder, cleaning the teeth rapidly, but it is much more apt 
to scratch the enamel than a tooth-powder of chalk. When taken into 
the stomach it relieves flatulent distention and acidity in the stomach 
and intestines. It has thus been used in acute and chronic dyspepsia, 
gastrodynia, and even cancer of the stomach ; in constipation, flatulent 
distention of the colon, diarrhoea, dysentery, cancer of the rectum. It 
has been supposed to relieve flatulence by absorbing the gases in the 
stomach and intestines, but as it will become wet by the juices of the 
'intestinal canal after it is swallowed, it is much more probable that it acts 
mechanically, by removing mucus, or by stimulating the circulation and 
peristaltic movements in the walls of the stomach and intestine. This is 
rendered all the more probable by the fact that in some cases where it is 
useful the patient is likewise benefited by beginning each meal with 
solid food, and abstaining from liquids until the meal is well over, so 
that the stomach may receive a mechanical stimulus from the food, which 
would be prevented by the ingestion of much liquid at the beginning of 
the meal. In large doses it acts as a mild purgative. It has also been 
used in diabetes and in intermittent fevers. 

Administration. — It is either used in the form of powder, or made 
up into biscuits or lozenges. 

Carbo Animalis, U.S. P. and B.P. Animal Charcoal. — Bone 
black. Animal charcoal prepared from bone, U.S. P. The residue of 
bones, which have been exposed to a red heat without the access of 
air. Consists principally of charcoal and phosphate and carbonate of 
lime, B.P. 

Carbo Animalis Pnrificatus, U.S. P. and B.P. PURIFIED 
Animal Charcoal. 

Preparation. — By dissolving out the earthy matter by hydrochloric 
acid, washing and drying. 

Characters. — It is a black powder without taste or smell. It 
absorbs coloring matters, and tincture of litmus diluted with 20 times its 
bulk of water agitated with it and thrown upon a filter passes through 
colorless. It is insoluble in all reagents. 

Impurities. — Too much ash. 

Test. — When burnt at a high temperature with a little red oxide of 
mercury and free access of air, it leaves only a slight residue. 

Dose. — 20-60 grains. 

Uses. — From its power of absorbing coloring matters, animal char- 
coal is used in the preparation of organic alkaloids, for the purpose of 
decolorizing them. It not only carries down coloring matters with it, 
but alkaloids as well, and therefore a considerable loss is occasioned in 
the process of bleaching. Advantage has been taken of this power to 
use animal charcoal as an antidote in poisoning by opium, aconite, nux 
vomica, etc. The alkaloid is removed from solution by the animal char- 
coal and retained by it with considerable pertinacity. It would, however, 
be gradually dissolved out if allowed to remain too long in the stomach, 
and therefore the stomach-pump, or emetics, must be used in addition. 
As an antidote it is used in doses of a tablespoonful frequently repeated. 



HYDROGEN, OXYGEN, OZONE, CARBON, ETC. 461 

SULPHUR (S : 32). 

Sulphur is found native in volcanic districts, and occurs in combina- 
tion with metals as sulphides in various ores, especially in iron and 
copper pyrites. 

Sulphur Suhlimatum, U.S. P. and B.P. Sublimed Sulphur, 
Flowers of Sulphur. 

Preparation. — Native sulphur is usually mixed with earthy impuri- 
ties. When heated the sulphur volatilizes. If the vapor is condensed 
in a large room it falls in a fine powder. If condensed in water it forms- 
masses, which, when melted and run into moulds, form roll sulphur, but 
this is not officinal. Ores containing sulphur are decomposed by heat, 
and part of the sulphur they contain sublimes, and may be condensed in 
the same way as native sulphur. 

Characters. — A fine, citron-yellow powder, of a slight characteris- 
tic odor and generally of a faintly-acid taste and an acid reaction from 
slight oxidation occurring with the formation of small quantities of sul- 
phurous acid. It is insoluble in water or alcohol, slightly soluble in oils 
and fats, and completely soluble in carbon disulphide. When ignited it 
burns with a blue flame, forming sulphurous acid gas and leaving no 
residue, or only a trace. 

Impurities. — Ores are apt to contain arsenic, and when this is the 
case, sulphide of arsenic, being volatile, sublimes along with the sulphur 
and renders it impure. During sublimation the sulphur may undergo 
oxidation, and thus sulphurous or sulphuric acids may be present in it 
as impurities. 

Tests. — Vide Sulphur Lotum. 

Officinal Preparations. 

u.s.p. B.P. DOSE. 

Sulphur Lotum. Confectio Sulphuris, as laxative 60-120 grs. 

" Prsecipitatum. " as alterative 5-20 grs. 

Unguentum Sulphuris. Ungueutum Sulphuris. 

B.P. Confectio Sulphuris. CONFECTION OF SULPHUR. — Sulphur 4; acid tartrate 
of potash 1 ; syrup or orange peel 4. The acid tartrate of potash is added for the 
purpose of increasing the secretion from the intestine, while the sulphur stimulates 
peristaltic action. 

Unguentum Sulphuris. Sulphur Ointment. — Sulphur mixed with benzoated 
lard 30 parts to 70, U.S.P. ; 1 to 4, B.P. The U.S.P. ointment is nearly twice as 
strong as the B.P. 

U.S.P. Sulphur Liotum. Washed Sulphur. 

Preparation. — By digesting sulphur with dilute ammonia, thor- 
oughly washing, drying at a gentle heat and passing through a No. 30 
sieve. In this process the ammonia not only neutralizes the sulphurous 
or sulphuric acid, but dissolves out and removes sulphide of arsenic, 
which is soluble in it. 

Characters and Impurities. — Those of sulphur sublimatum. 

Tests. — Water agitated with it should not redden blue litmus paper 
(absence of free acid). If washed sulphur be digested with two parts of 



462 INORGANIC MATERIA MEDICA. 

water of ammonia, and the mixture filtered, the filtrate, on being super- 
saturated with hydrochloric acid, should remain unaltered (absence of 
arsenious sulphide), nor should a precipitate make its appearance on 
passing hydrosulphuric acid through the filtrate (absence of arsenious 
acid). 

Officinal Peepaeations. 

u.s.p. 

Purvis Glycyrrhizae Compositus. 

Sulphuris Iodidum. 

Unguentum Sulphuris Alkalinum. 

U.S.P. Unguentum Sulphuris AlkaUnum. ALKALINE SULPHUE OINTMENT. 
Sulphur 20; carbonate of potassium 10; water 5; benzoated lard 65. 

Sulpliur Precipitatum, U.S.P. and B.P. PRECIPITATED SUL- 
PHUR, Lac Sulphuris, Milk of Sulphur. 

Preparation. — By boiling sulphur with slaked lime and water. 
Calcium sulphide and calcium hyposulphite are thus formed. Hydro- 
chloric acid is then added, which decomposes these substances and throws 
down sulphur in the form of an exceedingly fine powder which is washed 
until the washings are tasteless (U.S.P.), and have no acid reaction and 
cease to give a precipitate with oxalic acid (B.P.), showing that both acid 
and lime have been removed. 

Characters. — Being in a finer state of division than sublimed sul- 
phur, it looks almost white, with only a slight tinge of yellow. Otherwise 
its characters are the same. 

Impurities. — There is a great temptation to fraudulent manufac- 
turers to use sulphuric acid instead of hydrochloric acid. It is not only 
cheaper, but it yields a large product consisting to a great extent of sul- 
phate of lime which is precipitated along with the sulphur instead of 
remaining in solution like the calcium chloride which is formed when 
hydrochloric acid is employed. 

With Hydrochloric Acid, 2CaS 5 — CaS 2 3 — 6HC1 = (S 2 ) 6 + 3H 2 + 3CaCl 2 
" Sulphuric " 2CaS 5 + CaS 2 3 — 3H 2 S0 4 = (S 2 ) 6 + 3H 2 + 3CaS0 4 

Besides this there are the other impurities which may be present in 
the sublimed sulphur employed in the process. 

Tests. — It should be completely volatilized by heat and leave no resi- 
due of sulphate behind. Under the microscope it should exhibit only 
minute globules of sulphur and no crystals of sulphate. The absence of 
the impurities contained in sublimed sulphur is ascertained by the tests 
already given. 

Dose. — Of precipitated sulphur, as alterative 10 grs., as laxative 
30-60 grs. 

Sulphuretted Hydrogen or HYDROGEN SULPHIDE (H 2 S ; 34). 
A colorless gas, with a smell of rotten eggs. Used only as a test. 

Preparation. — By pouring diluted sulphuric acid on sulphide of 
iron. By passing the gas into cold water a solution is obtained. 



HYDROGEN, OXYGEN, OZONE, CARBON, ETC. 463 

Properties. — It precipitates most metals as sulphides from acid solu- 
tions, the precipitate with arsenic being yellow ; antimony, orange ; cad- 
mium, yellow ; copper, lead, mercury, and silver, black ; bismuth, brown ; 
gold and platinum, brownish black. 

General Action of Sulphuretted Hydrogen. — As sulphuretted 
hydrogen is formed in small quantities from sulphur when the latter is 
used in various ways, it may be more convenient to take its action before 
that of sulphur. It is very destructive to plant life even in very minute 
quantities. There is a curious difference between the action of sulphu- 
retted hydrogen and that of sulphurous acid on plants. The latter seems 
to act as an irritant, causing the leaves to crumble up and fall off, but 
even when the leaves are destroyed by sulphurous acid the plant may again 
recover. Sulphuretted hydrogen causes the leaves simply to become 
flaccid and droop, but when this has once taken place the plant does not 
recover. 

In animals it destroys the functions of all tissues, and in consequence 
has two actions which are well marked, (1) decomposing the blood and 
thus producing symptoms of asphyxia, and (2) paralyzing the nervous 
system and muscles. It is absorbed by the skin, by the lungs, 
mucous membrane of the alimentary canal, and subcutaneous cellular tis- 
sue, and may produce symptoms of poisoning through any of these chan- 
nels. In frogs, which are less affected than mammals by interference 
with the respiration, the symptoms produced by sulphuretted hydrogen 
are those of paralysis of voluntary motion and reflex action, preceded by 
a stage of restlessness. In mammals the symptoms are those of 
asphyxia ; muscular tremors occur and are succeeded by asphyxial con- 
vulsions and death. Most cases of poisoning by sulphuretted hydrogen in 
man occur from inhalation of the gas which is often found in large quan- 
tities in cesspools. 

One case has been recorded where symptoms of poisoning occurred 
irom excessive formation of the gas in the intestinal canal and subsequent 
absorption into the blood. Cases of poisoning are best treated by artificial 
respiration. 

Special Action. — Even in minute quantities it destroys the catalytic 
action of many substances on peroxide of hydrogen. In this respect as 
well as in many of the symptoms it produces, it resembles hydrocyanic 
acid. 

On the blood. It first reduces and then decomposes haemoglobin. 
Both the blood and the muscles of frogs poisoned by it exhibit a greenish 
color. As death occurs in mammals before the blood has become so exten- 
sively changed, it simply exhibits the characters of asphyxial blood. It 
induces rigor mortis rapidly in the muscular substance both of the 
voluntary muscles and of the frog's heart. 

Action of Sulphur. — Sulphur, when brought into contact with 
living protoplasm, enters into combination and forms sulphuretted 
hydrogen or sulphurous acid. When sulphur is sprinkled over actively- 
growing fungi, like those which cause the vine disease, these gases are 
formed and the fungi destroyed. 

Sulphur has little or no action on the skin, excepting a mechanical 
one. When taken into the intestinal canal, a considerable part of it 



464 INORGANIC MATERIA MEDICA. 

again passes out unchanged ; a little of it, however, appears to be con- 
verted into sulphides and into sulphuretted hydrogen. The latter is 
excreted by the breath, and may give to it the peculiar disagreeable 
smell of rotten eggs. It is also excreted by the skin, so as to blacken any 
silver articles which may be worn about the person. The sulphides give 
rise to increased peristaltic action of the bowels so that the motions become 
more frequent and softer ; colicky pains are sometimes produced. The 
sulphides, after absorption into the blood, are excreted in the urine, chiefly 
as sulphates. 

Uses. — It has been applied by insufflation to the throat in diphtheria, 
in order to destroy the organisms present in the pharynx, in the same 
way as in the vine disease. I have seen one case do very well under this 
treatment ; but its general efficacy is by no means certain. In the form 
of ointment it is used in scabies to kill the acarus which is the cause of 
the disease. Internally it is employed as a mild laxative in cases of con- 
stipation where active purgatives are inadmissible, as in pregnancy, in 
haemorrhoids, fissure of the anus, and stricture or prolapsus of the rectum. 
It has been used also in cases of lead-poisoning, to prevent the reabsorp- 
tion of the lead from the intestine. 

It has been found useful in cases of sexual irritation arising from 
hemorrhoidal congestion (pp. 387 and 389), and also in the nervous 
excitement and other disturbances accompanying the menopause. 

It exerts a beneficial action on the tissues in chronic rheumatism 
and gout, and is especially useful in the form of sulphurous waters. 
During its elimination by the lungs it is supposed to have a beneficial 
action on them, and it is consequently used in chronic bronchitis. 

HALOGEN ELEMENTS. 

Fluorine, Fl. ; 19 or 194. Chlorine, CI. ; 355 or 354. 
Bromine, Br.; 80 or 79-75. Iodine, I. ; 127 or 126-53. 

These substances form a series in which the atomic weights are nearly 
in the relation of 1, 2, 4, and 7, (vide also p. 42). They are distin- 
guished by the activity of their chemical affinities and the number of 
compounds they form. 

General Source. — The name halogen (from d?^ the sea) has been 
given to the group, because its most important members, chlorine, bro- 
mine, and iodine, are derived from the sea; chlorine being obtained from 
sea-salt, bromine from sea-water, iodine from sea-weed. 

General Characters. — They are all very volatile. At ordinary 
temperatures, chlorine is a gas, bromine a liquid, and iodine a solid, but 
both bromine and iodine give off vapor freely. On account of their 
active chemical affinities they unite directly with metals, as is seen in the 
officinal processes for the preparation of iodide of iron and green iodide of 
mercury. They have all a great affinity for hydrogen, and are therefore 
powerful decomposers of organic matter, destroying organic colors and dis- 
agreeable emanations of organic origin, as well as decomposing sulphuretted 
hydrogen (H 2 S -j- Cl 2 = 2IIC1 + S 2 ) and ammonia, which occur amongst 
the products of decomposition of organic matter. They are therefore 



HYDKOGEN, OXYGEN, OZONE, CARBON, ETC. 465 

used as deodorizers and disinfectants. Chlorine is used for bleaching, 
but bromine and iodine form colored compounds with many organic sub- 
stances, and so are not used for this purpose. 

Probably the bleaching power of chlorine is not due to its decompos- 
ing organic colors by removing hydrogen from them, but rather to its 
decomposing water by removing the hydrogen from it, and thus setting 
free nascent oxygen, which is the direct destroyer of organic matters. 
The reason for this supposition is that chlorine does not act upon coloring 
matters when they are dry, but only when moist. 

Mode of Preparation. — Chlorine, bromine, and iodine are all pre- 
pared by expelling them from their compounds with the alkaline metals 
by means of sulphuric acid and manganese dioxide. 

Chlorine is prepared by putting sodium chloride, sulphuric acid 
and manganese dioxide into a retort, applying heat and collecting the 
chlorine gas in a receiver, by displacement or over warm water, or 
passing it into cold water which dissolves it freely, forming aqua chlori 
U.S. P. or liquor chlori B.P. 

Bromine is prepared in a similar manner from the bromides of 
sodium and magnesium contained in the bittern or mother-liquor left 
after the salt has crystallized out of sea-water, or out of the brine 
obtained in salt mines. In order to obtain the bromine pure, the bittern 
is often not treated directly with sulphuric acid and manganese dioxide. 
Instead of this the bromine is first separated by passing chlorine through 
the liquid which is then shaken up with ether. The chlorine decom- 
poses the magnesium bromide and the ether dissolves the bromine thus 
set free. The bromine is then converted again by potash into bromide, 
from which bromine is obtained by means of manganese dioxide and acid. 

Iodine is prepared in a similar manner to chlorine from the iodides 
of sodium and magnesium contained in sea-weed. The iodides are 
obtained from the weed by calcining it in a retort, or by burning it, 
when the ashes in which they are contained form a hard mass called 
kelp. This is treated with successive portions of water until the soluble 
salts are all dissolved out (lixiviation). The solution is filtered, and evapo- 
rated to a small bulk, when the less soluble salts, as the sulphates, &c, 
crystallize out. The mother-liquor containing the iodides of sodium and 
magnesium is then treated with manganese dioxide and sulphuric acid, 
and the iodine distils over. 

The reactions which occur in the preparations just described are — 

Chlorine 2NaCl + 2H 2 S0 4 + Mn0 2 = Cl 2 + Na 2 S0 4 + MnS0 4 + 2H 2 0. 
bromine ^ MgBr2 + 2 H 2 So 4 + Mn0 2 = Br 2 + MgS0 4 + MnS0 4 + 2H 2 0. 

Torn™ / 2NaI + 2H 2 S0 4 + Mn0 2 = X 2 + Na 2 S0 4 + MnS0 4 + 2H 2 0. 
loume ^ Mg] - 2 + 2H2 gQ 4 +Mn Q 2 = t 2 _|_ MgSO, + MnS0 4 + 2H 2 0. 

General Action. — As chlorine, bromine, and iodine decompose 
organic compounds having a disagreeable odor, they have been sup- 
posed to have a similar action upon the germs of infectious diseases. 
Chlorine, and sometimes iodine, are therefore used as deodorizers and 
disinfectants in sick rooms. Bromine cannot well be used on account 
of its abominable smell. 
30 



466 INORGANIC MATERIA MEDICA. 

The objections to chlorine or the vapor of iodine as disinfectants are 
that we do not at all know that they have any disinfecting power in the 
dilute state, in which only they can be used in a sick room. When 
applied to the skin or mucous membranes they cause a greater or less 
amount of irritation or inflammation, according to the length of time 
during which they act, and the greater or less degree of concentration 
in which they are applied. They probably do not enter the blood in the 
free state, but combine with bases or with albuminous substances at the 
place of application, and are absorbed as chlorides, bromides, or iodides, 
or else as albuminous compounds. According to Binz, free chlorine, 
bromine, and iodine, and all their readily decomposable compounds, 
have a narcotic action, and paralyze nervous centres in the brain by a 
direct action on the nervous structures themselves. He considers that 
they cause death by paralysis of the respiratory centre, and not by 
paralysis of the heart. 

CHLORIXE. CI. 355. 

A greenish-yellow gas with a suffocating odor. Its preparation and 
general action have already been described (p. 465). 

Actiox. — When applied for a long time to the skin, as in persons 
who have to work in an atmosphere containing it, it causes itching, 
reddening and inflammation. When applied to the more sensitive 
mucous membranes of the respiratory passages, it acts as a stimu- 
lant or irritant. In a concentrated form it may cause death from spasm 
of the glottis, or intense bronchitis. In a more dilute form it is used as 
a stimulant, deodorizer, and disinfectant. The manner of employing 
it, is to put a saucer containing salt, binoxide of manganese, and sul- 
phuric acid on a shelf or high piece of furniture in the sick room, and 
thus allow the chlorine vapor, which is heavier than air, to diffuse itself 
through the apartment. When placed on the floor it is of little use. 

Aqua Clilori, U.S. P. ; Liquor Cnlori, B.P. CHLORINE 
Water. — An aqueous solution of chlorine containing at least 0-4 per 
cent, of the gas U.S. P., or 2*66 grains in 1 fluid ounce = about 0*6 
per cent. B.P. 

Preparation. — By passing washed chlorine into water, p. 465. 
The chlorine is directed by the U.S. P. and B.P. to be prepared from 
hydrochloric acid and manganese dioxide, instead of from sodium 
chloride. 4HC1 + Mn0 2 = Cl 2 + MnCl 2 + 2H 2 0. 

Characters. — A greenish-yellow clear liquid with a strong smell 
and taste of chlorine. It instantly decolorizes dilute solutions of litmus 
and indigo. 

Impurities. — The chief is too little chlorine. When exposed to 
light it is apt to be decomposed, the chlorine combining with the hydro- 
gen of the water and forming hydrochloric acid. The chlorine water 
thus loses strength, and it also becomes weaker by the chlorine escaping 
when the bottle is imperfectly stopped or frequently opened. A solution 
of chlorinated soda or lime may be .sometimes substituted for chlorine water. 

Tests. — The amount of chlorine is not tested directly, but indirectly, 
by estimating the amount of iodine which a definite quantity of chlorine 



HYDROGEN, OXYGEN, OZONE, CARBON, ETC. 467 

water liberates from iodide of potassium. In this process chlorine water 
(35-4 gm. U.S. P., or 439 grains or 1 fluid ounce B.P.,) is mixed with 
iodide of potassium (0*9 gm. U.S.P., 20 grains B.P.) and water (20 gm. 
U.S. P., 1 fluid ounce B.P.). The amount of iodine which is set free by 
the chlorine (2KI + Cl 2 — 2KC1 + I 2 ) gives a red color to the solution, 
and corresponds in quantity to the chlorine contained in the water. The 
red solution requires for its decolorization 40 cc. U.S. P., or 750 grain- 
measures B.P., of the volumetric solution of hyposulphite of soda. The 
reaction which occurs is : — 

Iodine. Sodium Hyposulphite. Sodium Iodide. Sodium Tetrathionate. Water. 
I 2 + 2NaH 2 S 2 4 = 2NaI + Na 2 S 2 4 + H 2 0. 

Uses. — Chlorine is used in solution as a lotion to foul-smelling 
ulcers or cancer ; as an application to relieve itching in chronic skin dis- 
eases ; and as a gargle or wash to the mouth in affections of the mouth, 
throat and tonsils, especially where they are accompanied by foetor, as 
in mercurial ptyalism and ulceration of the tonsils. It is sometimes 
given internally in cases of blood-poisoning. As an inhalation it has 
been used in cases of phthisis, it is said with good effect. It is also 
employed as a stimulant and deodorizer in cases of chronic bronchitis 
with foetid sputa. ( Vide Vapor Chlori, p. 468.) 

The aqueous solution is so unstable and liable to lose its strength, 
that compounds of chlorine from which it can be easily evolved are 
more convenient for general use. The chief of these are the following 
compounds with lime and with soda. 

Calx Clilorata, U.S. P. and B.P. Chlorinated Lime. — A 
compound resulting from the action of chlorine upon hydrate of calcium, 
and containing at least 25 per cent, of available chlorine, U.S. P. A 
product obtained by exposing slaked lime to the action of chlorine gas 
so long as the latter is absorbed, B.P. 

Characters. — A grayish-white powder having the odor of chlorine 
and an acrid taste ; absorbs carbonic acid and water when exposed to the 
air, and at the same time gives off chlorine ; it is only partly soluble in 
water. The solution is alkaline, and possesses bleaching properties 
(e.g., it bleaches sulphate of indigo). 

It is readily decomposed by acids, even by carbonic acid, and thus 

when exposed to the air chlorine is given off slowly. The addition of a 

stronger acid causes it to be evolved rapidly. Its probable constitution 

f CI 
is Ca< Qpi This is decomposed by water into a mixture of calcium 

chloride and hypochlorite, and as it is usually moist it may be regarded 
as usually consisting of a mixture of these substances. On the addition 
of sulphuric acid, hypochlorous and hydrochloric acids are set free, which, 
reacting on one another, yield free chlorine. HCIO + HC1 = Cl 2 + H 2 0. 

Reaction — The addition of oxalic acid causes the rapid and copious 
evolution of chlorine and the deposition of oxalate of lime. 

Impurities. — Imperfect saturation with chlorine. It is tested volu- 
metrically in a similar way to liquor chlori, the chlorine being set free 



468 INORGANIC MATERIA MEDICA. 

from it by the addition of hydrochloric acid. The chlorine thus liberated 
should amount to 25 per cent. U.S. P., 30 per cent, B.P. 

Officinal Peepaeations. 

U.S. p. B.P. 

Liquor Calcis Chloratae. Liquor Calcis Chloratse. 

Vapor Chlori. 
Liquor Calcis Cliloratae. SOLUTION OF CHLOEINATED LlME. — It is a solu- 
tion of 1 lb. to the gallon of water, and when tested volurnetrically it should contain 
13 grains of available chlorine in 1 fl. oz. 

B.P. Tapor chlori. IxHALATiox of Chloelne— Put 2 ounces of chlori- 
nated lime into an inhaler or jug, moisten it with water and let the vapor be inhaled. 

Liquor Sodse Cliloratae, U.S. P. and B.P. Solution of Chlo- 
rinated Soda. (Labarraque's disinfecting fluid.) 

Preparation. — By decomposing chlorinated lime by sodium carbon- 
ate U.S. P., or by passing chlorine into a solution of sodium carbonate B.P. 

Characters and Tests. — A colorless alkaline liquid, with astringent 
taste and feeble odor of chlorine. It behaves like a solution of chlo- 
rinated lime, but is not precipitated by oxalic acid nor oxalate of 
ammonia. (Distinction from and absence of solution of chlorinated lime.) 

Dose. — 10 to 20 minims. 

Officinal Peepaeation, B.P. 
Cataplasma Soda? Chloratae. 

Cataplasma Sodae Cliloratae. Linseed meal 4 ; solution of chlorinated soda 2 ; 
boiling water 8. 

Uses. — Chlorinated lime is chiefly employed as a disinfectant and a 
deodorizer. In sick rooms some of it is put in saucers, and either simply 
moistened and exposed to the air, when it is gradually decomposed by 
the carbonic acid, or acid is added to it according to the amount of chlo- 
rine which it is wished to evolve. It is employed also for disinfecting 
typhoid stools, water-closets and sewers. For this purpose it is used 
either in powder or solution. A solution is used to disinfect the sheets 
and bedding of patients suffering from infectious diseases. 

Solutions of chlorinated lime or of chlorinated soda may be employed 
instead of chlorine water or permanganate of potash for washing the 
hands after dissecting or performing post-mortem examinations. They 
are applied externally to wounds and ulcers of all sorts which have a 
foetid discharge and a tendency to slough. Not only do they remove the 
fcetor, but they often induce a healthy action in the tissues themselves ; 
and instead of the ulceration or sloughing extending farther and farther, 
the slough is thrown off and leaves behind it a healthy healing surface. 
As the removal of sloughs is aided by heat, we have in the B.P. the 
poultice of chlorinated soda. 

Like chlorine they are destructive to plant life, and they are there- 
fore useful in skin diseases depending on the presence of parasitic fungi, 
such as ringworm of the scalp, and in scabies which is due to the pres- 
ence of a parasitic acarus. As they have a stimulant action on the skin, 
they are sometimes useful in eczema and prurigo. 

They are employed as gargles, or washes to the mouth when foetid 
ulcers occur in these parts, as in ptyalism or in scarlatina; as an injection 
into the nose they have been used to lessen the discharge and to remove 



HYDKOGEN, OXYGEN, OZONE, CARBON, ETC. 469 

the foetor in ozgena, a disease in which the discharge from the nostrils 
is sometimes so disgusting as to be almost unendurable to the patient 
himself as well as to those around him. They are likewise useful in foetid 
discharges from the vagina, such as occur when the uterus is the seat 
of malignant disease. 

Internally they have been employed in so-called putrid fevers, when 
it was imagined there was a special tendency to decomposition in the 
blood, such as typhus and malignant scarlatina. They have been given 
more especially in these diseases when there was great prostration of 
strength, with foetid evacuations and a dry and furred tongue. 

BROMUM. Br. 80. 

Bromine, U.S. P. and B.P. A liquid non-metallic element 
obtained from sea-water and from some saline springs. 

Preparation. — Vide p. 465. 

Characters. — A dark brownish-red, very volatile liquid, with a 
strong, disagreeable odor. The solution renders cold starch-water yellow. 

Impurities. — Iodine. 

Test. — When agitated with sufficient soda to render the fluid very 
slightly alkaline, it forms a colorless liquid, which, if colored by a fur- 
ther addition of a little bromine, does not become blue on the subsequent 
addition of a cold solution of starch. B.P. (absence of iodine). 

If an aqueous solution of bromine be poured upon reduced iron and 
shaken with the latter until it has become nearly colorless, then filtered, 
mixed with gelatinized starch, and a few drops of bromine solution be now 
carefully poured on the top, not more than a very faint blue zone should 
appear at the line of contact of the two liquids (limit of iodine), U.S. P. 

Uses. — Bromine, although a powerful disinfectant, is not much used 
on account of its exceedingly foetid and disagreeable smell. It is a pow- 
erful irritant, and when inhaled without sufficient dilution with air will 
produce pneumonia. Taken in small doses, for a length of time, it has 
produced mental depression, drowsiness and stupidity. It is only used 
in the form of its potassium, sodium, ammonium, calcium, and zinc salts, 
and of hydrobromic acid, which have not its powerfully irritant local 
action. It is introduced into the pharmacopoeias for their preparation. 

IODUM. I. 127 or 126-6, U.S.P. 

Iodine. — A non-metallic element obtained principally from the ashes 
of sea-weed. 

Preparation. — Vide p. 465. 

Characters. — Heavy bluish-black rhombic plates of a peculiar odor 
and metallic lustre, which, when heated, yield a beautiful violet-colored 
vapor ; very sparingly soluble in water, but freely dissolved by alcohol, 
by ether, and by a solution of iodide of potassium. The aqueous solution 
strikes a deep blue color with starch. 

Impurities. — Moisture, metallic impurities fraudulently added, cya- 
nide of iodine (the nitrogen in this is yielded by marine animals amongst 
the sea-weed), chloride of iodine, chlorine and bromine. 

Tests. — It should not adhere to the sides of the bottle and its solution 
in chloroform should be clear and limpid (absence of moisture). It 



470 INORGANIC MATERIA MEDICA. 






sublimes as a purple vapor without leaving any residue (absence of fixed 
impurities), and the portion that first comes over does not include any 
slender colorless prisms emitting a pungent odor (absence of cyanide of 
iodine) ; 12*7 grains dissolved in an ounce of water containing fifteen 
grains of iodide of potassium require for complete discoloration 1000 
grain-measures of the volumetric solution of hyposulphite of soda. 



PREPARATIONS . TJ. S. P. 


Ammorrii Iodidum. Sulphuris Iodiduni. 


Argenti Iodidum. 


*Tinctura Iodi (8 in 100). 


Arsenici Iodidum. 


"^TJnguentuni Iodi (4 in 100). 


*Xiquor Iodi Corapositus (5 in 100) T 


Plumbi Iodidi. 


Plumbi Iodidum. 


Potassii Iodi. 


Potassii Iodidum. 


Zinci Iodidum. 


Sodii Iodidum. 





B.P. 



Cadmii Iodidum. 
Ferri Iodidum. 

Hydrargyri Iodidum Rubrum. 
" * " Viride. 

*L.inimentuni Iodi, alcoholic solution 
(1 in 9). 
Linimentum Potassii Iodidi cum 
Sapone, aqueous solution. 
liquor Iodi (1 in 24). 
Pilula Ferri Iodidi. 
Potassii Iodidum. 



Sulphuris Iodidum. 
Syrupus Ferri Iodidi. 
*Tmctura Iodi, alcoholic solution 
(1 in 40). 
Unguentum Cadmii Iodidi. 
* " " Iodi (1 in 31). 

Plumbi Iodidi. 
" " Sulphuris Iodidi. 

*Vapor Iodi (Tincture of Iodine, 1 n. dr. 
mixed with 1 fl. oz. of water, gently 
warmed, and the vapor inhaled). 



The preparations marked with * in the preceding list contain iodine in a free 
state. The others contain it in a state of combination. 

Sulphuris Iodidum. Iodide OF Sulphur, U.S. P. and B.P. 

Preparation. — By fusing iodine and sublimed sulphur together. 

Characters. — Grayish-black crystalline lumps. It smells like 
iodine and stains the skin. When boiled with water it is decomposed, 
iodine passing off and sulphur remaining. 

Officinal Preparation, b.p. 

Unguentum Sulphuris Iodidi. — Ointment of iodide of sulphur (30 grains to an 
ounce of prepared lead). 

U.S.P. 

\ 
None. 

Uses. — It has been given internally in scrofula, skin diseases, and 
glanders. It is used externally as ointment in lupus and parasitic skin 
diseases. 

Iodine is rendered much more soluble either in water or spirit by the 
addition of iodide of potassium, hence this substance is used in the com- 
pound solution and ointment of the U.S. P., and in the liniment, liquor, 
tincture, and ointment of the B.P. It is not contained in the tincture 
of the U.S. P., which is a simple solution of iodine in alcohol. 

Dose. — The only preparations of iodine used for internal adminis- 
tration are the tincture U.S.P. and B.P., the compound solution U.S.P. 
and the liquor B.P., of all of which the dose is 5 to 20 minims. 

PHYSIOLOGICAL Action. — Like chlorine and bromine, iodine is a 
powerful antiseptic and oxidizing agent. When applied to the unbroken 
skin, iodine stains it of a dark yellowish-brown color, causes slight 



HYDROGEN, OXYGEN, OZONE, CARBON, ETC. 471 

warmth, and afterwards a little itching. In stronger solutions it will 
cause a painful burning sensation, and desquamation of the epidermis. In 
still stronger solution it may produce vesication. When taken internally, 
in small doses, it acts as an irritant to the intestinal canal, causing 
catarrh of the mucous membrane. When absorbed into the blood it some- 
what increases the rapidity of the pulse. It has little action upon 
blood-pressure. Its influence upon the temperature is very slight, but 
seems rather to raise it. Iodine appears to have a tendency to cause 
absorption of enlarged glands and thickenings caused by chronic 
inflammation. It seems to combine with such metals as lead and mer- 
cury, which have become deposited in the tissues in cases of chronic 
poisoning, forming with these soluble iodides, which are eliminated in 
the same way as iodine itself. It is eliminated by the urine, nasal 
mucous membrane, saliva, intestinal mucus and milk, in all of which it 
may be readily detected. It appears to be eliminated even more readily 
by the saliva than by the urine (p. 315), and on this account it may 
remain a considerable time in the body. During the process of elimina- 
tion it may irritate those parts where it is set free from its compounds, 
as the nose or skin. Even in small doses it may cause symptoms of 
iodism. These consist in irritation, either of the nose or intestinal 
tract ; the most prominent are great running at the nose, lacrymation, 
and sometimes frontal headache. Similar symptoms are produced by 
exposure to the fumes of iodine for a length of time. The nasal symp- 
toms may be accompanied or replaced by symptoms of gastric irritation, 
loss of appetite, slight nausea, and tendency to looseness of the bowels. 
The symptoms of poisoning', such as have occurred from the injec- 
tion of large quantities of iodine solution into the ovarian cyst, were 
first, collapse, followed after a little while by an appearance of fever, 
with rapid pulse and flushed face, but without any rise of temperature. 
This condition passed off in several days, but during apparent convales- 
cence the patient suddenly died. Small doses of iodine, by improving 
the health of patients, may increase the menstrual flow, and may act as 
aphrodisiacs. Larger doses generally have a very marked anaphro- 
disiac action, and it has been stated that long continued use has pro- 
duced atrophy of the mammae, ovaries, and testes. It has been stated 
that very large doses affect the nervous system, causing delirium,and 
twitching or paralysis of the muscles (p. 466). 

Uses. — Iodine applied to the epidermis acts as a parasiticide, and 
may be used, in cases of tinea, either alone or combined with tar to 
destroy parasitic fungi. Its solution, painted on the surface, is useful 
in removing muscular pains, and in causing absorption of thickening 
around joints, or of enlarged strumous glands. When painted on the 
surface it sometimes causes absorption of the enlarged thyroid gland in 
goitre, and, when outward application is insufficient, success is some- 
times obtained by injecting from ten to thirty minims of tincture of 
iodine into the substance of the tumor by means of a hypodermic syringe, 
care being taken to avoid injection into a vein. Its solution, painted on 
the surface, is also useful in causing absorption of fluid from serous cavi- 
ties, as pleurisy. Sometimes, after the fluid has been evacuated from a 
serous sac, such as the pleura, or the tunica vaginalis in hydrocele, or 



472 IXORGANIC MATERIA MEDICA. 

from ovarian cysts, a dilute tincture of iodine is injected into the sac to 
prevent the fluid from again accumulating. 

In removing slight consolidation of the lung, remaining after pneu- 
monia or pleurisy, or in cases of commencing phthisis, the external 
application of liniment of iodine is very useful. It should be painted on 
the surface, every second or third day, so as always to keep one part a 
little tender. By mixing the liniment with the tincture in varying pro- 
portions any degree of strength can be obtained. Cases of ozoena are 
sometimes much benefited by washing out the nose with a solution of 
common salt to which a few drops of tincture of iodine have been added. 
The vapor of iodine is employed in chronic bronchitis and phthisis. 

On account of its irritating action on the intestinal mucous mem- 
brane, iodine is rarely given internally, its place being supplied by iodide 
of potassium, but some consider that iodine is sometimes more effectual. 

The compound solution of iodine U.S. P., or liquor iodi B.P., is useful 
in arresting vomiting when administered internally in doses of 3 to 5 
minims. 



CHAPTER XXIII. 

ACIDS. 



General Characters. — It is somewhat difficult to get a correct 
definition of an acid. Most of them have a sour taste and redden blue 
litmus: they combine with alkalies and destroy the power which these 
have of turning red litmus-paper blue. 

They may be regarded as compounds of hydrogen with certain radi- 
cals, hydrogen being readily displaced by other bases. Some acids, as 
boric and carbolic, have no sour taste. Carbolic acid does not redden 
litmus-paper, but it is in reality an alcohol, although in chemical com- 
binations it behaves like an acid. 

General Preparation of Acids. — Most acids are prepared by 
liberating them from their alkaline salts by means of sulphuric acid. 
When they are volatile they are separated by distillation, and when non- 
volatile by crystallization. 

Sulphuric acid, which is of such importance in the preparation of 
other acids, is itself prepared by oxidizing the fumes of sulphur by means 
of nitric acid. Sulphur is burnt, and the sulphurous oxide thus produced 
is conducted along with the vapor of nitric acid into a large leaden 
chamber where it is mixed with steam. Sulphurous oxide is oxidized by 
the nitric acid and sulphuric oxide is formed, which, uniting with the 
watery vapor, forms sulphuric acid. The nitric acid is deoxidized in this 
process into nitric oxide, this unites with the oxygen of the air to form 
nitric peroxide, and this again supplies fresh oxygen to the sulphurous 



ACIDS. 



473 



acid, N0 2 + S0 2 + H 2 = NO + H 2 S0 4 . In this way a small quantity 
of nitric acid is sufficient to oxidize a large quantity of sulphuric acid ; 
reduction and reoxidation going on alternately in the nitrous fumes. 
The sulphuric acid formed in the leaden chamber is drawn off and evapo- 
rated to the proper strength. 

The acids which are prepared by liberation from their salts by sul- 
phuric acid are given in the following tables : — 



Volatile Acid. 


Prepared from 


By addition of Sulphuric Acid and 


Carbonic Acid. 


Any carbonate, gener- 
ally carbonate of 
lime. 


Conducting into water or alkaline 
solution, according to the purpose 
required. 


Hydrochloric Acid, 
U.S.P. and B.P. 


Sodium chloride. 


Distilling into water, which dis- 
solves the acid. 


Nitric Acid, U.S.P. 
and B.P. 


Sodium Nitrate, or 
Potassium Nitrate. 


Distilling. 


Acetic Acid, U.S.P. 
and B.P. 


Crystallized Sodium 
Acetate. 


Do. 


Glacial Acetic Acid, 
U.S.P. and B.P. 


Dried Sodium Ace- 
tate. 


Do. 


Dilute Hydrocyanic 
Acid,U.S.P.andB.P. 


Potassium Ferrocy- 
anide. 


Distilling into water. 


Dilute Hydrobromic 
Acid, U.S.P. 


Potassium Bromide. 


Crystallizing out potassium sul- 
phate, distilling the mother- 
liquor, and diluting the distillate. 



Sodium chloride and sodium nitrate are found native: the sodium 
acetate is prepared from gas liquor by saturating with sodium carbonate. 

In preparing hydrocyanic acid the cyanide is not employed, but the 
ferrocyanide which is prepared by heating together animal refuse and 
iron filings and potassium carbonate. 



Non-Volatile Acid. 



Tartaric Acid,U.S.P. 
and B.P. 



Citric Acid, U.S.P. 
and B.P. 



Boric Acid U.S.P., or 
Boracic Acid B.P. 



Prepared from 



Tartrate of lime made 
from acid tartrate of 
potash. 

Citrate of lime pre- 
pared from lemon 
juice. 

Sodium borate. 



By addition of Sulphuric Acid and 



Subsequent decantation from cal- 
cium sulphate, evaporation and 
crystallization. 

Subsequent decantation from cal- 
cium sulphate, evaporation and 
crystallization. 

Precipitation ; the boracic acid, 
sparingly soluble in water, falls 
as a precipitate, and the sodium 
sulphate is removed by decanta- 
tion or nitration. 



474 



INOBGAmC MATERIA MEDICA. 



If sulphuric acid were added to citrate or tartrate of potassium or 
sodium, it would be difficult to separate the acid from the sulphate. To 
avoid this, the citrates and tartrates of lime are first prepared, and to 
these sulphuric acid is added. There results an insoluble calcium sul- 
phate which falls as a precipitate, and the solution of citric or tartaric 
acid is readily separated by decantation or filtration, and evaporated to 
crystallization. 

Citrate of lime is prepared by adding chalk to boiling lemon-juice, 
and washing the coloring matter from the precipitate by hot water. Hot 
is employed in preference to cold water because citrate of lime is less 
soluble in it. Tartrate of lime is prepared from the crude acid tartrate 
of potash or argol, which is deposited from wine during the process of 
fermentation. Chalk is first added to a solution of it, whereby a neutral 
tartrate is formed, 2(KHC 4 H 4 6 ) + CaC0 3 = CaC 4 H 4 6 + K 2 C 4 H 4 6 
-f- C0 2 + H 2 0. This is then decomposed by the addition of calcium 
chloride or sulphate, K 2 C 4 H 4 6 + CaCl 2 = CaC 4 H 4 6 + 2KC1. 

Hydrobromic acid, although volatile, is not unfrequently prepared 
without distillation. Hamilton's plan is to dissolve 84J grs. potassium 
bromide in a fluid ounce of water, and add 99 grs. of tartaric acid to it. 
After standing at a low temperature for twelve hours, acid tartrate of 
potassium crystallizes out, and leaves a solution containing about 10 per 
cent, of real hydrobromic acid. 

Exceptions to the rule that acids are prepared from salts by the 
addition of sulphuric acid : — 



Acid. 


Prepared by- 


Sulphuric Acid. 


Oxidizing sulphur by means of nitrous fumes. 


Phosphoric Acid Dilute. 


Oxidizing phosphorus by heating it with diluted 
nitric acid until nitrous fumes have ceased to form, 
and then diluting it to the proper strength. 


Oxalic Acid. 


Oxidizing sugar by heating with nitric acid. 


Sulphurous Acid. 


Deoxidizing sulphuric acid by means of charcoal and 
passing the fumes into water. 


Arsenious Acid. 


Roasting arsenical ores, collecting the acid which sub- 
limes, and purifying it by resublimation. 


Benzoic Acid. 


Heating gum benzoin when the acid sublimes. 


Carbolic Acid. 


Fractional distillation of tar. 


Oleic Acid. 


Decomposing lead oleate by hj'drochloric acid. 


Salicylic Acid. 


By passing carbonic acid gas over sodium carbolate 
which is made by evaporating caustic soda and car- 
bolic acid together to dryness. 


Tannic Acid. 


Dissolving out from the fresh nut-galls in which it is 
contained by ether and water. 


Gallic Acid. 


Dissolving it out from fermented nut-galls by hot 
water. 






acids. 475 

General Action of Acids. — They have an affinity for electro-positive 
or basic substances, and combine with them when they come in con- 
tact. Stronger acids drive out weaker ones from their combination with 
bases, setting them free ; but are themselves sometimes driven out by 
weaker ones if these form an insoluble combination. 

When they come in contact with the tissues they produce changes in 
a twofold manner ; (1) by forming new compounds, (2) by destroying 
others previously existing. The different acids possess different affinities, 
and the actions they exert vary with the acid and with the degree of its 
concentration, weak acids having their affinities easily satisfied. All the 
tissues of the body are alkaline, and the first effect of acids will be to 
neutralize the alkali, and if albumen be dissolved in it to precipitate it. 
If sufficient acid be present, they all, with the exception of nitric acid, 
again redissolve it. Acids unite with albumen in different proportions, 
forming acid albumins. When mixed with blood they not only precipi- 
tate albuminous substances, but decompose haemoglobin, forming a sub- 
stance which holds oxygen with more tenacity than haemoglobin. They 
coagulate myosin and produce instantaneous rigidity in muscles. Sul- 
phuric and phosphoric acids have, besides their chemical affinities, a 
strong attraction for water, and completely decompose the tissues to 
which they are applied, so that they are most powerful eseliarotics. 
Nitric acid does not readily redissolve the albumen precipitated by it, and 
thus forms a barrier to its own action, so that it does not penetrate so 
deeply as sulphuric acid. 

Round the tissue killed by the acids inflammation ensues, and an 
eschar is separated. When their action is less intense they cause inflam- 
mation of the surface of the dermis, and produce vesication. Still less 
concentrated, they precipitate albumen from its solutions in the tissues, 
act as irritants, and cause contraction of the blood-vessels. This effect is 
removed by the alkalinity of the blood, and the irritation may be only 
sufficient to cause a temporary congestion subsequent to the contraction. 
Then the acids act only as rubefacients. As such they are used in 
the form of baths. 

In the mouth they cause a peculiar taste, and a feeling of roughness 
in the teeth. They cause an increased flow of saliva from the parotid, 
and of the thin saliva which the submaxillary secretes when the chorda 
tympani is irritated, but have no effect on the sympathetic saliva. They 
are therefore given to allay thirst in fever, the increased secretion of 
saliva which they provoke keeping the fauces moist (p. 316). 

Acids stimulate the secretion of the alkaline saliva and intestinal 
juice, and excite the expulsion of bile from the gall-bladder. They are 
supposed generally to stimulate those glands whose secretions are alka- 
line. On the other hand alkalies stimulate the secretion of gas trie juice, 
which is acid ; and they are supposed to stimulate in general those glands 
whose secretion is acid. Professor Ringer supposes that the converse is 
also the case, and that acids and alkalies severally hinder the secretions 
of a like character. This supposition may be correct, and no doubt when 
an acid is present, e.g., in the stomach, it will neutralize any alkali which 
may be taken and either retard its stimulant action on the gland or pre- 
vent it altogether, according to the relative quantities of acid present 



476 INORGANIC MATERIA MEDICA. 

and of alkali employed. The presence of much alkali will also hinder 
the action of an acid stimulus in the same manner, but whether acids 
and alkalis have any farther effect in hindering secretion than that just 
mentioned is uncertain. 

Acids are partly neutralized by the saliva, and partly act as astrin- 
gents on the mouth and fauces. They are thus used in congestion of the 
throat. As they corrode the teeth, they are generally given through a 
glass tube or quill, and the teeth should be rubbed with chalk afterwards. 

Digestion in the stomach is accomplished by the action of pepsin 
along with dilute hydrochloric acid. This ferment only acts in presence 
of free acid ; but the amount of acid necessary is different in different 
animals, being greatest in the carnivora and least in the herbivora. 
Pepsin seems able to go on dissolving fibrin almost without a limit, but 
fresh acid must always be added. If the secretion is deficient, digestion 
goes on slowly and fermentation of the food takes place, causing the 
formation of other acids and liberation of gases. 

The secretion of gastric juice may be stimulated by alkalis given 
just before meals, but if the stomach is so much out of order as not to 
respond to the stimulus, hydrochloric or phosphoric acid may be given 
after meals, alone or with pepsin. In febrile conditions there is a defi- 
ciency of acid in the stomach, although pepsin is present in plenty. In 
chronic gastric catarrh, especially when accompanied by dilatation, the 
acid is greatly diminished, and in carcinoma of the stomach it would 
seem to be wanting in the great majority of cases. In such conditions, 
therefore, the administration of diluted hydrochloric acid is indicated. 

For acid eructations and heartburn depending on excessive acidity 
of the gastric juice, acids should be given before meals (Ringer). 

Some persons are troubled by eructations of sulphuretted hydrogen 
with a taste of rotten eggs. These persons have generally oxalic acid 
in the urine, and frequently suffer from depression of spirits. Such 
patients are benefited by acids, especially nitro-hydrochloric acid. Per- 
sons who suffer from dyspepsia and depression of spirits with oxaluria 
are also benefited by mineral acids, even when no sulphuretted hydrogen 
is present in the intestines. 

When the use of acids is long continued they lessen the secretion of 
gastric juice, and produce a catarrhal condition of the mucous membrane 
of the stomach. They should therefore not be given for more than a 
week or two at a time. They should then be left off for a short time, 
or alternated with alkalis. Constant use of acid wines has a similar 
tendency to produce catarrh. Vinegar is sometimes drunk in order to 
lessen obesity or even plumpness. It has this effect by inducing gastro- 
intestinal catarrh, but sometimes the derangement of the digestion occa- 
sioned by it has been so great as to cause death. 

Acids stimulate the expulsion of bile from the gall-bladder, and the 
secretion of intestinal juice. As they will be rapidly neutralized by 
the bile and pancreatic juice, and absorbed in the duodenum, they can 
hardly reach the lower and middle parts of the alimentary canal as 
acids. Their action in relieving diarrhoea is difficult to explain. 

When absorbed from the intestine they must pass through the liver 
before they can reach the general circulation. It is probable that during 






acids. 477 

their passage through the portal system they alter the processes of tissue 
change which go on in the liver, and check the formation of urea. The 
reason for this supposition is that acids are excreted in the urine, chiefly 
in the form of ammoniacal salts. In the normal condition ammonia is 
readily converted into urea in the organism, and when given internally 
it appears in the urine in the form of urea and not of ammoniacal salts. 
The appearance of these salts in the urine after the administration of 
acids shows that the normal process of conversion into urea has been 
diminished. Possibly it is to such alterations in the tissue change 
in the liver that the so-called tonic action of acids is due (p. 356), as 
well as the marked benefit obtained in hepatic disorders from the admin- 
istration of nitric and nitro-hydrochloric acids. Although acids appear 
in the urine in combination with ammonia and other bases, yet their 
free administration increases the acidity of the urine. They are there- 
fore used to prevent the deposits of phosphatic calculi which are apt to 
occur in alkaline urine. 

Poisoning by Acids. — The symptoms of poisoning by acids, and 
the antidotes to be employed, have already been described (pp. 345, 347, 
and 417). In cases of acute poisoning where death has not occurred 
too quickly, much albumen, hsematin and indican have appeared in the 
urine, and fatty degeneration of the liver, muscles and kidneys has been 
found. In the kidneys the cloudy swelling and fatty degeneration of 
the cells was accompanied by evidences of inflammation in the connec- 
tive tissue also, as it exhibited proliferation of nuclei, especially along 
the course of the vessels. 

Acidum Sulpliuricum, U.S. P. and B.P. Sulphuric Acid. 
— It contains 96*8 per cent, of H 2 S0 4 (98) and corresponds to 79 per 
cent, of anhydrous sulphuric acid, S0 3 (80). 

Preparation. — Vide p. 474. 

Properties. — A colorless, oily-looking heavy liquid. Sp. gr. 1*843 ; 
no smell ; but intensely acid taste. It blackens and corrodes most 
organic substances. It has a great affinity for water, and when mixed 
with it evolves much heat. When diluted it gives a copious white pre- 
cipitate of barium sulphate (BaS0 4 ) with chloride of barium, insoluble 
in nitric or in hydrochloric acid. 

Impurities. — Lead derived from the leaden chambers in which it is 
prepared ; nitric acid from the nitrous fumes ; arsenic from impure 
sulphur being used and the arsenious fumes passing over with the 
sulphurous acid ; and water from imperfect concentration or fraudulent 
addition. 

Tests. — Not unfrequently it contains so much lead in the form of 
sulphate, that when diluted with water it deposits a white precipitate, 
the sulphate being soluble in the strong but not in the weak acid. It 
should not do this, and when evaporated in a platinum dish it should 
leave little or no residue (no lead, arsenic, or saline impurities). When 
a solution of sulphate of iron is carefully poured over its surface, there is 
no purple color developed where the two liquids unite (no nitric acid). 
Diluted with six times its volume of distilled water, it gives no precipi- 
tate with sulphuretted hydrogen (no arsenic or lead). The absence of 



478 INORGANIC MATERIA MEDICA. 

water is ascertained by the sp. gr. not being below 1*840, and by the 
volumetric estimation of its neutralizing power with solution of soda. 

Officixal Peepakations. 

AcidmnSulplmricitru Aroinaticuin, U.S.P. antlB.P. AEOMATIC SULPHUEIC ACID. — 
Is sulphuric acid diluted with alcohol and flavored with cinnamon and ginger. 
1 in 10 U.S.P. and about 1 in 13 B.P. by measure. 

Aciduui Siilpburicum Dilutum, U.S.P. and B.P. DILUTE SULPHUEIC ACID. — Is the 
strong acid diluted with 164- parts U.S.P., 11 parts B.P., of water by measure; 1 in 
10 by weight U.S.P. 

Doses. — Of either aromatic or dilute sulphuric acid 5-30 min. freely 
diluted. 

Incompatibles. — Preparations of lead. 

Action. — It is a most powerful caustic and quickly chars and 
destroys the parts it touches. When mixed with charcoal paste it is used 
as a caustic in cancer, and with lard in obstinate skin diseases. When 
swallowed, as it not unfrequently is in manufacturing districts, it pro- 
duces symptoms of irritant poisoning (p. 344). The antidotes are alkalis, 
soap, oil, whiting, milk, plaster from the wall, or magnesia. 

Uses. — Internally it is used after free dilution to quench thirst in 
fever, to prevent absorption of lead from the stomach in painters and 
color-grinders, to check diarrhoea, especially in phthisis, to arrest haemop- 
tysis and other haemorrhages, and to lessen night sweats and mucous 
discharges. 



- - 



Acidum Sulplmrosuiii, U.S.P. and B.P. SULPHUROUS Acid. 
— Sulphurous acid gas (S0 2 ; 64) dissolved in water and constituting 9-2 
per cent, of the solution. 

Preparation.— Vide p. 474, 2H 2 SO, + C = C0 2 + 2S0 2 + 2H 2 0. 

Properties. — A colorless liquid with a strong sulphurous odor. 
Unlike sulphuric acid, it gives no precipitate with chloride of barium, but if 
chlorine be added to it, it becomes converted into sulphuric acid, and 
then gives a precipitate, S0 2 + 2H 2 + Cl 2 = H 2 SO, + 2HC1. 

Impurities. — Sulphuric acid, solid impurities, too little sulphurous 
acid. 

Test. — It should give no precipitate, or only a slight one, with chlo- 
ride of barium (little or no sulphuric acid) ; but very few specimens answer 
either to this test or to the officinal volumetric test on account of the 
liability of the acid to decompose. It should leave no residue on evapo- 
ration. Its strength is determined by its sp. gr. 1-04 and the volumetric 
test. 

Dose. — J— 1 fluid drachm diluted with water. 

Action. — It is a powerful deoxidizing agent. It is extremely de- 
structive to plant life, and so may destroy disease germs. 

Uses. — Gaseous sulphurous acid is used to disinfect rooms. The 
room should be closely shut up, and a brazier with charcoal placed in it. 
On this sulphur is thrown, and the fumes are allowed to permeate the 
room for several hours. Care must be taken that the brazier is so placed 
that there is no danger of anything in the room catching fire. A solu- 
tion mixed with glycerine may be applied in skin diseases depending on 



acids. 479 

parasitic fungi. It is very useful in cases of vomiting, especially when 
the vomited matters have a frothy or yeasty appearance, due to the pres- 
ence of sarcinie and to the occurrence . of fermentation in the stomach. 
Applied as spray it sometimes gives relief in laryngeal phthisis. 

Acidum Hydrocliloricum, U.S. P. and B.P. HYDROCHLORIC 
or Muriatic Acid. — Hydrochloric acid gas (HC1; 36*4) dissolved in 
water, and forming 31*9 U.S. P., 31-8 B.P., per cent, by weight of the 
solution. 

Preparation. — By warming chloride of sodium with sulphuric acid, 
washing the evolved HC1, and conducting it into cold water by which it 
is absorbed. Excess of sulphuric acid is employed if glass vessels are 
used in the preparation either of this or of nitric acid, as the bisulphate 
of potash left behind is more soluble than the neutral sulphate, and thus 
the vessels are more easily cleaned. NaCl -f- H 2 S0 4 = NaHS0 4 + HC1. 

Properties. — A nearly colorless liquid, sp. gr. 1-16. It emits 
white vapors having a pungent odor, and has a strongly acid taste. 

Reaction. — It gives with nitrate of silver a curdy white precipitate 
soluble in excess of ammonia, insoluble in nitric acid. 

Impurities. — Salts ; sulphuric acid, with its impurities, lead and 
arsenic ; chloride of sodium or chlorine ; sulphurous acid formed from 
sulphuric by organic substances ; iron from the apparatus in which it is 
made commercially.'] 

Arsenic is of importance as an impurity because hydrochloric acid is 
sometimes used in testing for arsenic by the formation of arsenuretted 
hydrogen. When testing for arsenic in cases of suspected poisoning both 
the acid and the zinc must be tested first, in order to ascertain their 
purity before the suspected substance is added. 

Tests. — When diluted with four times its volume of distilled water 
it gives no precipitate with solution of chloride of barium (absence of 
sulphuric acid), or with sulphuretted hydrogen (absence of lead or 
arsenic), and does not tarnish or alter the color of bright copper foil 
when boiled with it (absence of arsenic). When diluted with five 
volumes of water it should not liberate iodine from iodide of potas- 
sium (absence of chlorine) ; and when 1 c.c. is diluted to 10 c.c. with 
water, and supersaturated with ammonia, the addition of two drops of 
ammonium sulphide causes no black color (absence of iron). If a fluid 
drachm of it mixed with half an ounce of distilled water be put into a 
small flask with a few pieces of granulated zinc, and while the effer- 
vescence continues a slip of bibulous paper wetted with solution of 
nitrate of silver, U.S. P., or subacetate of lead, B.P., be suspended in 
the upper part of the flask above the liquid for about five minutes, the 
paper will not become discolored (absence of sulphurous or arsenious 
acid, S0 2 + 6H = H 2 S -f- 2H 2 0). When evaporated it leaves no 
residue (no sodium chloride or other fixed impurity). 

Peepaeatioxs coxtaining feee Hydeochloeic Acid. 

U.S.P. DOSE. 

Acidum Hydrocliloricum Dilutum (acid 6, water 

13 by weight ; 5 j and 14 by measure) 10-30 m. 

Acidum Nitro-hydrochloricum 

" " Dilutum 10-30 m. 



480 INOKGANIC MATERIA MEDICA. 

Peepaeations containing feee Hydeochloeic Acid. 

B.P. DOSE. 

Aoidimi Hydrochloricum Dilutura (acid 8, diluted 

with water up to 26 J by measure) 10-30 m. 

Acidum Nitro-hydrochloricuin Dilutum 10-30 m. 

Liquor Antimonii Chloridi 

" Arsenici Hydrochloricus 

" Morphise Hydrochloratis 

Action and Uses. — It produces symptoms of poisoning like those 
of sulphuric acid. The stains which it leaves upon the mucous mem- 
brane are white. It is rarely used externally. It may be employed to 
quench thirst in fevers, and to lessen phosphatic deposits in the urine. 
As it is the acid of the gastric juice, it may be given after meals in cases 
of indigestion, where we suspect deficiency of acid (p. 475) and to aid 
the digestion of food, as well as to relieve thirst in febrile conditions 
(pp. 475 and 316). 

Acidum Nitricum, U.S. P. and B.P. Nitric Acid, (HN0 3 ; 63.) 
— An acid prepared from nitrate of potash or nitrate of soda by distilla- 
tion with sulphuric acid and water, and containing 69*4 per cent. U.S. P. 
or 70 B.P. by weight of nitric acid, HN0 3 , corresponding to 60 per cent, 
of anhydrous nitric acid, N 2 5 . 

Characters. — A colorless liquid, having a specific gravity of 1*42. 
When exposed to the air it emits an acrid, corrosive vapor. If it be 
poured over copper filings, dense red vapors are immediately formed, but 
if the acid be mixed with an equal volume of water, and then added to 
the copper, it gives off a colorless gas, which acquires an orange-red 
color as it mixes with the air, and which, if it be introduced into a solu- 
tion of sulphate of iron, communicates to it a dark purple or brown color, 
due either to solution of N 2 2 in the sulphate or combination with it. 
The boiling point of the acid is 250°. If submitted to distillation the 
product continues uniform throughout the process. 

Impurities. — Weaker or stronger acid, sulphuric or hydrochloric 
acids, fixed impurities. 

Tests. — It leaves no residue when evaporated to dryness (no fixed 
impurities, as iron, lead, &c). Diluted with six times its volume of 
distilled water it gives no precipitate with chloride of barium or nitrate 
of silver (absence of sulphuric or hydrochloric acids). 

Peepaeations containing feee Niteic Acid. 

u.s.p. B.P. dose. 

Acidum Nitricum Dilutum (acid 1, water Acidum Nitricum IMlutuin (1 *) 

6 by weight; 1£ and 12J by measure). with about 4 of water by > 10-30 m. 

Acidum Nitro-hydrochloricum measure) J 

" Dilutum. Acidum Nitro-hydrochloricum 

Dilutum 

Liquor Ferri Pernitratis 

" Hydrargyri Nitratis 

Acidus 

Ungucntum Hydrargyri Ni- 
tratis 

Action. — It is an exceedingly powerful caustic, and destroys the 
tissues, but, unlike sulphuric acid, it forms, to some extent, a barrier to 



ACIDS. 481 

its own action by coagulating the albumen with which it meets. When 
swallowed, it may not only produce the symptoms of irritant poisoning 
already described, but the vapor, getting into the larynx, may cause 
spasm of the glottis, and death from suffocation, or may produce intense 
bronchitis. 

Uses. — Nitric acid is applied externally to destroy chancres, warty 
growths, and haemorrhoids ; to the surface of phagedenic ulcers ; and to 
bites of snakes or rabid dogs in order to destroy the virus and prevent 
its absorption. Internally the dilute acid is used to quench thirst in 
febrile conditions, like other dilute acids, and it is useful in cases of 
dyspepsia. It is supposed to have an action upon the liver, and certainly 
appears to be of use in cases of so-called biliousness. When absorbed 
it has an astringent action, and is exceedingly serviceable in diminishing 
the secretion from the lungs in bronchitis and in the sub-acute exacerba- 
tions of phthisis. It is also employed in cases of syphilis occurring in 
debilitated subjects, where mercurials are not well borne. It diminishes 
phosphatic deposits in the urine, and, in a dilute condition, has been 
injected into the bladder in order to dissolve calculi already formed. 

U.S. P. Acidum Xitrohydrocliloricum. NITROHYDROCHLORIC 
Acid. 

Preparation. — By mixing nitric acid (4) with hydrochloric acid 
(15 parts) and when effervescence has ceased, preserving it in glass- 
stoppered bottles, which should not be more than half filled and kept in 
a cool place. 

Characters. — A golden yellow, fuming and very corrosive liquid, 
having a strong odor of chlorine and a strongly acid reaction. By heat 
it is wholly volatilized. It readily dissolves gold leaf, and a drop added 
to test solution of iodide of potassium liberates iodine abundantly. 

Acidum Nitrohydrochloricum Dilutum, U.S. P. and B.P. 

Dilute Nitrohydrochloric Acid. 

Preparation. — By diluting nitrohydrochloric acid (1) with water 
(26 parts by weight U.S. P.). The proportions in the U.S. P. by 
measure, are nitric 3, hydrochloric acid 13J, water 80. In the B.P., 
nitric 3, hydrochloric 4, water 25, by measure. 

Dose. — 5-20 min. 

Use. — This, like nitric acid, is supposed to have a special action 
upon the liver. It is sometimes used in the form of baths or compresses 
in hepatic disorders, and is frequently given in cases of dyspepsia, bil- 
iousness and jaundice. When given before meals it seems to check acidity 
in the stomach, and it is very useful in removing headache situated in 
the forehead, just above the eyebrows, and unaccompanied by constipation. 

Acidum Aceticum, U.S. P. and B.P. Acetic Acid — HC 2 H 3 
2 ; 60. An acid liquid prepared from wood by destructive distillation 
and subsequent purification. 100 parts by weight contain 36 U.S. P., 
33 B.P. parts of acetic acid HC 2 H 3 2 ; 60 corresponding to 28 parts of 
anhydrous acetic acid, C 4 H 6 3 . 

Characters and Tests. — A colorless liquid having a strong acid 
reaction and a pungent odor. Specific gravity 1*048 U.S. P., 1*044 B.P., 
at 15° C. 
31 



482 INORGANIC MATERIA MEDICA. 

Impurities. — Lime, lead, copper, tin, sulphuric and hydrochloric 
acids, and sulphurous acid due to the action of organic matter on the 
sulphuric acid. 

Tests. — It leaves no residue when evaporated (no lime, &c), and 
gives no precipitate with sulphuretted hydrogen (no metals), chloride of 
barium (absence of sulphuric acid), or nitrate of silver (absence of hydro- 
chloric acid). If a fluid drachm of it mixed with half an ounce of dis- 
tilled water and half a drachm of pure hydrochloric acid be put into a 
small flask with a few pieces of granulated zinc, and while the efferves- 
cence continues a slip of bibulous paper wetted with solution of sub- 
acetate of lead be suspended in the upper part of the flask above the 
liquid for about five minutes, the paper will not become discolored 
(absence of sulphurous acid S0 2 + 6H = H 2 S -f 2H 2 0). 

Preparations containing feee Acetic Acid. 
Acetuiu ....4*6 per cent, anhydrous acetic acid. 

" Cantharidis 

" Scillae 

Acidum Aceticuiu Giaciale 84 per cent, anhydrous acid. 

" Aceticuiu 28 per cent. 

" " DUutuni 3'6 per cent. " 

fExtractum Colchici Aceticum 

Linimentuni Terebinthinse Aceticum 1 volume acetic acid in 3. 

Liquor Epispasticus 1 volume acetic acid in 5. 

Mistura Creasoti 

Oxvmel 

" Scillse 

Sy rupus Scillse 

Acidum Aceticum Dilutum, TJ.S.P. aud B.P. DILUTED ACETIC ACID.— 
Acetic acid 17 parts, water 83 parts, U.S.P., or acetic acid 1 part diluted with water 
7 parts, B.P. 

Properties, Impurities. — The same as of acetic acid, except so far as they 
are affected by its dilution. 

Dose. — 1 to 2 fluid drachms. 

Preparations in which Diluted Acetic Acid is used. 

b.p. 
Acetuin Scillae. Liquor Morphia? Acetatis. 

Acidum Aceticum Giaciale, U.S. P. aud B.P. — Glacial 
Acetic Acid, HC 2 H 3 2 ; 60. Nearly or quite absolute acetic acid, U.S. P. 
Concentrated acetic acid, corresponding to at least 84 per cent, of anhy- 
drous acid, C 4 H O 3 , B.P. 

Characters axd Tests. — At or below 15° C. (59° F.) a crystalline 
solid; at higher temperature, a colorless liquid. "When liquefied and as 
near as possible to 15° C. (59° F.) it has the sp. gr. 1-056-1-058. Its 
properties are similar to those of acetic acid, and it is similarly affected 
by reagents. U.S. P. 

It crystallizes when cooled to 34°, and remains crystalline until the 
temperature rises to above 48°. Specific gravity 1-065 to 1*066, and 
this is increased by adding ten per cent, of water. At the mean tem- 
perature of the air it is a colorless liquid, with a pungent acetous odor. 
B.P. 

Preparations in which Glacial Acetic Acid is Used. 

b.p. 

\< itum Cantharidis. Mistura Creasoti. 



acids. 483 

B.P. Acetum. Vinegar. — An acid liquid, prepared from malt 
and unmalted grain by the acetous fermentation. 

Characters. — A liquid of a brown color and peculiar odor. 

Impurities. — A little sulphuric acid added to it is said to make 
it keep better. Too much may be fraudulently added in order to 
increase its acidity. Lead from the vessels in which it is kept. 

Tests. — If ten minims of solution of chloride of barium be added 
to a fluid ounce of the vinegar, and the precipitate, if any, be separated 
by filtration, a further addition of the test will give no precipitate (limit 
of sulphuric acid). Sulphuretted hydrogen causes no change of color 
(absence of lead). 

Dose. — 1 to 2 fluid drachms. 

Peepaeation in which Vinegae is Used. 
Emplastrum Cerati Saponis. 

Action and Uses. — When applied externally to the skin, glacial 
acetic acid causes the formation of a large bleb. It is used to destroy 
warts, and is sometimes employed as a vesicant in cases of kidney dis- 
ease, where danger is apprehended from the use of cantharides. When 
the vapor of it is sniffed up the nose, it causes reflex contraction of the 
blood-vessels, and raises the blood-pressure. It is therefore useful in 
lessening drowsiness and preventing syncope, or arousing patients from 
it (pp. 177 and 231). 

Dilute acetic acid is applied to the skin in cases of headache, and is 
used to sponge the surface and check perspiration when too profuse. 
It checks bleeding, and may be used to stop oozing from leech bites, or 
to wash out the mouth after the extraction of a tooth ; and, when sniffed 
up the nose, sometimes arrests epistaxis. It is occasionally employed in 
the form of an enema to destroy ascarides. 

U.S. P. Aciduiu Pliosplioricum. Phosphoric Acid. — A liquid 
composed of 50 per cent, of orthophosphoric acid (H 3 P0 4 ; 98) and 50 
per cent, of water. 

Preparation. — Oxidizing phosphorus by nitric acid. Vide p. 474. 

Characters. — A strongly acid liquid, without odor, and of a 
strongly acid taste and reaction, sp. gr. 1*347. When heated it loses 
water, and when a temperature of about 200° C. (392° F.) has been 
reached, the acid is gradually converted into pyrophosphoric and meta- 
phosphoric aeids, which may be volatilized at a red heat. When diluted, 
and supersaturated with ammonia, the test solution of magnesium gives 
a white precipitate. Vide also the reactions and tests of acidum phos- 
phoricum dilutum. 

Officinal Peepaeation. 

u.s.p. 
Acidum Phosphoricum Dilutum. 

Acidum Phosphoricum Dilutum, U.S.P and B.P. Diluted 
Phosphoric Acid. — Phosphoric acid, H 3 P0 4 , 20 parts dissolved in 80 
parts of water, U.S.P. Phosphoric acid, dissolved in water and corres- 
ponding to 10 per cent, by weight of anhydrous phosphoric acid, P 2 5 , B.P. 



484 INORGANIC MATERIA MEDICA. 

Characters and Tests. — A colorless liquid, with a sour taste and 
strongly acid reaction. Specific gravity, 1*08. With ammonionitrate 
of silver it gives a canary-yellow precipitate, soluble in ammonia and in 
diluted nitric acid. Evaporated, it leaves a residue which melts at a low 
red heat, and upon cooling exhibits a glassy appearance. 

Impurities. — Phosphorous acid, meta-, and pyro-phosphoric acids, 
nitric, sulphuric and hydrochloric acids, arsenic. 

Tests. — It is not precipitated by sulphuretted hydrogen (no metals), 
chloride of barium (no sulphuric acid), nitrate of silver acidulated with 
nitric acid (no hydrochloric acid), nor by the solution of albumen 
(absence of metaphosphoric acid which coagulates albumen). When 
mixed with an equal volume of pure sulphuric acid, and then introduced 
into solution of sulphate of iron, it does not communicate to it a dark 
color (absence of nitric acid). Mixed with an equal volume of solution 
of perchloride of mercury and heated, no precipitate is formed (no 
pyrophosphates). Its strength is estimated gravimetrically by ascer- 
taining the increase in weight which occurs in oxide of lead when phos- 
phoric acid is poured on it, evaporated and ignited. 

Dose. — 10 to 30 minims. 

B.P. Prepakatton containing feee Phosphoeic Acid. 
Syrupus Ferri Phosphatis. 

Uses. — Phosphoric acid may be used to allay thirst, like other dilute 
acids, in febrile states, and in diabetes. It may be given in larger doses 
than other mineral acids without deranging digestion, and is therefore 
to be preferred to them in cases where it requires to be given for a length 
of time, as in diabetes and alkalinity of the urine. It is said to be 
useful in scrofula, and to diminish the growth of bony tumors. 

Acidum Tartaricum, U.S. P. and B.P. TARTARIC AciD. 
H 2 C 4 H 4 6 ; 150. — A crystalline acid prepared from the acid tartrate of 
potash. 

Preparation. — Vide p. 473. 

Characters. — In colorless crystals, the primary form of which is 
the oblique rhombic prism. It has a strongly acid taste, and is readily 
soluble in water and in rectified spirit. When to either solution, not 
too much diluted, a little acetate of potash is added, a white crystalline 
precipitate is formed. 

{27 grains bicarbonate of potash. 
22 " soda. 

15} " carbonate of ammonia. 

Dose. — 10 to 30 grains. 

Impurities. — Lead, copper, and iron from the vessels in which it is 
prepared ; lime, or acid tartrate of potash, from the substances used in 
its preparation ; racemic and oxalic acids. 

TESTS. — An aqueous solution of the acid is not affected by sulphu- 
retted hydrogen (absence of metals), and gives no precipitate with the 
solution of sulphate of lime (no racemic or oxalic acids) or of oxalate of 
ammonia (no lime). It leaves no residue, or only a mere trace, when 
burned with free access of air (no acid tartrate of potash). 

Action and Uses. — Used for cooling drinks. 



acids. 485 

Aciclum Citricum, U.S. P. and B.P. Citric Actd. H 3 C 6 H 5 
7 .H 2 ; 210. A crystalline acid prepared from lemon juice, or from the 
juice of the fruit of the Lime, Citrus Limetta. 

Preparation. — Vide p. 473. 

Characters. — In colorless crystals, of which the right rhombic prism 
is the primary form : very soluble in water, less soluble in rectified spirit, 
and insoluble in pure ether. The crystals dissolve in three-fourths of 
their weight of cold, and in half their weight of boiling water. The 
diluted aqueous solution has an agreeable acid taste. When the solu- 
tion is made by dissolving thirty -four grains of the acid in one ounce of 
water, it resembles lemon juice in strength and in the nature of its acid 
properties, and, like lemon juice, it undergoes decomposition and becomes 
mouldy by keeping. 

The quantity contained in j- fl. oz. of this solution ; viz : — 

f 25 grains bicarbonate of potash. 
17 grains neutralize -j 20 " " soda. 

(. 15 " carbonate of ammonia. 

Impurities. — Lead and copper from the vessels in which it is pre- 
pared, lime used in its preparation, tartaric acid, which is cheaper, and 
is apt to be mixed with or substituted for it, sulphuric acid or sulphates, 
oxalic acid. 

Tests. — The aqueous solution is not darkened by sulphuretted hydro- 
gen (absence of metals), gives no precipitate when added in excess to 
solution of acetate of potash (no tartaric acid), or of chloride of barium 
(no sulphates), and if sparingly added to cold lime-water it does not render 
it turbid (no oxalic acid). The crystals leave no ash when burned with 
free access of air (no lime). 

Dose. — 10 to 30 grains. 

Peepaeations containing free Citeic Acid. 

U.S.P. B.P. 

Syrupus Acidi Citrici. Succns Limonis. 

Syrupus Limonis. 
Vinnm Quinise. 

u.s.p. syrupus Acidi citrici. Syrup oe Citric Acid. — Citric acid 8, 
water 8, spirit of lemon 4, syrup 980. 

Action and Uses. — Citric acid, from the agreeable taste of its solu- 
tion in water, is used for drinking in fever to allay thirst, either alone or 
with alkaline bicarbonates as effervescing drinks. It is also used in 
scurvy, as it is supposed by some to be the ingredient to which lemon 
juice owes its properties. 

B.P. Oxalic Acid, Purified. H 2 C 2 4 . 2H 2 0. ; 126. 

Dissolve 1 pound of commercial oxalic acid in 30 fluid ounces of boil- 
ing distilled water, filter the solution, and set it aside to crystallize. 
Pour off the liquor, and dry the crystals by exposure to the air on filter- 
ing paper placed on porous bricks. 



486 INORGANIC MATERIA MEDICA. 

Test. — It is entirely dissipated by a heat below 350°. 

Uses. — As a test. 

Standard Solution of Oxalic Acid, U.S.P. and B.P. 63 grammes dissolve ill 

water to 1000 cc. 

Aeiclum Gallicuin. — Vide Cupuliferse, Sect, v., Chap, xxxiv. 
Acidum Tannicum. — Vide Cupulifene, Sect, v., Chap, xxxiv. 

U.S.P. Aciduni Boricum. Boric OR Boracic Acid, H 3 B0 3 ; 62. 

Preparation. — Vide p. 473. 

Characters. — Transparent, colorless, six-sided plates, slightly 
unctuous to the touch, permanent in the air, odorless, having a cooling 
bitterish taste and a feebly acid reaction ; in solution turning blue litmus 
paper red and turmeric paper brown, the tint in the latter case remain- 
ing unaltered in presence of free hydrochloric acid. The alcoholic solu- 
tion burns with a flame tinged with green. 

Impurities. — Sulphates, chlorides, lead, copper, iron, &c, calcium 
and sodium salts. 

Tests. — An aqueous solution of boric acid should not be precipitated 
by test solutions of chloride of barium, nitrate of silver with nitric acid, 
sulphide of ammonium, or oxalate of ammonium. A fragment heated on 
a clean platinum wire in a non-luminous flame should not impart to the 
latter a persistent yellow color. 

Action. — It has the power of destroying low organisms, and has 
therefore been used as an antiseptic application to wounds either in the 
form of a solution (1 part in 20 of hot water) or of an ointment. The 
antiseptic ointment originally recommended by Lister consisted of a mix- 
ture of the acid (1) with white wax (1), paraffin (2), almond oil (2). 
This is rather hard, and a better ointment consists of the powdered acid 
(3), paraffin (5) and vaseline (10). The relative proportions of these may 
be varied according to the temperature, more or less paraffin being added 
according as the temperature is high or low. The powdered acid, mixed 
with starch, forms a useful dusting powder for infants, and lessens the 
foetor of perspiration. When given internally it is said to be occasionally 
useful in cases of vomiting in somewhat the same way as sulphurous acid, 
and it has also been given along with ether in septic diseases. Boro- 
glyceride, discovered and patented by Barff, is made by heating 92 
parts of glycerine with 62 of boric acid. A solution of 1 in 40 of water 
is recommended as a powerful antiseptic. It is used to preserve food, 
and as a lotion for the treatment of wounds and in purulent ophthalmia. 1 

U.S.P. Acidum Chromicum. Chromic Acid, Cr0 3 ; 100-4. 

Characters. — Small, crimson, needle-shaped or columnar crystals, 
deliquescent, odorless, having a caustic effect upon the skin and other 
animal tissues, and an acid reaction. Very soluble in water, forming an 
orange-red solution. Brought in contact with alcohol, mutual decompo- 
sition takes place. When heated to about 190° C. (374° F.) chromic 

' Extra Pharmacopoeia, Martindale and Wcstcott. 



acids. 487 

acid melts, and at 250° C. (482° F.) it is mostly decomposed with the 
formation of dark green chromic oxide and the evolution of oxygen. On 
contact, trituration, or warming with strong alcohol, glycerine, spirit of 
nitrous ether, or other easily oxidizable substances, it is liable to cause 
sudden combustion or explosion. 

Tests. — If 1 grain of chromic acid be dissolved in 100 cc. of cold 
water and mixed with 10 cc. of hydrochloric acid, the further addition 
of 1 cc. of test solution of chloride of barium should cause not more than 
a white turbidity (limit of sulphuric acid). 

Actions. — It has a great power of coagulating albumen, and 
destroying low organisms, and as it parts very readily with oxygen it 
oxidizes organic matter and decomposes ammonia and sulphuretted 
hydrogen. It is thus a powerful deodorizer and disinfectant. It is 
chiefly used as a caustic to destroy condylomata, and morbid growths 
in the mouth, larynx, or uterus, and to phagedenic ulcers, poisoned 
wounds, &c. As a solution of 1 in 40 it has been especially recom- 
mended in syphilitic affections of the tongue, mouth and throat. As a 
lotion it has been employed to lessen foetid discharges, and as an injection 
in ozoena, leucorrhoea and gonorrhoea. Care must be taken not to pre- 
scribe it with any substance to which it readily yields oxygen, such as 
glycerine, as the mixture may explode spontaneously. 

Acidum Carbonicum. Carbonic Acid, C0 2 ; 44. Not officinal. 
It is very extensively used dissolved in water, as aerated water, effer- 
vescing soda, potash or lithia waters, or in wine as champagne. 

Properties. — Colorless gas, heavier than air, causes a pungent 
feeling in the nostrils. Soluble in its own volume of water. Its solu- 
bility is increased by the presence of carbonates, or by pressure, and 
when this is removed the gas escapes and causes the fluid to effervesce. 
The solution has an acid reaction. Carbonates of magnesia, lime, iron, 
&c, which are only sparingly soluble in water, are dissolved with com- 
parative ease by water holding the gas in solution. 

Action and Uses. — Like other acids, when applied to the skin 
it acts as an irritant, but only slightly. After a prolonged application 
it causes a slight reddening of the skin and a feeling of warmth, which 
changes on the continuance of the application into burning or prickling, 
most felt where the skin is thin and richly supplied with nerves, as the 
external genitals, and this is not unfrequently accompanied by sweat. 
Carbonic acid baths are therefore sometimes used in catarrh and rheu- 
matism as a slight rubefacient to the whole skin, and to cause sweat, 
especially where it can be obtained with ease, as in places where there 
are springs containing much C0 2 . It has been used as a stimulant to 
ulcers, either by directing a stream of gas directly upon them or by 
applying a poultice of yeast (Cataplasma Fermenti, B.P.), which, in the 
process of fermentation, causes a constant production of this gas. 

Streams of C0 2 have been applied to the eyes, ears, nose, vagina, and 
rectum in catarrhal inflammation or ulceration of these parts, in order to 
cause a slight hyperemia of the parts and healing of the inflammation 
and to diminish pain, as C0 2 is supposed to act locally by diminishing 
the sensibility of the nerves of the part. 



488 INORGANIC MATERIA MEDICA. 

In the moutli C0 2 , like other acids, acts as a stimulant to the secre- 
tion of saliva, and so water containing C0 2 quenches thirst better than 
pure water, and it is therefore often used in feverish states (p. 317). 

In the stomach it causes that slight pain which we confound with 
hunger, and a pleasant feeling of warmth just as on the skin. Here too it 
most probably causes a slight hyperemia, and increased secretion. The 
greatest part leaves the stomach as gaseous eructations, but a portion is 
absorbed and enters the blood. Its action is thus transient, and it pro- 
duces no material change in the chemical composition either of the con- 
tents or walls of the stomach. It increases the rapidity of the absorption 
of water in the intestinal canal, as is shown by the fact that water 
containing carbonic acid is excreted by the kidneys much sooner after it 
has been drunk, than water without it. It relieves irritation in the 
stomach, and allays or stops vomiting or nausea and slight derangements 
of digestion. Carbonic acid is naturally present in the intestines in 
greater quantities in the large than the small. The C0 2 is partly that 
which passes from the blood into the intestine in interchange for the 
contained in the air we swallow, and is partly formed by processes of 
fermentation which take place in the chymus. 

That part of the C0 2 which, after introduction into the stomach 
passes into the blood, is excreted by the lungs. C0 2 injected into the 
blood through a vein is likewise excreted in the same way without causing 
any injury, unless it is injected in such a quantity that some remains as 
gas undissolved in the blood, and then it causes death mechanically, just 
like air, by hindering the passage of blood through the lungs. 

Poisoning by Carbonic Acid. — When C0 2 is inhaled, the ordi- 
nary interchange between the C0 2 in the blood and the of the air is 
prevented, the C0 2 in the blood accumulates, and the processes of oxi- 
dation in tissues being interfered with, their functions are lessened or 
destroyed (p. 229). 

The nervous system is first affected, and there is headache, beating or 
singing in the ears, giddiness, flushing of the .face. Then there is a feeling 
of want of breath, tightness of the breast, palpitation of the heart and 
great anxiety. If the C0 2 be still inhaled, the pulse becomes slower, 
consciousness is lost, delirium or coma ensues, and death occurs with 
convulsions. 

In poisoning by carbonic acid three stages may be distinguished, (1) 
dyspnoea ; (2) convulsions ; (3) paralysis. 

During the first stage the carbonic acid appears to act as a stimulus 
to the nerve-centres in the medulla, and especially. to the respiratory and 
vaso-motor centres. In the second stage it stimulates other motor centres 
(p. 212). In the third it paralyzes them. In the first stage, that of 
dyspnoea, the respirations are both rapid and deep, the inspiratory as 
well as the expiratory movements being increased. Both the inhibitory 
and the accelerating centres for the heart are stimulated, but the irrita- 
tion of the vagus roots preponderates, and the heart is generally slow. 
The vaso-motor centre in the medulla is also stimulated, and the blood- 
pressure rises. Besides this the carbonic acid also stimulates either sub- 
sidiary centres in the spinal cord (pp. 251 and 252), or acts directly on 
the walls of the vessels themselves, causing them to contract (p. 247), for 



acids. 489 

the blood-pressure rises during inhalation of carbonic acid even when the 
spinal cord has been divided below the medulla. The vessels of the sur- 
face become dilated. This is ascribed by Frankel to stimulation of a 
dilating centre. During the second stage, that of convulsions, the 
respiration becomes more and more labored, and the expiratory move- 
ments greater, until general convulsions occur. The blood-pressure rises 
still more, the heart becomes still slower, and the right ventricle more 
distended. In the third stage, that of paralysis, the inspiratory move- 
ments become more and more feeble, the intervals between them longer 
and longer, and finally they cease. The vaso-motor centre becoming 
exhausted the blood-pressure falls, and this fall is probably aided by the 
action of the carbonic acid on the muscular walls of the blood-vessels 
themselves (p. 247), as well as by weakness of the heart. The heart 
generally continues to beat for some minutes after respiration has com- 
pletely ceased, and if artificial respiration be commenced before pulsation 
is entirely arrested, life may generally be saved. Indeed, this is the case 
even when the cardiac pulsations are quite imperceptible, and therefore 
in cases of death from asphyxia it is well to keep up artificial respiration 
if possible for an hour or even longer, notwithstanding the apparent hope- 
lessness of the case. It should only be discontinued when a ligature tied 
moderately tightly, causes no trace of congestion in the finger-tip after 
being on for ten minutes, and it ought to be supplemented by intermittent 
pressure on the cardiac region in order to stimulate the heart. These 
observations apply not only to poisoning by carbonic acid, but to poison- 
ing by all drugs which produce death by asphyxia. 

Post-mortem examination shows great venous congestion everywhere, 
the right side of the heart being distended with blood, the brain much 
congested, with exudation and even extravasation, and the blood extra- 
ordinarily dark. 

Treatment. — In the case of poisoning by C0 2 , as in miners or men 
who have been suffocated in wells or brewers' vats, the great object is to 
get the blood oxygenated as quickly as possible. Get the person into the 
fresh air, and if the respiratory movements have ceased, dash cold water 
on the face and chest to awaken them reflexly. If this does not do, have 
recourse to artificial respiration. The next thing is to see that the heart 
is beating. When the right ventricle is distended with blood it becomes 
paralyzed, and if it does not begin to beat shortly after artificial respira- 
tion has been begun, the jugular vein should be opened in order to relieve 
the dilatation. There are no valves between the heart and the jugular 
vein (at least of any importance), so the blood flows directly out and the 
distended ventricle is relieved. One must of course be careful to prevent 
the access of air into the vein. 

Acicluni Hydrocyanicnm Dilntum, U.S. P. and B.P. — 
Diluted Hydrocyanic Acid. Prussic Acid. — A liquid consisting of 
2 per cent, of absolute hydrocyanic acid (HON; 27) and 98 per cent, of 
water, U.S. P. Hydrocyanic acid, HON, dissolved in water, and con- 
stituting 2 per cent, by weight of the solution, B.P. 

Preparation. — By distilling yellow prussiate of potash with H 2 S0 4 . 

Potassium Ferrocyanide. Everett's yellow salt. 

2K 4 FeCy 6 + 6H 2 S0 4 = 6HCy + K 2 Fe 2 Cy 6 + 6KHS0 4 . 






490 INORGANIC MATERIA MEDICA. 

Half the cyanogen of the ferrocyanide passes over as hydrocyanic 
acid, while a ferrocyanide of potassium and iron, often called Everett's 
yellow salt, remains behind along with potassium sulphate. 

Characters and Tests. — A colorless liquid, with a peculiar odor. 
Specific gravity, 0-997. It only slightly and transiently reddens litmus 
paper. Treated with a minute quantity of a mixed solution of sulphate 
and persulphate of iron, afterwards with potash, and finally acidulated 
with hydrochloric acid, it forms Prussian blue. 

Impurities. — The most important is want of strength, so that when 
prescribed it has not the desired effect. It loses strength when kept, and 
therefore the volumetric test is more important than in the case of other 
acids. 

Tests. — A fluid drachm of it evaporated in a platinum dish leaves 
no fixed residue (no fixed impurities). It gives no precipitate with chlo- 
ride of barium (no sulphuric acid), but with nitrate of silver it gives a 
white precipitate entirely soluble in boiling concentrated nitric acid (no 
hydrochloric acid). 270 grains of it rendered alkaline by the addition of 
solution of soda, require 1000 grain-measures of the volumetric solution 
of nitrate of silver to be added before a permanent precipitate begins to 
form, which corresponds to 2 per cent, of the real acid. Silver nitrate 
forms a soluble double cyanide of silver and sodium, and till all the hydro- 
cyanic acid is used up no silver oxide is precipitated. AgN0 3 +2NaCy 
= NaNO s + NaAgCy 2 . 

Standard silver test solution contains fa of an equivalent of AgN0 3 
and 1000 grains therefore combine with fa of 2 Na Cy. 

Dose. — 2 to 8 minims. As a lotion, 5-10 min. to 1 fl. oz. of water, 
rose water, elderflower water, or almond mixture. The addition of 1 fl. 
dr. of glycerine tends to prevent evaporation. 

Preparations, b.p. 
Vapor Acidi Hydrocyanici. 

B.P. Vapor Acidi Hydrocyanici. VAPOR OF HYDROCYANIC ACID. — Mix 10 to 15 
minims of diluted hydrocyanic acid with 1 fluid drachm of cold water in a suitable 
apparatus, and let the vapor that arises be inhaled. 

Actiox. — Hydrocyanic acid differs from all the other acids in having 
upon the organism an action peculiarly its own. It is one of the most 
powerful and most rapid poisons known. It destroys protoplasmic 
movement, kills infusoria, checks oxidation and arrests fermentation. 
When applied to the skin it passes through the epidermis and paralyzes 
the ends of the sensory nerves below, so that the part becomes numb, 
and tactile sensation is diminished or destroyed. It is rapidly absorbed 
from the mucous membranes, and its action is the same when applied to 
any of them. A single drop of pure hydrocyanic acid injected into the 
eye, nose, or mouth of a small animal, causes it to fall down dead as if 
struck by lightning, and the same dose is sufficient to cause the death 
oven of a large animal. In these cases the pupils are usually widely 
dilated, and the animal generally utters a characteristic cry. When a 
smaller but still fatal dose is given, the poisoning may be divided into 
three stages. In the first stage the brain is chiefly affected. There is 



ACIDS. 491 

giddiness, uncertain gait, a few slow breaths, and then rapid respiration, 
and irregular action of the heart. These are succeeded in the second 
stage by violent convulsions, tonic and clonic. The head is bent back- 
wards, the limbs are stiffly extended, and sensibility is generally lost, 
although reflex action may still persist. In the third stage there is 
coma, complete loss of sensibility, paralysis of the voluntary muscles, 
almost imperceptible pulse, slow and weak respiration — the expiratory 
movements predominating, and death. 

It is evident that these are the symptoms of rapid asphyxia. They 
are very like those produced by carbonic acid, but much more rapid, and 
resemble those of poisoning by sulphuretted hydrogen. The convulsions 
occur only in warm-blooded animals, and not in frogs. In this point 
they resemble those of simple asphyxia (p. 212). They differ from 
those of ordinary asphyxia, however, in the fact that whereas the blood 
is venous when asphyxial convulsions occur, the blood is arterial in color 
when the hydrocyanic acid convulsions occur. They differ also in not 
being arrested by artificial respiration. 

Death, in animals poisoned by hydrocyanic acid, is due to sudden 
arrest of the heart in the more rapid cases, and to paralysis of the res- 
piration in those which occur more slowly. In consequence of this, the 
blood in the left side of the heart is found to be arterial in cases of 
instantaneous death, but venous in those instances where some minutes 
have been required. It is stated that in the first stage of poisoning the 
blood is more arterial than usual, though it afterwards becomes more 
venous. This has been said to depend upon diminution of the oxidizing 
power of the "blood by the action of the acid. Hydrocyanic acid is said 
to form a compound with haemoglobin (cyan-haemoglobin) which does 
not readily give up its oxygen (p. 80). But this compound is often not 
to be found in the blood of animals poisoned by the acid, and the arterial 
appearance is more probably due to dilatation of the peripheral vessels 
allowing the blood to pass through them rapidly, without undergoing the 
usual changes, just as it does in the sub-maxillary gland on irritation of 
the chorda tympani nerve. This is rendered all the more probable by 
the fact, that at the exact moment in which the blood becomes of an 
arterial color in the veins, the blood-pressure suddenly falls in the arte- 
ries (Rossbach). 

The respiratory cliang-es, however, do seem to be also interfered 
with, for in the first stage of poisoning the exhalation of carbonic acid is 
diminished. As the diminution in the power of the blood to give 
oxygen off is hardly sufficient to explain this, and as the convulsions, 
apparently asphyxial in character, come on while the blood is still arte- 
rial, we may, with some probability, suppose that the respiratory changes 
are due to the effect of the hydrocyanic acid in lessening internal respira- 
tion in the nervous tissues themselves (p. 214). 

The stoppage of the heart in mammals is partly due to irritation of 
the vagus roots in the medulla, and partly to paralysis of the motor gan- 
glia in the heart. 

When placed upon the heart of a frog, it arrests its beats, but the 
heart, at first, still contracts when irritated, although after a short time 
its muscular irritability is also lost. 



492 INORGANIC MATERIA MEDICA. 

That its action in stopping the mammalian heart is partly due to 
irritation of the vagus roots is shown by the fact that, in some animals, 
section of the vagi prevents the stoppage. The effect of hydrocyanic 
acid is, first to raise, and afterwards greatly to depress the arterial 
pressure, and at the same time to slow the pulse. The slowing and 
paralysis of respiratory movements which this acid produces are chiefly 
due to its action on the respiratory centre in the medulla oblongata. 
When directly applied to the medulla in the alligator it causes continu- 
ous powerful expiration and death, whereas when given in other ways 
considerable time is required for its action to be produced. It appears 
to paralyze the brain, peripheral afferent nerves, then spinal cord, 
motor nerves and muscles. That the afferent nerves are paralyzed 
before the cord is proved by the fact that when frogs are poisoned with 
prussic acid, and afterwards with strychnine, slight irritation of the sen- 
sory nerve roots will cause tetanus, after irritation of the periphery has 
ceased to produce any effect. 

This fact was observed by von Kiedrowski, working under Reichert's 
direction. The same author observed the effect of the local application 
of hydrocyanic acid in paralyzing muscle and nerve, by removing the 
soft parts and bone from the lower part of the thigh of a frog, leaving 
the leg attached to the body only by nerves. The gastrocnemius and 
crural muscles were then separated, and the gastrocnemius with its nerve 
was immersed in aqueous humor diluted with water, and the crural 
muscles with their nerves in a similar liquid to which hydrocyanic acid 
had been added. After four hours the crural muscles did not contract 




Fig. 129. — After Kiedrowski. Diagram to show the effect of hydrocyanic acid when applied locally, 
a, the sciatic nerve; 6, thigh of a frog; d and e, branches of sciatic going to the crural muscles; 
/ g, branch going to the gastrocnemius. 

on direct irritation, but the gastrocnemius did so readily. This showed 
that the acid had paralyzed the muscles. Irritation of the gastrocne- 
mius, of its nerve f g y or of the sciatic nerve a b, caused reflex move- 
ments in the body of the frog, but irritation of the crural muscles caused 
no such reflex movements, showing that the ends of the sensory nerves 
within them had been paralyzed. When the sciatic a b was irritated 
the crural muscles did not contract, but the gastrocnemius did. This 
poison probably paralyzes motor nerves as well as muscles, for it is 
found that the muscles contract, though feebly, on direct irritation, 



acids. 493 

after they have ceased to respond to the strongest irritation of the motor 
nerves. 

Uses. — Hydrocyanic acid is used externally in order to lessen itch- 
ing in skin diseases, and is best applied in combination with glycerine. 
It is chiefly employed internally to diminish irritability of the stomach, 
and to relieve vomiting, also pain in the stomach or intestines, and 
functional palpitation of the heart dependent on dyspepsia. It is also 
used to relieve cough in cases of bronchitis, phthisis, asthma and whoop- 
ing cough. It has sometimes been employed, though with doubtful 
effect, in chorea, epilepsy and hysteria. Its vapor is sometimes used to 
lessen irritability of the respiratory passages and cough. 

Aciduni Arseniosum. — Vide Sect, iii., Chap, xxvii. 

Aciclum Benzoicum. — Vide Styracacse, Sect, v., Chap, xxxiii. 

Aciduni Chrysophaiiicum. — Vide Leguminosae; Papilionacese, 
Sect, v., Chap, xxxii. 

U.S. P. Acidum Lacticum. Lactic Acid. HC 3 H 5 3 ; 90. 
A liquor composed of 75 per cent, of absolute lactic acid and 25 per 
cent, of water. 

Preparation. — By adding chalk to sour milk and decomposing the 
lactate of lime with sulphuric acid. 

Characters. — A nearly colorless syrupy liquid, odorless, having a 
very acid taste, and an acid reaction. Sp. gr., 1*212. It is freely 
miscible with water, alcohol and ether, but nearly insoluble in chloro- 
form. It is not vaporized by a heat below 160° C. (320° F.) ; at higher 
temperatures it emits inflammable vapors, then chars, and is finally 
entirely volatilized, or leaves but a trace of residue. 

Impurities. — Hydrochloric acid, sulphuric acid, sarcolactic acid, 
lead, iron, sugars, glycerin, organic impurities. 

Tests. — When diluted with water, lactic acid should afford no pre- 
cipitate with test solutions of nitrate of silver, chloride of barium, sul- 
phate of copper, nor with sulphide of ammonium after addition of excess 
of water of ammonia. It should not reduce warm test solution of 
potassio-cupric tartrate. When mixed and heated with excess of 
hydrated zinc oxide and extracted with absolute alcohol, the latter 
should not leave a sweet residue on evaporation. Cold concentrated 
sulphuric acid shaken with an equal volume of lactic acid should assume 
at most only a pale yellow color. 

Dose. — 1 to 3 fl. dr. per diem, diluted or sweetened, like lemonade. 

Action. — It has been employed in solution of 1 part to 5, to dissolve 
the false membrane in croup and diphtheria. In cases of dyspepsia it 
is used to aid digestion in somewhat the same way as hydrochloric acid, 
and it has been given also to lessen the alkalinity of the urine and pre- 
vent phosphatic deposits. In diabetes it has been employed with con- 
siderable success along with an exclusively meat diet in doses of J oz. 
in 1 pint of water daily. Buttermilk has been recommended in place 
of it, but the difficulty of obtaining this in towns is very great. 

U.S. P. Aciduni Hydrobroinicum Dilutum. Diluted Hydro- 
bromic Acid. — A liquid composed of 10 per cent, of absolute hydro- 
bromic acid (HBr; 80*8) and 90 per cent, of water. 



494 INORGANIC MATERIA MEDICA. 

Characters. — A clear, colorless liquid, odorless, having a strongly 
acid taste and an acid reaction. Sp. gr., 1*077. By heat it is completely 
volatilized. On adding chlorine or nitric acid to diluted hydrobroniic 
acid, bromine is liberated, which is soluble in chloroform or in disulphide 
of carbon, imparting to these liquids a yellow color. Test solution of 
nitrate of silver causes a white precipitate, insoluble in nitric acid and in 
water of ammonia, and sparingly soluble in stronger water of ammonia. 

On being kept for some time, the acid should not become colored ; 
test solution of chloride of barium should not produce a turbidity or pre- 
cipitate (sulphuric acid). 

Dose. — Two fluid drachms, which are equal to about 18 grains of 
bromide of potassium. It may be given in syrup. 

Action and Uses. — It appears to act as a sedative to the nervous 
system, diminishing reflex action and lessening tendency to spasm, in the 
same way as bromide of potassium, but differing from it in not producing 
the feeling of depression frequently caused by potassium bromide. 

It has been employed in epilepsy, and to relieve nervousness. 

It is useful in headache and singing in the ears, either idiopathic or 
due to the administration of quinine or of iron. It is used also to remove 
the bad effects of excess in tea or alcohol, and to quiet palpitation. 

U.S. P. Acidum Oleicum. Oleic Acid.— HC 1S H 33 2 ; 282. 

Preparation. — It is obtained from almond oil by adding lead oxide, 
which forms an oleate of lead, and decomposing this by hydrochloric 
acid. Or by decomposing palm oil by superheated steam. 

Characters. — A yellowish, oily liquid, gradually becoming brown, 
rancid and acid, when exposed to the air ; odorless, or nearly so ; taste- 
less, and, when pure, of a neutral reaction. Sp. gr., 0-800 to 0*810. 
Oleic acid is insoluble in water, but completely soluble in alcohol, chlo- 
roform, benzol, benzin, oil of turpentine, and the fixed oils. At 14° C. 
(57 -2° F.) it becomes semi-solid, and remains so until cooled to 4° C. 
(39-2° F.), at which temperature it becomes a whitish mass of crystals. 
At a gentle heat the acid is completely saponified by carbonate of 
potassium. If the resulting soap be dissolved in water and exactly neu- 
tralized with acetic acid, the liquid will form a white precipitate with 
test solution of acetate of lead. This precipitate, after being twice 
washed with boiling water, should be almost entirely soluble in ether 
(abs. of more than traces of palmitic and stearic acids). Equal volumes 
of the acid and of alcohol, heated to 25° C. (77° F.), should give a clear 
solution, without separating oily drops upon the surface (fixed oils). 

Uses. — Oleic acid is employed only for the preparation of oleates, 
which are not only elegant preparations, but appear to be more readily 
absorbed than other ointments. 

Q.8.P. Preparations. dose. 

Oleatum Hydrargyri. OLEATE OF MERCURY (Hy- 1 

drargyri Oxiduui Flavum, 1 part ; Acidum Olei- > 10 min., externally. 

cum, 9 parts) J 

Oleatum Veratrinee. (Veratrinum, 2 parts; Acidum \ „ or - «-**im«liir 
Oleicum, 98 parts). >b-~{>gi., exteinauj. 

Acidum Carbolicum. — Vide Sect, iv., Chap. xxx. 
Acidum Salicylicum. — Vide Sect, iv., Chap. xxx. 



METALS. 495 

CHAPTER XXIV. 

METALS. 

GENERAL CLASSIFICATION OF THE METALS. 

It has already been mentioned (p. 47) that Mendelejeff's classification 
of the elements, although it gives us the outlines of a true natural classi- 
fication, is not at present perfect, inasmuch as it separates members of 
natural groups, such as those of the earthy metals. In regard to this 
classification it must be borne in mind that by it the elements are arranged 
in groups according to their atomicity, and this is not in all cases deter- 
mined. A glance at the table (p. 45) will show this, for copper, silver, 
and gold are there included both in Group I., containing monad metals, 
and in Group VIII. But the commonest and most stable compounds of 
copper, such as cupric oxide or cupric sulphide, appear to show that it is 
a dyad rather than a monad. Silver, also, though it appears like copper 
in Groups I. and VIII., may also be a dyad, 1 while gold forms two series 
of compounds, in one of which it is monad and in the other triad. In the 
classification which I have adopted I have followed Mendelejeff's tables, 
as modified by Watts, but I have modified them somewhat in order not 
to separate metals having a similar physiological action. 

Class I.— MONAD METALS. 2 

Group I. — Alkalis — Potassium, Sodium, Lithium, Catsium, Rubidium. 
II. — Ammonium. 

Class II.— DYAD METALS. 

Group I. — Metals of the alkaline earths — Calcium, Strontium, 
Barium. 
(Appendix.) Metals of the earths — Aluminium, Cerium, 
Beryllium, Zirconium, Thorium, Lanthanum, Didy- 
mium, Yttrum, Erbium. 
II. — Magnesium. 
III. — Copper, Zinc, Silver, Cadmium. 
IV. — Mercury. 

Class III.— TRIAD METALS. 
Thallium,, Iridium, G allium. 

Class IV.— TETRAD METALS. 
Tin, Lead, Titanium. 



1 The formula of argentons oxide is Ag^O, and if this formula be correct, and silver 
be a monad, oxygen must be a tetrad; but if silver be a dyad, argentous oxide maybe 

represented as \ fr ?Q_f„ (Fownes' Chemistry, by Watts, 12th ed., p. 324.) 

2 The metals whose names are printed in italics are not officinal. 



496 



INORGANIC MATERIA MEDICA. 

Class V.— PENTAD ELEMENTS. 



Nitrogen, Phosphorus, Arsenic, Antimony, Bismuth, Vanadium, 
Tantalum, Niobium or Columbium. 



Class VL— HEXAD METALS. 

Chromium, Uranium, Tungsten, Molybdenum. 



Class VIL— HEPTAD METALS. 

Manganese, vide next group. 

Class YIII. 

Group I. — Iron metals — Iron, Nickel, Cobalt, Manganese. 
II. — Platinum, Gold. 



General Tests for the Acid Radicals in Metallic Salts. — 
As the same acids occur in the salts of different metals, the tests for 
their presence are described again and again in the Pharmacopoeias. In 
order to save repetition, it may be advisable to give here in a tabular 
form the tests for the different acids. It is to be remembered that the 
same tests apply to the simple recognition of a metallic salt and to its 
detection as an impurity in other substances. The tests are generally 
applied to solutions of the salt in water. 



Salt. 


Reagent. 


Reaction. 


Acetate* 


Sulphuric acid. 


Vapor of acetic acid given off and recog- 
nized by its smell. 


a 


Ferric chloride. 


Deep red color. 


Borate. 


Sulphuric acid. 


The saturated solution causes deposit of 
shining scales, which give a green color 
to the flame of alcohol. 


Benzoate* 
Bromide. 


Dilute solution of 
ferrous sulphate. 

Disulphide of car- 
bon and chlorine 
water. 


Flesh-colored precipitate. 

If disulphide of carbon be poured into a 
solution of the salt, the chlorine water 
added drop by drop, and the whole 
agitated, the disulphide will acquire a 
yellow or yellowish-brown color. (If 
iodine be present there will be a violet 
tint, ) 


Carbonate. 


Acid. 


Causes effervescence. 


Bicarbonate. 




Causes effervescence more abundant than 
in the case of the carbonate. With solu- 
tion of mercuric chloride bicarbonates 
give a white, and carbonates a yellow, 
precipitate. 



METALS. 



497 



Salt. 



Citrate.* 



Chloride. 
Hypophosphite. 



Hyposulphite. 



Iodide. 



Nitrate. 



Oxalate* 



Phosphate. 

Phosphide. 

Salicylate* 
32 



Eeagent. 



Calcium chloride. 

Sulphuric acid and 
heat. 

Nitrate of silver. 
Heat. 

Nitrate of silver. 



Hydrochloric acid 
and mercuric chlo- 
ride. 

Sulphuric acid. 



Disulphide of car- 
bon and chlorine 
water. 



Starch water, starch 
paste, or gelati- 
nized starch, with 
chlorine water. 

Sulphuric acid and 
copper. 

Sulphuric acid and 
solution of ferrous 
sulphate. 



Calcium chloride. 



Chloride of ammon- 
ium, ammonia and 
sulphate of mag- 
nesia. 

Sulphuric or hydro- 
chloric acid. 

Ferric salts. 



Reaction. 



The solution remains clear, but deposits 
white precipitate on boiling (calcium 
citrate being less soluble in hot than in 
cold water). 

Is charred and evolves the odor of acetic 
acid. 

White precipitate, soluble in ammonia, 
insoluble in hydrochloric or nitric acid. 

Heated in a dry test-tube it evolves phos- 
phoretted hydrogen, which takes fire 
spontaneously, and burns with a bright 
flame. 



White precipitate, 
brown and black. 



which rapidly turns 



White precipitate of calomel, and on fur- 
ther addition separation of metallic mer- 



Gives rise to the smell of burning sulphur, 
and causes white precipitate of sulphur 
(bisulphite and sulphite give no precipi- 
tate). 

If disulphide of carbon be poured into a 
solution of the salt, then chlorine water 
added drop by drop, and the whole 
agitated, the disulphide of carbon will 
acquire a violet color. 

Blue color in the cold, discharged by 
boiling. 



Nitrous fumes. 



When sulphuric acid is added to a solu- 
tion containing a nitrate, and a solution 
of ferrous sulphate is carefully poured 
over it, a dark color appears at the junc- 
tion of the two liquids. 

White precipitate. In applying the test 
to cerium and iron, their salts must be 
decomposed by boiling with potash or 
soda. The oxide of cerium or iron is 
removed by filtration, and the reagent 
applied to the filtrate, which contains 
oxalate of potash or soda. 

White precipitate. 



Evolves phosphoretted hydrogen. 
Intense violet color. 



498 



INORGANIC MATERIA MEDICA. 



Salt. 


Reagent. 


Reaction. 


Sulpho-carbolate. 


Ferric chloride. 


Violet color. This salt can be distin- 
guished from the salicylate by heat, when 
it gives off inflammable vapors having 
the odor of carbolic acid. 


Sulphate. 


Barium chloride. 


White precipitate, almost insoluble in 
nitric acid. 


Sulphide. 


Mineral acids, e. g., 
sulphuric or hydro- 
chloric. 


Gives off sulphuretted hydrogen. 


Sulphite. 


Ditto. 


Gives off sulphurous acid (has neutral or 
feebly alkaline reaction). 


Bisulphite. 


Ditto. 


Ditto (has acid reaction). 


Tartrate* 


Acetic acid in pres- 
ence of potash. 


White crystalline precipitate of bitartrate. 


« 


Sulphuric acid and 
heat. 


Is charred and evolves the odor of burnt 
sugar. 


u 


Xitrate of silver. 


White precipitate, becoming black on boil- 
ing. 


Bitartrate.* 


Nitrate of silver. 


Solution rendered neutral by potash, gives 
with the reagent a white precipitate, 
becoming black on boiling (very spar- 
ingly soluble in water : is thus distin- 
guished from neutral tartrate, which is 
readily soluble). 


u 


Sulphuric acid and 
heat. 


Same reaction as tartrate. 



* In the preceding table the salts of organic acids marked * when ignited in a 
crucible, or on a piece of platinum foil, become charred and oxidized, leaving a 
residue which consists of carbonate. This is black from the presence of carbon, if 
ignition has not been carried sufficiently far to convert all the carbon into carbonic 
acid. This residue gives the reaction of a carbonate, effervescing with acids, and it 
is frequently convenient to convert the carbonate into chloride, before applying tests 
for the base. 

Class I. — MONAD METALS. 



Group I.— METALS OF THE ALKALIS. 

Lithium, Sodium, Potassium, Rubidium, Ccesium. 
Group II.— AMMONIUM. 

I have omitted silver and gold from this class, because both their 
physiological actions and physical properties appear to show that they do 
not belong to it. I have put ammonia into a group by itself and separated 
it from the other members of this class, because it differs from them in 
being a compound and not an element ; in being volatile ; and in having 
an entirely different physiological action. 

General Characters. — They are all powerful bases and have a 
great affinity for oxygen. The oxides of the first group are non-volatile 



METALS. 499 

and are sometimes termed fixed alkalis, while ammonia is volatile. They 
all have a strong alkaline reaction, neutralizing acids readily, turning red 
litmus paper blue and turmeric paper brown. 

General Reactions. — They are not precipitated from solutions by 
the successive addition of (1) hydrochloric acid, (2) hydrogen sulphide, 
(3) ammonium sulphide, (4) ammonium carbonate, and (5) sodium 
phosphate. 

General Physiological Action. — The alkalis are of great physio- 
logical importance, and salts of potash and soda form a large proportion 
of the saline constituents of the body. These two bases are differently 
distributed, potash being chiefly found in solid tissues, while soda is more 
abundant in the fluids. They are found as carbonates, bicarbonates, 
chlorides, phosphates, and sulphates. The proportion of these salts in 
the body is, however, very different, as are also their uses in the economy. 
The chlorides are by far the most abundant, and sodium chloride may be 
looked upon as the most important constituent of the nutritive fluids in 
which all the tissues of the body are bathed. But while sodium chloride 
forms the saline basis of these fluids, the other constituents are indispen- 
sable for the continued life of the tissues. All the fluids of the body are 
alkaline, and death occurs whenever the alkalinity is diminished below a 
certain point, even though the fluids and tissues are far from having an 
acid reaction. Such a reaction is only observed in the tissues after death. 
The importance of the different saline constituents in nutrition has been 
most fully worked out in the case of the frog's heart (p. 270). 

In the case of the heavy metals, which are not normal constituents 
of the body, the action of their salts depends almost entirely on the "base 
and only slightly on the acid with which it is combined. In the case of 
the alkalis, however, this is not so, the action of their salts depending 
much on the acid. 

In consequence of this it is necessary in considering the physiologi- 
cal action of salts of the alkaline metals to divide them into at least 
three groups : — 

1. Alkaline salts, hydrates, carbonates and bicarbonates. 

(Sub-groups — Salts of organic acids, acetates, citrates, 
tartrates.) 

2. Chlorides. 

3. Sulphates and other salts which are slowly absorbed. 

General Action of the Alkaline Group.— Alkaline salts have 
their activity diminished by combination with carbonic or organic acids. 
The hydrates have an intense local action on the tissues; and the 
carbonates have an action, the same in kind, but much less in degree. 
In the case of the bicarbonates it is still further diminished, and in the 
acetates, citrates, and tartrates it is absent. The hydrates of potash 
and soda dissolve horny tissues such as the epidermis. They combine 
with albumin and form a soluble alkali-albuminate. 

When applied to the skin the hydrated alkalis, which have a great 
affinity for water, withdraw it from the tissues and form a solution which 
softens and partly dissolves the epidermis and then acts on the softer 



500 IXOKGA1STC materia medica. 

textures below, combining with and dissolving them. Round the part 
thus killed, inflammation sets in, and a slough separates. The rapidity 
with w T hich they absorb water and form a solution which flows readily 
over adjacent parts, where its action is injurious, is an objection to their 
application, and the part actually cauterized by them should always be 
less than the part we wish to destroy. From this very property of 
widely destroying the tissues over which they flow, or through which 
they soak, they are admirably adapted for application in cases where we 
desire this effect, as in cauterizing poisoned wounds. 

When applied as caustics to unhealthy sores, cancer, &c, their 
action is sometimes limited by adding lime and forming the so-called 
Vienna paste. The water which they withdraw from the tissues is 
sucked up by the lime, forming a solid hydrate and preventing the caustic 
from becoming too fluid and running over other parts. When less con- 
centrated they may only irritate the surface sufficiently to produce 
exudation, but they generally soften or dissolve the epidermis so much 
that vesicles do not form well. When still more diluted they may cause 
only congestion or redness of the skin. They are then said to act as 
rubefacients. This rubefacient action may be used for the purpose 
of relieving troublesome itching in skin diseases, or to produce deriva- 
tion from other parts. 

Ammonia does not dissolve the epidermis, and so, unlike potash or 
soda, it does not act as an immediate caustic, but only passes through 
the epidermis and irritates the skin below, causing lymph to be effused 
between it and the epidermis, and thus acting as a vesicant. It may, 
however, act as a caustic if its evaporation is prevented and it is applied 
too long, the irritation then becoming so great as to lead to suppuration 
or even to sloughing of the part. 

From their great solvent power, and especially their power of dis- 
solving greasy substances, alkalis are used for cleansing* the skin, but 
when used alone they very frequently produce irritation, and we there- 
fore generally employ them in the form of soap, or in the form of those 
salts which have only a very slight alkaline character, such as borax. 

In the mouth they neutralize any acid present. They may thus 
relieve toothache due to irritation of the exposed nerve in a carious tooth 
or of the roots of the teeth close to the gums by acid secretions. A dilute 
solution of sodium bi-carbonate as a wash to the mouth frequently relieves 
soreness of the teeth, or headache depending on dental irritation and 
prevents injury from acid tonics. Alkalis are used in the shape of borax 
to heal aphthae in the mouth and as soap for cleaning the teeth. 

In the stomach they increase the amount of gastric juice secreted; 
and where this is deficient and the food lies heavy and is digested slowly 
and with difficulty, they should be given before a meal or just at its 
commencement, either in the form of a medicinal mixture or as aerated 
potash or soda water. The amount of acid secreted by the stomach after 
their introduction is sufficient to neutralize them pretty rapidly, and 
probably only the caustic alkalies which act very rapidly have time to 
produce any local action before they are neutralized, unless large quan- 
tities have been ingested. Where there is a large amount of mucus on 
the surface of the stomach it will both hinder the exit of the gastric 



METALS. 501 

juice from the follicles and the entrance of the peptones from the stomach 
into the blood. Caustic alkalies have a great power of dissolving mucus. 
They probably do this to some extent before they are neutralized, and 
this may be the reason why we occasionally find that they are of great 
service when a corresponding amount of their carbonates does little or 
no good. From the effect they produce on the secretion of gastric juice, 
alkalis in small doses are said to act as gastric stimulants (p. 320). 

When the amount of acid in the stomach is too great, either because 
too great a proportion of it has been present in the gastric juice, or 
because it has been generated by the decomposition of food, digestion 
goes on slowly, and acid, burning eructations take place after meals. In 
such cases we give alkalies to neutralize the excess and to restore the 
proportion of acid in the stomach to its normal. They are then said to 
act as antacids (p. 322). 

Alkalies are serviceable as antidotes in poisoning by acids, metals 
and alkaloids. They neutralize the acids, they precipitate the metals 
as insoluble oxides, and they render alkaloids less soluble by taking 
away the acid with which they are generally combined. They thus 
retard their absorption and afford time for the use of other means. 

The chyme from the stomach is normally acid, and will therefore act 
as a stimulus to the expulsion of bile from the gall bladder. It is partly 
neutralized by the bile and pancreatic juice, but generally remains acid 
throughout the small intestines and will act as a stimulus to the secretion 
of intestinal juice. If it be neutralized by alkalies in the stomach, this 
stimulus will be removed and digestion consequently impaired. Many 
substances will thus pass through the intestinal canal undigested, which 
amounts to the same thing as if less food had been taken. 

Through this derangement of the digestion the blood will become 
poorer in solids, the person will become emaciated, the fat will naturally be 
first absorbed, and, along with this, perhaps pathological formations may 
also disappear. 

The excessive use of alkalis or their carbonates is thus injurious and 
their employment to reduce obesity may, unless carefully watched, be 
followed by serious consequences like the use of acids for a similar pur- 
pose (p. 476). 

Caustic alkalies injected directly into the blood cause death in a few 
minutes, probably from formation of alkaline albuminate in the blood 
and its consequent coagulation. Shortly after death the blood is found 
coagulated. Smaller amounts taken in from the stomach will to some 
extent increase the alkalinity of the blood, but are rapidly separated by 
the kidneys. They cause thirst, and probably the larger amount of 
water drunk in consequence is one cause of the diuresis they produce. 
From their power of dissolving fibrin outside the body, they have been 
given in acute rheumatism to prevent fibrinous deposits on the heart. It 
is not certain that the amount we can introduce into the blood without 
injury to the patient has this effect. 

After small doses of liquor potassii the urea and sulphuric acid in 
the urine are increased, and Parkes therefore thinks that the tissue 
change of the albuminous substances is increased. Alkalis are therefore 
classed as alteratives (p. 358). 



502 INORGANIC MATERIA MEDICA. 

They are used both to increase the amount of water passed and to 
to diminish its acidity if this be excessive. They are therefore classed 
amongst diuretics (p. 373), and remote antacids (p. 322). 

General Action of the Group of Chlorides. — Chloride of 
sodium is not only one of the most abundant saline constituents of the 
animal body, but it is one of the most important solvents of albuminous 
substances. Water will dissolve albumins proper, but globulins are in- 
soluble in it, and are precipitated by it from solutions. Dilute solutions 
of chloride of sodium on the contrary dissolve both albumins and globu- 
lins. From this action of water on albuminous substances it is very 
irritating when applied to a cut surface, or to the delicate mucous mem- 
brane of the nose, while muscles dipped in it swell up, and pass into a 
state of rigor. Weak solutions of chloride of sodium, on the other hand, 
have no irritating action, and may be applied to cut surfaces or mucous 
membranes without causing pain, and to muscle and nerve without pro- 
ducing any injurious effect. A solution of the strength of 0*65 per cent, 
is the one usually employed in physiological experiments as a basis for 
the nutritive fluid in artificial circulation through the frog's heart or 
vessels, and as a solvent for alkaloids which are to be injected into the 
lymph sac of the frog, in order to avoid the local irritation which the 
injection of a watery solution would produce. A solution of this strength 
is often called "normal salt solution " in physiological treatises. 

While dilute solutions of chloride of sodium are ready solvents of 
albuminous substances and are non-irritating, sodium chloride, in sub- 
stance or in concentrated solutions, precipitates globulins, withdraws water 
from the tissues, and acts as an exceedingly powerful irritant to cut sur- 
faces, mucous membranes, muscle, and nerve. Common salt taken in a 
large quantity at once will irritate the stomach and cause vomiting. It 
is absorbed with great rapidity, but is also excreted so rapidly that it 
produces no definite symptoms of irritation in any part of the body, ex- 
cepting that part of the nervous system by which the sensation of 
thirst is perceived. This sensation becomes so urgent when much salt 
has been taken that any risk will be encountered in order to gratify it. 
Should it be impossible to obtain fresh water, other parts of the nervous 
system become involved, and travellers whose supply of water has failed 
in the desert, or shipwrecked sailors who have drunk sea-water, have 
become delirious. It is difficult to say, however, how far the delirium is 
due to the direct irritant action of sodium chloride on the brain, as many 
other factors may concur in its production. Under ordinary circum- 
stances, the thirst occasioned by sodium chloride, after its absorption, 
causes as much water to be drunk as will allow the salt to be excreted by 
the kidneys, leaving the proportion both of salt and water in the body 
nearly the same as before. During its stay in the body the salt does not 
appear to alter the composition of the tissues, and the chief alterations 
produced by it are probably due to its action on the solubility of albumi- 
nous substances and on the processes of osmosis between the intercellular 
fluid and blood, and the circulation of lymph in the tissues. In conse- 
quence of this, sodium chloride increases tissue change as is shown by an 
increase in the amount of urea excreted. A similar increase, however, 
occurs when the quantity usually taken is diminished, the amount of 



METALS. 503 

water daily consumed remaining the same. The alteration here is probably 
also due to increased rapidity of the circulation of fluid through the tissues 
(Voit), but it may also be due in part to the different solubilities of albu- 
minous substances in solutions of sodium chloride of different strengths. 
Certain albuminous tissues may thus be affected by one proportion of salt 
in the blood, others by another, so that increase and diminution of the 
normal proportion of sodium chloride may increase tissue change in the 
body as a whole, though not in the same tissues. The proportion of 
chloride of sodium in the body is not always the same. It depends on the 
quantity taken daily, and may be increased or diminished within certain 
limits. If a definite quantity be taken daily for some time, the same quan- 
tity will be found in the urine, so that the amount present in the body is 
constant. If the quantity consumed be now increased, no increase takes 
place in the excretion for about three days, a storage of salt taking place 
in the body. After about three days the quantity excreted daily in the 
urine will again be found equal to the quantity daily taken, the amount 
present in the body remaining constantly at the higher level. If the quan- 
tity daily taken be now diminished, no diminution takes place in the 
quantity excreted for about three days, and then the quantities daily taken 
and excreted again correspond. The amount stored up at first is now 
gone, and the proportion of salt in the body is now again reduced to its 
lower level. 1 

Increased consumption of sodium chloride not only increases the quan- 
tity of it and of urea in the urine but increases also the excretion of 
potash salts. 

On the other hand, potash salts also increase the excretion of sodium. 
Between salts containing no chlorine, such as carbonate or phosphate, and 
the sodium chloride in the blood, a double decomposition takes place, 
potassium chloride, and sodium carbonate or phosphate, being formed. 
These newly-formed salts are unnecessary for the organism, and are 
excreted in the urine along with the unaltered remainder of the phosphate 
or carbonate administered. Considerable quantities both of chlorine and 
sodium may thus be removed from the organism. In consequence of this, 
herbivorous animals and people living chiefly on a vegetable diet, and who 
thus consume considerable quantities of potash salts, feel the need of 
sodium chloride greatly, and on the American prairies the herds of buffa- 
loes travel hundreds of miles to visit the salt licks. Beyond a certain 
point, however, the excretion of sodium chloride is not increased by potash 
salts, and when the quantity of sodium salts in the body is low, excretion 
is not increased at all. 

When an abnormal quantity of fluid is present in the tissues, as in 
dropsies, an increase in the saline constituents of the blood may cause its 
absorption, especially if the quantity of water drunk by the patient be 
limited. It is probable that in addition to their diuretic action the alka- 
line salts affect the nutrition of the tissues themselves, and that salts of 
potash are better than those of soda in cases of dropsy, because of their 
action on the tissues. 



1 Lmebvig, Manuscript Notes of Lectures, 1S69-1S70. 



504 IXOEGAXIC MATERIA MEDICA. 

GrENERAL ACTION OF THE S-UB-GeOUP OF SULPHATES, &C. — This 
group contains salts which are sparingly absorbed, such as sulphates, phos- 
phates, and bitartrates. That they are sparingly absorbed is shown by 
the fact that when administered internally they only appear to a small 
extent in the urine. They usually act as purgatives, but if from any 
cause their purgative action should be prevented, and they remain long in 
the intestine, absorption will occur, though slowly. In herbivorous ani- 
mals, which have a much longer intestinal canal than carnivora, larger 
doses of these salts are required to produce a purgative action. The mode 
of action has already been discussed (p. 341). 

Comparative Action of the Alkalixe Metals. — As the action 
of the base appears to be less modified by the acid radical in the case of the 
chlorides than of other salts of the alkaline metals, they are better adapted 
for experiments on the comparative action of the members of this class. 

Group I. — The chlorides of lithium, sodium, potassium, rubidium, and 
caesium produce in frogs gradually increasing torpor, paralysis and 
death. The chief action appears to be on the spinal cord, which is 
paralyzed, a slight primary excitement occurring in the case of potas- 
sium and rubidium. Lithium and potassium paralyze also the ends of 
the motor nerves. Sodium does so also, though to a much less extent. 
Caesium and rubidium do not do so, excepting when given in very large doses. 

The contractile power of muscle is almost always diminished by 
lithium, unaffected by sodium, and increased by the other members of this 
group in small or moderate doses. Large quantities of potassium diminish 
both the irritability and contractile power of muscle voluntary and invol- 
untary. 

In frogs the heart becomes weaker and finally stops in diastole. 

Group II. — Ammonium differs entirely from the members of the first 
group in the symptoms it produces. While they paralyze the spinal cord 
with little or no previous excitement, causing torpor and death, ammonia 
at first stimulates the cord, producing tetanic convulsions. The action 
of ammonium is considerably modified by the acid radical with which it is 
combined. All the ammonium salts have an action on the spinal cord, 
motor nerves, and muscles, and, in advanced poisoning, paralyze 
these structures. 

They do not, however, affect all these structures with equal readiness. 
The organ first affected, and consequently (p. 48) the symptoms of poison- 
ing, vary with the salt employed. Some salts affect the spinal cord first, 
others the motor nerves. Ammonia and ammonium chloride produce 
tetanus. The bromide produces hyperesthesia witli some clonic spasm, 
passing into tetanus, which, however, comes on very late. 

The sulphate also produces hyperesthesia and clonic spasms, but rarely 
tetanus. The phosphate produces paralysis without convulsions, either 
clonic or tonic, the only indication of any convulsant action being slight 
twitches accompanying movements in the hind limbs before reflex action 
has ceased. The iodide produces progressive paralysis and no tetanus. 
The brain appears to be affected before the spinal cord. This is shown 
by the frog croaking when stroked, as it does after removal of the cere- 
bral hemispheres, and by the reflex from the conjunctiva failing before 
that from the limb-. 



METALS. 505 

Ammonium salts appear to form a series, at one end of which the 
members stimulate the spinal cord and have no marked paralyzing 
action on the motor nerves, while those at the other end have no marked 
stimulating action on the cord, but, on the contrary, have a marked 
paralyzing' action both on the cord and on motor nerves. At the 
stimulating; end of this series are ammonia and ammonium chloride, and 
at the paralyzing end ammonium iodide ; whilst the bromide, phosphate, 
and sulphate lie between. 

Group I.— METALS OF THE ALKALIES. 

POTASSIUM. K; 39. 

General Sources of Potash Salts. — The chief source of potash 
salts is the ash left by the combustion of plants or trees ; but there are 
two subsidiary sources, viz., nitrate of potash, which is found native, and 
bitartrate of potash, which is deposited from wine in the process of fer- 
mentation. 

General Reactions of Potash Salts. — In analysis, potassium is 
distinguished from all other bases, excepting magnesium, sodium, and 
ammonium, by not being precipitated by ammonium sulphide nor carbo- 
nate of ammonia. The positive reactions by which its presence is 
ascertained are — (1) its precipitation when converted into an acid tar- 
trate : (2) its precipitation by perchloride of platinum ; (3) the violet 
color it imparts to flame. 

The sparing solubility of the acid tartrate is the test which is used 
in the U.S. P. to distinguish all salts of potash. The reagent employed 
is tartaric acid in the case of potassium hydrate, carbonate and bicarbo- 
nate; in the case of the tartrate of potassium and sodium, acetic acid 
is used. In the case of most other salts a saturated solution of bitar- 
trate of sodium is added to their aqueous solution. Potassium chlorate 
is calcined and the reagent added to a solution of the residue. Potassa 
sulphurata is decomposed by boiling with hydrochloric acid, the sulphur 
removed by filtration, and the filtrate neutralized by soda before the 
reagent is applied. No test for potassium is given in the case of potas- 
sium bitartrate or permanganate. 

This test is only employed in the British Pharmacopoeia in four 
instances, viz., neutral tartrate, acetate, bromide, and iodide. In the 
case of the neutral tartrate the test is applied by adding a small quantity 
of acetic acid, and thus producing acid tartrate. In the case of the 
acetate, bromide, and iodide, it is applied by adding tartaric acid. On 
the addition of perchloride of platinum to chloride of potassium a 
double chloride of potassium and platinum is formed, and falls as a 
sparingly soluble pale-yellow precipitate. If the potassium salt be other 
than a chloride, part of the chlorine in the platinum salt is used up to con- 
vert the potassium into a chloride, and thus loss of the expensive reagent 
takes place. To avoid this loss hydrochloric acid is always to be added 
before the addition of the platinum salt. This reaction is not used for 
the bromides and iodides, because bromide and iodide of platinum would 
be formed and a loss of the reagent would occur. In testing some 



506 



INORGANIC MATERIA MEDICA. 



potassium salts, modifications are observed in the mode of applying the 
test. Before applying it to the chlorate the salt is calcined, oxygen is 
thus driven off, and the residue, consisting of chloride of potassium, does 
not require the addition of hydrochloric acid. The permanganate is also 
calcined, but the potash contained in the residue, after being dissolved 
out by water from its admixture with manganese dioxide, requires to be 
treated with acid as usual. In the case of the sulphide the hydrochloric 
acid causes the evolution of hydrogen sulphide, which must be removed 
by boiling, and causes also the precipitation of sulphur, which must be 
removed by filtration before the addition of platinum chloride. 



Preparation of Potash Salts. 





Prepared from 


By 


Potassium carbonate, 
U.S. P. and B.P. 


Wood ashes. 


Lixiviating, evaporating, and crys- 
tallizing. 


Liquor potassii, U.S. P. 
" potassae, B.P. 


Carbonate of potash. 


Treating solution with slaked lime 
and partially evaporating. 


Caustic potash, U.S. P. 
and B.P. 


Do. 


Ditto, and evaporating to dryness. 


Potassium bicarbon- 
ate, U.S. P. and B.P. 


Do. 


Passing carbonic acid gas into solu- 
tion. 


Potassium sulphite, 
U.S.P. 


Do. 


Passing sulphurous acid gas into 
strong solution until acid, adding 
equal weight of potassium carbo- 
nate, and crystallizing. 


Potassium acetate, 
U.S.P. and B.P. 


Do. 


Dissolving in acetic acid. 


Potassium citrate, 
U.S.P. and B.P. 


Do. 


Neutralizing with citric acid. 


Potassium hypophos- 
phite, U.S.P. 


Do. 


Decomposing by hypophosphite of 
lime. 


Potassium chlorate, 
U.S.P. and B.P. 


Do. 


Treating with lime and chlorine. 


Potassium ferrocyan- 
ide, U.S.P. 


Carbonate of potash. 


Heating animal matter and iron 
together. 


Potassium cyanide, 
U.S.P. 


Potassium ferroc3 T an- 
ide. 


Igniting either alone, or with car- 
bonate of potash. The former 
process gives a purer, the latter a 
more abundant, product. 


Potassa sulphurata, 
I'.S.P. and B.P. 


Carbonate of potash 
and sulphur. 


Heating together. 


Potassium acid tar- 
trate, U.S.P. and B.P. 


Crude tartar or argol. 


Treating with charcoal or clay. 


Pol assi urn tartrate, 
U.S.P. and B.P. 


Acid tartrate of pot- 
ash. 


Neutralizing with carbonate of pot- 
ash. 



METALS. 507 

Preparation of Potash Salts — {continued). 



Potassium nitrate, 
U.S.P. and B.P. 

Potassium sulphate, 
U.S.P. and B.P. 



Potassium permanga- 
nate, U. S. P. and 
B.P. 

Potassium iodide, 
U.S.P. and B.P. 

Potassium bromide, 
U.S.P. and B.P. 



Prepared from 



Native. 



Acid sulphate left 
from admixture of 
sulphuric acid and 
potassium nitrate 
in the preparation 
of nitric acid. 

Chlorate of potash, 
caustic potash, and 
oxide of manganese. 

Potash and iodine. 



Potash and bromine. 



By 



Neutralizing with carbonate of pot- 
ash or lime. 



Ignition together, boiling and neu- 
tralizing. 



Mixing and heating with charcoal. 



As in the iodide. 



General Action of Potash Salts. — According to Ringer, potash 
is a protoplasmic poison destroying muscle, nerves and nerve-centres 
when applied to them sufficiently long and in a sufficiently concentrated 
form. But this action is not peculiar to potassium, for sodium, ammonium, 
hydrocyanic acid, and probably many other substances possess it. Potash 
salts differ from soda salts in diffusing- more readily through membranes. 
They are more easily absorbed and more easily excreted than soda salts. 
In the living organism they occur chiefly in the solid structures, such 
as blood-corpuscles and muscles, while soda salts occur chiefly in the 
fluids of the body. 

When applied to muscle, potash salts in minute doses may increase 
its contractile power (p. 126) ; but in larger doses, or when continued for 
a longer time, they diminish its power and finally paralyze it altogether. 
They remove the excessive prolongation of muscular contraction produced 
by veratrine, barium, calcium, strontium, and by large doses of sodium 
or lithium (p. 127). 

They have a somewhat paralyzing action on motor nerves. They 
paralyze also the nerve-centres, generally after a primary, transitory, 
excitement. 

A peculiar difference in the action of sodium and potassium salts 
locally applied to the intestine has been already noticed (p. 334). Large 
doses paralyze the muscular fibre of the intestines, and it is possible that 
this paralyzing action is the cause of the digestive disturbances which the 
prolonged use of potash salts causes (Rossbach). 

When administered by the mouth they may produce, like other salts 
in large doses, irritation of the gastro-intestinal canal. They are, 
however, so quickly excreted that they can hardly produce poisoning 
by their action on the heart while circulating in the blood ; they probably 
modify the nutrition of the tissues and act as alteratives. It is probable 



508 INOEGANIC MATERIA MEDICA. 

that potash salts may accumulate to a certain extent in the body in the 
same way as sodium chloride (p. 503). By feeding animals with potash 
salts the poisonous action of barium may be lessened. Cash and I have 
now found that when injected simultaneously with salts of barium (cf., p. 
132), they will antagonize the action of the latter, and prevent death 
from an otherwise lethal dose of barium. Similar experiments with 
veratrine have given negative results. The prolonged use of potash salts 
is apt to cause some depression, and larger doses continued for some time 
may diminish the force of the circulation. They do not paralyze the 
heart when given by the mouth, but when injected directly into the 
veins they produce transitory excitement, clonic spasms, paralysis, and 
death. 

Deatli is preceded by convulsions, and is caused by stoppage of the 
heart while respiration still continues. Even after both heart and respi- 
ration have ceased and the animal is apparently dead, life may be restored 
by the patient use of artificial respiration, and mechanical irritation of the 
heart by compressing the cardiac region. After the heart has thus been 
induced to beat spontaneously, respiration still remains in abeyance for 
some time. The nerve-centres are also paralyzed, and neither volun- 
tary movement nor reflex action occur for some time. When reflex 
excitability returns it is often much exaggerated, so that a slight shake 
or gentle touch on the surface may cause spasms. In this respect potas- 
sium somewhat resembles atropine, and the possible explanation of this 
action has already been discussed (p. 158). 

The effect of potash salts on the circulation somewhat resembles 
that of digitalis. In large doses they cause a rapid fall of the blood- 
pressure and pulse-rate. Smaller doses cause a slight fall of both 
pulse-rate and pressure, followed by a rise of both. During the rise of 
pressure, however, the pulse becomes again slow, and continues so even 
when the pressure again begins to fall to the normal. The rise of 
pressure occurs even when the spinal cord is divided, and probably 
depends on contraction of the arterioles (p. 246). 

Potassii Carbonas, (K 2 C0 3 )3H 2 0, 330, TJ.S.P. ; Potassse 
Carbonas, B.P. Carbonate of Potash. K 2 C0 3 , with about 16 per 
cent, of water of crystallization, B.P. 

Characters axd Tests. — A white crystalline powder, alkaline, 
and caustic to the taste, very deliquescent, readily soluble in water but 
insoluble in spirit, and giving the reactions of a carbonate and of 
potassium. 

20 grains Carbonate' \ , v J 11 grains Citric Acid, or 

of Potash ? / neutralize j lg graing Tartaric Acid> 

Dose. — 10 to 30 grains. 

A' TION. — When taken internally it acts as an irritant poison. It 
is rarely used' internally, but may be given instead of liquor potassa?, 
or of bicarbonate, or in an effervescent form with citric or tartaric acid. 
It is chiefly employed in the preparation of other potash salts. A dilute 
solution of it may be used as an application to the skin to relieve itch- 
in-, and for this purpose may be alternated with dilute acid. 



METALS. 509 

Liquor Potassae, U.S. P. and B.P. Solution of Potassa, 
U.S. P.; of Potash, B.P. — An aqueous solution of hydrate of potas- 
sium (KHO; 56) containing about 5 per cent, of the hydrate, U.S. P. 

Uses. — Dilute liquor potassas is used externally as a lotion in 
freckles, and, when diluted with water in the proportion of 1 to 6, is 
employed in order to soften in-growing toe-nails. It is also administered 
internally in scaly skin diseases, in eczema and acne, especially when 
these occur in gouty subjects, or are accompanied by acidity of the 
stomach. In cases of dyspepsia, with irritability, liquor potassse is said 
to have a sedative action upon the stomach, and thus to be preferable 
to the bicarbonate. It is believed to be useful in jaundice, and enlarge- 
ment or cancer of the liver. For its action upon the system it has been 
administered in rheumatism, both acute and chronic. It is given to 
cause the absorption of fat in obese persons, but may destroy the 
general health (cf., p. 501). It has been used to cause the absorption 
of scrofulous glands and of bronchocele. It increases the bronchial 
secretion, and renders it more liquid and easier to cough up. It is there- 
fore useful in bronchitis where the secretion is scanty and difficult to 
expectorate, and is equally serviceable in the intercurrent bronchitic 
attacks to which phthisical patients are liable (p. 225). 

Potassa, U.S. P.; Potassa Caustica, B.P. KHO; 56. Caus- 
tic Potash. — Hydrate of potash, KHO, containing some impurities. 

Characters and Tests. — In hard white pencils, very deliquescent, 
powerfully alkaline and corrosive. A watery solution gives the reactions 
of potassium and those showing the absence of impurities. 

Peepaeation containing Caustic Potash. 
Liquor Potassse « 27 grains in 1 fluid ounce. 

Peepaeation in which Caustic Potash is used. 
Potassse Permanganas. 

. Uses. — It is used as a caustic where we wish to burn deeply and 
widely, as in snake-bites, the bites of rabid animals, or in poisoned 
wounds. It is sometimes employed to open abscesses, more especially 
abscess of the liver, in which it is preferred to the knife, as by its use 
we secure adhesion of the liver to the abdominal wall before the abscess 
is opened, and thus prevent any pus from finding its way into the peri- 
toneal cavity. Ringer says that the best way to apply it is to cut a hole 
in a thick piece of plaster, smaller than the size of the slough which we 
wish to make, and rub on the caustic potash, slightly wetted until the 
tissues assume a grayish color, then to wash the part with vinegar, and 
apply a poultice. 

U.S.P. Potassa cum Calce. Potassa with Lime; Vienna Paste. 

Preparation. — Equal parts of caustic potash and lime made into 
a paste with alcohol. 

Characters. — It is a grayish white, deliquescent powder with a 
strongly alkaline reaction. It gives the tests of potassium and calcium. 

Uses. — It is used for the same purposes and in the same manner as 
caustic potash, but being less deliquescent its action is slower and more 



510 INORGANIC MATERIA MEDICA. 

limited ; it is thus more easily restricted to the part which it is wished 
to destroy, and is less liable to spread. 

Potassae Bicarbonas, U.S. P. and B.P. Bicarbonate of 

Potash. KHC0 3 ; 100. 

Characters and Tests. — Colorless right rhombic prisms, not 
deliquescent, of a saline feebly alkaline taste, not corrosive. Diluted 
hydrochloric acid causes strong effervescence, forming a solution which 
gives the reactions of potassium and those showing the absence of 
impurities. 



20 grains Bicarbonate 



1 Y f 14 grains Citric Acid, or 

of Potash J \ 15 grains Tartaric Acid. 

Dose. — 10 to 40 grains. 

Peeparatiox. 
b.p. 

Liquor Potassae Effervescens (Potash water) 30 grs. in 1 pint. 

Uses. — Solutions of bicarbonate of potash may be used externally 
to relieve itching. Internally it is given in dyspepsia, rheumatism, 
gout, and scalding depending upon excessive acidity of the urine with 
presence of uric acid, or in cases of deposit of this acid in the urinary 
passages. 

Potassae Acetas, U.S. P. and B.P. Acetate of Potash. 
KC 2 H 3 2 ; 98. 

Characters and Tests. — White foliaceous satiny masses, very 
deliquescent, with a watery solution of which tartaric acid causes a crys- 
talline precipitate (potash), sulphuric acid the disengagement of acetic 
acid, and a dilute solution of perchloride of iron strikes a deep red color 
(acetate). 

Impurities. — Acid, carbonate, lead. 

Tests. — Xeutral to test paper (no acid) ; entirely soluble in rectified 
spirit (no carbonate). Its solution is unaffected by sulphide of ammonium 
(no metals). 

Dose. — 10 to 60 grains. 

Preparation ix which Acetate of Potash is used. 
Tinctura Ferri Acetatis. 

Uses. — From its slight local action and its great solubility it produces 
little effect directly on the stomach and is easily absorbed into the blood. 
Here it is converted into carbonate and renders the blood and the secre- 
tions which come from it more alkaline. This salt of potash is one which 
is very frequently used for the purpose of rendering the urine alkaline. It 
is -.ne of the most powerful saline diuretics we possess, and is much used 
in dropsies, alone or combined with other diuretics, or witli tonics and 
stimulants, '-.//.. acetate of iron and acetic ether. 

When given in large doses (120 grains and upwards) and in a con- 
centrated form it act- a- a purgative. 

It is employed like other potash salts as an alterative in acute rheu- 
matism, -kin <li-ca<«-<, and enlarged glands. 



METALS. 511 

Potassae Citras, U.S. P. and B.P. Citrate of Potash. K 3 C 5 

H 5 7 H 2 0; 324. 

Characters axd Tests. — A white powder, of saline feebly acid 
taste, deliquescent, and very soluble in water. Heated with sulphuric 
acid it forms a brown fluid, gives off an inflammable gas, and evolves the 
odor of acetic acid (citrate). Its solution gives the reactions of potassium, 
and, mixed with a solution of chloride of calcium, remains clear till it is 
boiled, when a white precipitate separates, which is readily soluble in acetic 
acid. This precipitate is citrate of lime, which is less soluble in hot than 
in cold water. 

Dose. — 20 to 60 grains. 

Uses. — Is very pleasant to the taste, produces no local action and is 
very soluble. It is thus easily absorbed into the blood, and there becomes 
carbonate. It is less liable to purge than other potash salts, and can thus 
be given in larger doses. After absorption it acts like the carbonate, 
causes diuresis and lessened acidity* or even alkalinity of the urine, 
and probably influences tissue change as well. It is antiscorbutic. 

Potassii Bitartras, U.S. P. ; Potassse Tartras Acicla, B.P. 

BlTARTRATE OF POTASSIUM, U.S. P., ACLD TARTRATE OF POTASH, B.P. 

Cream of Tartar. KHC 4 H 4 6 ; 188. 

An acid salt obtained from the crude tartar which is deposited during 
the fermentation of grape juice, B.P. 

Characters and Tests. — A gritty white powder, or fragments of 
cakes crystallized on one surface ; of a pleasant acid taste, sparingly solu- 
ble in water, insoluble in spirit. Heated in a crucible it evolves inflam- 
mable gas and the odor of burned sugar, and leaves a black residue 
(tartrate). The calcined residue consists of potassium carbonate and gives 
its reactions. 

Dose. — 20 to 60 grains as a diuretic ; J- J oz. as purgative. 

Preparations in which Acid Tartrate of Potash is used, 
u.s.p. B.P. 

Pul vis Jalapae Compositus. Acidum Tartaricum. 

Antimonium Tartaratum. 
Confectio Sulphuris. 
Ferrum Tartaratum. 
Potassse Tartras. 
Pulvis Jalapa? Compositus. 
Soda Tartarata. 

Uses. — From there being two equivalents of tartaric acid to one of 
potash it has a somewhat acid taste, and is used instead of tartaric or other 
acids for making cooling- drinks in fevers, &c. A refreshing drink called 
Potus Imperialis, or Imperial, is made by dissolving 1 to 1J drachms of 
acid tartrate and a little sugar in a pint of boiling water and infusing with 
half the fresh peel of a lemon. 

In small doses it is absorbed, oxidized in the blood to carbonate, and 
acts like the acetate as a diuretic. 

In larger doses it retains water with gneat avidity, and prevents its 
absorption into the blood for a long time. It therefore causes the stools 
to be very watery, by detaining water in the intestine, but it has no irri- 
tating action on the intestine, and produces no increased peristalsis. If 



512 INORGANIC MATERIA MEDICA. 

no other medicine be given to cause peristalsis, the salt and the water it 
has been retaining will be absorbed. Its action is thus very much like that 
of a simple enema of water going along the whole intestine, and like a 
simple enema it produces no depressing effect. 

It is much used in dropsies as a purgative, generally in combination 
with jalap or scammony to produce peristalsis, whether the dropsy be due 
to affections of the heart or kidneys, and also in Bright 's disease, even 
when unaccompanied by dropsy. It has also been employed as a laxative 
in dysentery, piles and prolapsus ani. 

Potassii Tartras, U.S. P.; Potassse Tartras, B.P. Tartrate 
of Potassium, U.S. P. ; Tartrate oe Potash, B.P. 2KO,C 8 H 4 O 10 

or(K 2 C 4 H 4 6 ) 2 H 2 0; 470. 

Characters and Tests. — In small, colorless, four or six-sided 
prisms. It gives the reactions showing the presence of tartaric acid and 
potassium like the bitartrate, but it is readily distinguishable by its greater 
solubility in water. 

Impurity. — Bitartrate. 

Test. — Entirely dissolved by its own weight of water. 

Dose. — As a diuretic, 20-60 grains. As a purgative, J -J ounce. 

Uses. — In small doses it is absorbed, converted into carbonate in 
the blood and acts as a diuretic, antilitliic, &c, like the acetate and 
citrate. In larger doses it acts as a purgative like other saline 
cathartics. 

Potassii Sulphas, U.S.P. ; Potassae Sulphas, B.P. Sulphate 
of Potassium, U.S.P. ; of Potash, B.P. K 2 S0 4 . 

Characters and Tests. — Colorless, hard, six-sided prisms termi- 
nated by six-sided pyramids; decrepitates strongly when heated; 
sparingly soluble in water; insoluble in alcohol. Its solution in water 
gives the reactions showing the presence of potassium and a sulphate. 

Impurities. — Lime, chlorides, iron and lead. 

Test. — The solution should give no precipitate with oxalate of 
ammonia (no lime), nitrate of silver (no chloride), nor ammonium sul- 
phide (no metals). 

Dose. — 15 to 60 grains. 

Preparations, 
b.p. 

Pilula Colocvnthidis Composita 1 part in 24. 

" r ' et Hyoscyami 1 " 36. 

" Ipecacuanha? cum Scilla I " 3. 

Pulvis Ipecacuanha} Conipositus 4 " 5. 

Uses. — Sulphate of potash is employed as a saline purgative in 
cases of dyspepsia, biliousness and albuminuria. It is generally com- 
bined with some other aperient, such as rhubarb. From its hardness it is 
used to aid in pulverizing tough vegetable substances, like ipecacuanha in 
the preparation of Pulv. Ipecacuanhas Co., B.P. It was once supposed 
to have the power of arresting the secretion of milk, and was therefore 
given to women who wished to stop suckling. 

Potassii Xitras, U.S.I'.; Potass;*? Nitras, B.P. NlTRATE OF 

Potassium, U.S.P.; Nitrate of Potash, B.P. KN0 3 ; 101. 



METALS. , 513 

Nitrate of potash of commerce, purified, if necessary, by crystalli- 
zation from solution in distilled water. 

Characters and Tests. — In white crystalline masses or fragments 
of striated six-sided prisms, colorless, of a peculiar cool saline taste. 
Thrown on the fire it deflagrates ; warmed in a test-tube with sulphuric 
acid and copper wire it evolves ruddy fumes (nitrate). Its solution gives 
the reactions of potassium. 

Impurities. — Sulphates and chlorides, which are detected by the 
usual tests. 

Dose. — 10 to 30 grains. 

Peepaeations. 

u.sp. 
Charta Potassii Nitratis. Nitrate of Potassium Paper. Unsized paper dipped in 
a 20 per cent, solution of nitrate of potash and dried. 
Argenti Nitras Dilutus. 

Action.— In large doses, nitrate of potash will produce death by 
g-astro- enteritis, with vomiting, weakness, and arrest of the circula- 
tion, due partly to the reflex action of the drug, and partly to its direct 
action on the heart after absorption. When injected into the blood, 
it slows the pulse by lessening the irritability of the cardiac ganglia, 
lowers the temperature, and causes dyspnoea and death with convul- 
sions. The convulsions are due to arrest of the heart, and consequent 
irritation of the brain by venous blood. 

Uses. — Nitrate of potash gives up its oxygen readily, and paper 
dipped in a strong solution of it (Charta potassii nitratis, U.S. P.), and 
then dried, may be burnt in a plate, and the fumes inhaled, in asthma. 
It has been suggested that among the products of combustion the nitrite 
of potassium is the most efficacious. A ball of nitre, kept in the mouth 
and allowed to melt slowly away, gives relief in cases of relaxed sore 
throat. It has been used internally in acute bronchitis, spasmodic 
asthma (either internally or by inhaling its fumes), and in dyspepsia 
with congestion of the mucous membranes. Generally it is avoided in 
inflammation of the stomach, intestine, kidneys and bladder, on account 
of its local irritant action. On account of its action on the heart it has 
been given in haemoptysis and other haemorrhages. On account of its 
supposed action on the blood it was, and is, used in inflammation, fevers 
and exanthemata. As an alterative it is used in scurvy, purpura, rheu- 
matism and gout. Twenty grains of nitre with thirty of potassium 
bicarbonate taken in the morning in a large soda-water tumbler full of 
water will sometimes prevent the onset of a gouty paroxysm, and will 
also remove the headache consequent upon a debauch. Nitrate of pot- 
ash is also used as a diuretic in cases of dropsy and gonorrhoea, and 
as a stimulant to the bladder in cases of incontinence of urine. 

Potassii Chloras, XJ.S.P. ; Potassae Cliloras, B.P. Chlorate 
of Potassium, U.S. P.; Chlorate of Potash, B.P. KC10 3 ; 122-4. 

Preparation. — By passing chlorine through a mixture of potassium 

carbonate and slaked lime. If potassium carbonate alone were used 

part of it would be converted into KC1 and lost. 3K 2 C0 3 -f- 3C1 2 = 

5KC1 + KC10 3 -f 3C0 2 . To save this, lime is used, which is much 

33 



514 IXOKGAKTC materia medica. 

cheaper. After the mixture has been saturated with chlorine it is 
boiled, filtered, evaporated, and the chlorate crystallized out. K 2 C0 3 
+ 6CaH 2 2 + 6C1 2 == 2KC10 3 + 5CaCl 2 + CaC0 3 + 6H 2 0. 

Chaeacters and Tests. — In colorless rhomboidal crystalline plates, 
with a cool saline taste, sparingly soluble in cold water. It explodes when 
triturated with sulphur. By heat it fuses, gives off oxygen gas, and 
leaves a white residue, which dissolves in water and gives the reactions 
of potassium and of a chloride. 

Impurities. — Chloride and lime. 

Test. — Its solution is not affected by nitrate of silver (no chloride) 
nor oxalate of ammonia (no lime). ' 

Dose. — 10 to 30 grains. 

Officinal Peepaeations. 

u.s. p. and b.p. dose. 

Trocliisci Potassae Cliloratis 5 grains ill each lozenge. — 1 to 6. 

Used also in preparing Potassse Permanganas. 

Action. — Chlorate of potash, when injected into the circulation, has 
not the same action as other salts of potash. Small doses generally at 
first depress, and afterwards raise the Tblood-pressure and accelerate 
the pulse. Large doses cause sudden stoppage of respiration, and sink- 
ing of the blood-pressure down to zero, while the exposed heart continues 
to beat at nearly its normal rate, or a little over it, for half or three- 
quarters of an hour. 

Large doses administered medicinally have caused poisoning, espe- 
cially in children. The symptoms are due to the haemoglobin of the 
blood being converted in methaemoglobin by the action of the chlorate. 
They consist in hematuria with blood-casts and diminished secretion of 
urine, many of the renal tubules being filled with plugs of blood. The 
skin becomes discolored or jaundiced, and death occurs with coma or 
convulsions. 

Uses. — Chlorate of potash is chiefly used as a local application to 
the mouth, to bring about a more healthy condition of the mucous mem- 
brane, and to cause ulceration present there to heal up. It is used in 
stomatitis occurring during nursing, on whatever this depends, in 
aphthae, in cancrum oris. As a gargle it is used in follicular pharyn- 
gitis, and has been employed internally and as a local application in 
cases of croup, diphtheria, and spasm of the larynx. It may be used 
internally as a lotion to relieve the dryness of the throat after 
diphtheria and scarlatina. When taken early, it is said to lessen or 
arrest catarrhal conditions of the nose, throat, and larynx. It has been 
recommended in chronic mucous diarrhoea with whitish or mucilaginous- 
looking stools. It has also been used as an enema in cases of dysentery. 
After absorption into the blood it has been supposed to give off its 
oxygen, and thus to have a disinfectant action in cases of blood-poisoning 
and malignant fevers. A great part of it is excreted unchanged by the 
kidneys, but in large doses it decomposes the blood and converts it into 
methjemoglobin. It lias been employed in acute and chronic bronchitis, 
in order to thin the secretion and promote expectoration, and as a 



METALS. 515 

diuretic in cases of dropsy. It was recommended by the late Sir James 
Simpson in 20-grain doses three times a day, to pregnant women where 
abortion was liable to occur from fatty degeneration of the placenta. 

Potassii Pernianganas, U.S. P.; Potassae Permanganas, 

B.P. Permanganate of Potassium, U.S. P.; Permanganate of 
Potash, B.P. K 2 Mn 2 O s ; 314, U.S.P. KMn0 4 , B.P. 

Preparation. — By heating caustic potash and manganese dioxide 
together in a crucible with chlorate of potash, which yields up its oxygen 
to the manganese and forms manganate of potash. 3Mn0 o + 6KHO 
- KCIO3 = 3K 2 Mn0 4 + KC1 - 3HO. On boiling this with water 
it is decomposed, permanganate being formed, and manganese dioxide 
being deposited. 3K 2 MnO, - 2H 2 = 2KMn0 4 - Mn0 2 - 4KHO. 
On decanting from the manganese dioxide, neutralizing with sulphuric 
acid, evaporating, filtering through asbestos, and evaporating further, 
the salt crystallizes out. 

Characters and Tests. — Dark purple, slender, prismatic crystals, 
inodorous, with a sweet astringent taste, entirely soluble in cold water. 
A single small crystal suffices to form with an ounce of water a rich 
purple solution. It gives off oxygen readily to organic substances and 
is decomposed, manganese dioxide being precipitated, so that the solution 
when mixed with a little rectified spirit and heated, becomes yellowish- 
brown. The crystals heated to redness decrepitate, evolve oxygen gas, 
and leave a black residue from which water extracts potash, recognized 
by its alkaline reaction and by the appropriate tests. 

Peepabatiox. 

b.p. Solution of Liquor Potassae Perraanganatis (Permanganate of Potash 4 grs. 
in 1 fl. oz. of water). 

Condy's Fluid is a solution of 2 grains to the ounce. 

Administration. — The solution has a disagreeable taste, and the 
solid permanganate of potash gives off oxygen so readily that, if mixed 
with easily-oxidizable substances, such as sugar, syrup, or glycerine, the 
mixture may explode or take fire spontaneously. Martindale recom- 
mends that the necessary quantity of permanganate should be made into 
a pill with kaolin ointment, consisting of equal parts of vaseline, paraffin, 
and kaolin.' 

Action. — Permanganate of potash very readily parts with its oxygen, 
and thus destroys organic matter ; when mixed with cobra poison 
it completely destroys the deadly power of the latter, and the mixture 
may be injected subcutaneously without any bad effects. When injected 
after the poison, however, it does not appear to come into such immediate 
contact with it in the tissues as to destroy it, and it therefore does not 
act as an antidote. 

Uses. — It is used to disinfect the stools in typhoid fever, and to 
disinfect the hands after making post-mortem examination, or after 
coming in contact with matters likely to convey contagion or infection 
(p. 107). It is applied as a lotion to wounds and sores, especially those 
having a foul-smelling discharge, and may be injected into the cavity of 
abscesses after evacuation of pus, or used to wash out the cavity of the 



516 IXOKGAXIC MATERIA MEDICA. 

pleura after the fluid has been removed in cases of pleurisy. In cases 
of ozama it is employed to wash the nose, and as a lotion or gargle to the 
mouth in ulceration with fcetor, such as mercurial stomatitis, and also in 
diphtheria. It has been recommended internally in cases of diabetes. 
It is said by Ringer and Murrell to be of very great use in araenorrlioea, 
two or three grains being given in pill three or four times a day for some 
days before the period. 

Potassa Sulplmrata, U.S.P. and B.P. Sulphurated Potassa, 
U.S. P. ; Sulphurated Potash, B.P. 

Characters and Tests. — Solid, greenish fragments, liver-brown 
when recently broken, alkaline and acrid to the taste, readily forming 
with water a yellow solution, which has the odor of sulphuretted hydrogen, 
and evolves it freely when excess of hydrochloric acid is dropped into it, 
sulphur being at the same time deposited. The acid fluid when boiled 
and filtered is precipitated yellow by perchloride of platinum, and white 
by chloride of barium. 

Impurity. — Carbonate left in the preparation, or sulphate formed by 
decomposition. 

Test. — About three-fourths of its weight are dissolved by rectified 
spirit, in which both carbonate and sulphate are insoluble. 

Dose. — 2 to 10 grains. 

Preparation, 
b.p. 

Unguentum Potassse Sulphuratae (30 grs. to 1 OZ. of lard). 

Action. — When applied to the skin, the ointment may be used 
instead of simple sulphur ointment. In the intestine sulphurated potash 
seems to stimulate peristaltic action, and to act as a laxative. Appa- 
rently also, like sulphur, it has a somewhat stimulating action upon the 
respiratory mucous membrane, and upon the sweat glands. 

Uses. — The ointment is used externally in cases of scabies and acne. 
Sulphurated potash is used as a bath in rheumatism (p. 403), and as a 
diaphoretic in albuminuria. It has been given internally in chronic 
bronchitis, croup, and whooping-cough, and used as an injection into the 
rectum to destroy ascarides, in solutions of half a grain to a grain in the 
ounce of water. 

Potassii Bicliromas, U.S.P. ; Potassse Bicliromas, B.P. 

Bichromate of Potassium, U.S.P. ; Bichromate of Potash, B.P. 
K 2 Cr 2 7 ; 294-8. 

Characters and Tests. — In large red, transparent, four-sided 
tables ; anhydrous ; fuses below redness ; at a higher temperature is 
decomposed, yielding green oxide of chromium and yellow chromate of 
potash, which may be separated by dissolving the latter in water. The 
bichromate dissolved in water gives a yellowish-white precipitate with 
chloride of barium, and a purplish-red precipitate with nitrate of silver, 
and both these precipitates are soluble in diluted nitric acid. The solu- 
tion also when digested with sulphuric acid and rectified spirit acquires 
an emerald green color. 



METALS. 517 

Peepakation in which Bichromate of Potash is used. 
Sodse Valerianas. 
Test Solution of Bichromate of Potassium, U.S.P. 1 in 10 of water. 

Action. — In frog's it causes general feebleness of motion, respiration 
and circulation, and sometimes convulsions. The nerve-centres are first 
excited and then depressed. The nerve-centres are affected before the 
nerves or muscles. The heart stops in diastole. In lnaniraals it causes 
vomiting, diarrhoea, and bloody stools, great feebleness, and general clonic 
movements. In rabbits and guinea-pigs convulsions and paralysis 
occur, chiefly affecting the posterior limbs. Post-mortem a red colora- 
tion of the muscles is observed, and the gastric and intestinal mucous 
membranes are congested. 

Uses. — It has been used by Yulpian alternately with iodide of 
potassium and nitrate of silver in tabes dorsalis ; and in doses of J— 1 J 
grs. it is said to be useful in dyspepsia simulating cancer of the stomach. 

Potassii Ferrocyanidnni, U.S.P. ; Potassae Prussias Flava, 

B.P. Ferrocyanide of Potassium, U.S.P. ; Yellow Prussiate 
of Potash, B.P. K 4 Fe(CN) 6 3H 2 ; 421-9.— A salt obtained by fusing 
animal substances, such as the cuttings of horns, hoofs, and skins, with 
carbonate of potash, in an iron pot, lixiviating the crude product with 
water, and purifying the salt by crystallization. 

Characters and Tests. — In large yellow four-sided tablets or 
prisms, permanent in the air, soluble in water, insoluble in alcohol. The 
aqueous solution precipitates deep blue with persulphate of iron, brick- 
red with sulphate of copper, and white with acetate of lead. Heated 
with diluted sulphuric acid, hydrocyanic acid vapors are evolved. 

Uses. — As a test and in the preparation of hydrocyanic acid. 

Test Solution of Yellow Prussiate of Potash. Dissolve 1 Ounce of yellow prussiate 
of potash in crystals in 10 fluid ounces of distilled water and filter, U.S.P. ; % oz. in 
5 of water, B.P. 

Test Solution of Red Prussiate of Potash. Dissolve 1 oz. of red prussiate of potash 
in crystals in 10 fluid ounces of distilled water and filter, U.S.P.; J oz. in 5 of 
water, B.P. 

Potassii Iodiduin, U.S.P. and B.P. Iodide OF POTASSIUM. 
KI; 165-6. 

Preparation. — By mixing iodine and solution of potash, when iodide 
and iodate of potassium are formed, 6KHO -{-61 = KI0 3 -f- 5KI -f- 3H 2 0. 
The iodate is then reduced to iodide by roasting with charcoal, 5KI -f- 
KI0 3 +3C = 6K3-f-4CO. 

Characters. — In colorless, generally opaque, cubic crystals, readily 
soluble in water, and in a less degree in spirit. It commonly has a 
feeble alkaline reaction ; its solution gives the reactions of potassium and 
an iodide. 

Impurities. — Iodate from imperfect reduction, chlorides, sulphates, 
carbonates. Iodate is the most important impurity, since the dilute acid 
of the gastric juice will liberate free iodine from it in the stomach, and 
thus give rise to such gastric irritation that the iodide cannot be borne in 
doses where pure iodide would be readily tolerated. 



518 INORGANIC MATERIA MEDICA. 

Tests. — The addition of dilute sulphuric acid, U.S. P., or tartaric 
acid, B.P., and gelatinized starch, U.S. P., or mucilage of starch, B.P., 
to its watery solution does not develop a blue color. (Absence of iodate.) 
If iodate be present the acid liberates hydriodic acid, and this re-acting on 
the iodate forms free iodine, 6HI -f- KI0 3 = 3H 2 -j- KI + I^ Solution 
of nitrate of silver added in excess forms a yellowish-white precipitate, 
which, when agitated with ammonia, yields by subsidence a clear liquid 
in which excess of nitric acid causes no turbidity, B.P. (absence of 
chloride). Iodide of silver is insoluble in ammonia, but chloride is readily 
soluble, so the chlorides, if present, would be taken up by the ammonia 
and re-precipitated on the addition of acid. Its aqueous solution is only 
faintly precipitated by the addition of saccharated solution of lime. 

Dose. — 2 to 10 grains. 

Pbepaeations containing Iodide of Potassium, 
u.s.p. dose. 

Ungnentum Potassii Iodidi 

Liquor Iodi Compositus 2-6 min. (0"10-0'40 c.c.) 

B.P. STEENGTH. 

Linimentum Iodi 22 grs. in 1 fl. oz. nearly. 

Potassii Iodidi cum Sapone 4^ grs. in 1 fl. oz. nearly. 

Liquor Iodi 30 grs. in 1 fl. oz. 

Tinctura Iodi (Dose, 1-5 min.) 5£ grs. in 1 fl. oz. nearly. 

Unguentum Iodi 16 grs. in 1 oz. nearly. 

" Potassii Iodidi 1 part in 8| nearly. 

Unguentum Potassii Iodidi, U.S.P. and B.P. OINTMENT OF IODIDE OF POTAS- 
SIUM. Iodide of potassium 12, hyposulphite of sodium 1, boiling water 6, benzoated 
lard 81, U.S.P. Iodide of potassium, 64 grains, carbonate of potash, 4 grains, distilled 
water, 1 fluid drachm, prepared lard, 1 ounce. Dissolve the iodide of potassium and 
carbonate of potash in the water, and mix thoroughly with the lard, B.P. 

The ointment is apt to become discolored by the liberation of free iodine when 
iodide of potassium and lard only are used. The hyposulphite, U.S.P., is added in 
order that it may combine with any iodine set free, and the carbonate of potash, B.P., 
is also used to prevent this discoloration. 

U.S.P. Liquor Iodi Compositus. Iodine 5, iodide of potassium 10, distilled water 
85. The iodide of potassium is used to hold the iodine in solution. 

B.P. Uinimentum Potassii Iodidi cum Sapone. LlNIMENT OF IODIDE OF POTAS- 
SIUM and Soap. — It contains hard soap, iodide of potassium, glycerine, oil of lemon, 
distilled water. 

Actiox. — The action of iodide of potassium appears to depend partly 
on the iodine and partly on the potassium it contains. It differs from 
that of free iodine (p. 470) in being much less irritant. On this account 
it is of little use as a local stimulant, but it can be given in much larger 
doses. It has been supposed that iodine is set free from iodides in the 
stomach, but probably this is not the case, at least to any great extent, 
unless the iodides are contaminated with iodates. Iodide of potassium 
and other alkaline iodides are readily absorbed. It is conveyed by the 
blood to the various tissues of the body. It has been supposed by Binz 
to be partially decomposed by some of them, with the evolution of free 
iodine both in the blood and in the tissues, and he attributes its most 
important actions to this decomposition. The iodine set free from the 
iodide is taken up by albuminous substances, and the entrance of 



METALS. 519 

the iodine molecule into their composition causes them to undergo more 
rapid metamorphosis. Gummatous deposits appear to be especially 
affected in this way. 

Lead and mercury also appear to be set free by it, from their com- 
binations with the tissues, and entering once more into the circulation 
are eliminated. Iodides are eliminated very rapidly by the kidneys, 
salivary glands, probably by all mucous membranes, and by the skin. 
During the process of elimination iodine is occasionally set free and 
causes local irritation. This is especially marked in the mucous mem- 
brane of the nose, and in the skin, but it may occur also in the 
conjunctivae, bronchi, and stomach. The irritation of the nasal mucous 
membrane thus produced gives rise to the symptoms generally known as 
iodism. They are exactly the same as those produced by prolonged 
exposure to the fumes of iodine. They consist of running at the nose, 
and frontal headache, which probably depends upon swelling of the 
mucous membrane lining the frontal sinuses. There is also frequently 
running of the eyes. Not unfrequently the bronchial mucous mem- 
brane becoming congested there is cough and pain in the chest. These 
symptoms are most readily produced by small doses of 2-5 grains, and 
they may usually be arrested either by discontinuing the medicine or 
increasing the dose. When the dose is raised to 10 grains the symptoms 
usually disappear, and I have only seen one case in which they persisted 
after the dose had been raised to 30 grains. In some persons the con- 
gestion is not confined to the nose but extends to the back of the throat 
and to the larynx, so that serious symptoms of suffocation may follow 
the laryngeal congestion produced in them by iodide. As the iodine is 
eliminated in the tears, serious conjunctivitis may follow application of 
calomel to the eyes of persons who are taking iodide at the same time. 
Affections of the skin usually occur with large doses of iodide. The 
most common form of eruption is acne, but tubercular eruptions are also 
met with. They appear to be caused by decomposition of the iodide with 
elimination of free iodine in the sweat and sebaceous matter. They are 
said to be lessened by the simultaneous use of arsenic, and to be pre- 
vented by perfect cleanliness and daily baths. Occasionally the iodide 
causes gastric irritation with diminished appetite. It is readily excreted 
by the salivary glands, and may give rise to salivation (p. 315.) It 
sometimes gives rise not only to congestion of the bronchial mucous 
membrane and cough, but to haemoptysis, exudation into the pleural 
cavity, and even pneumonic consolidation. 

In some persons it greatly depresses the genital functions. 
• During its excretion by the kidneys it acts as a diuretic, though 
not a very powerful one. 

Uses. — Although iodide of potassium is probably absorbed in very 
small quantity by the unbroken skin, even when mixed with oil or fat, 
yet the iodide of potassium and soap liniment, especially when mixed 
with its own bulk of opium liniment, sometimes gives considerable relief 
when applied to inflamed and rheumatic joints by means of flannel or lint. 
Iodide of potassium is chiefly used, however, internally in syphilis, rheu- 
matism, scrofula and chronic poisoning by lead or mercury. In the 
primary and secondary stages of syphilis, mercury is generally used 



520 INORGANIC MATERIA MEDICA. 

either alone or in combination with iodine. In the tertiary stage, iodide 
of potassium is more generally given alone, although it is said by some 
to have but little effect unless mercury has been administered at some 
previous time. If this opinion be correct, the beneficial action of iodide 
of potassium may be due, in part at least, to its again liberating part of 
the mercury which has been in a state of more or less dormant combi- 
nation with some of the tissues. The powerful action of iodide of potas- 
sium in removing syphilitic deposits is readily seen when these deposits 
are superficial, as nodes on the shin or on the sternum, or when they can 
be readily seen like deposits in the larynx. Sometimes such deposits 
are unaffected by small doses, such as five grains of iodide, but disappear 
rapidly when the dose is increased to ten grains or more. From its 
beneficial action on visible deposits we may infer that it has a similar 
action on those which are deeply situated, and indeed sometimes we may 
observe enlargement and induration of the liver, probably dependent on 
a syphilitic condition, rapidly disappear under the use of the iodide. In 
chronic rheumatism, especially when the pain is worse at night, it is 
sometimes useful. 

It apparently increases the activity of the lymphatic system, and is 
used in enlargement of glands connected with this system, e.g., enlarged 
thyroid, enlarged spleen, and the enlarged lymphatic glands which occur 
in scrofula, as well as in scrofulous conditions generally. 

It is given wherever absorption is deficient and organs become hyper- 
trophied, e.g., the breasts, testicles, prostate, uterus, ovaria, &c. In 
cancer and tubercle it is of little benefit, but it is sometimes given, and 
possibly with benefit, in order to aid the absorption of pneumonic con- 
solidation. 

In bronchitis with much congestion and deficient secretion it is a 
useful expectorant, rendering the mucus more abundant and less tena- 
cious, so that it is more readily expectorated. 

As syphilitic skin diseases often disappear under its use it has been 
applied to other skin diseases not dependent on syphilis, such as psoriasis, 
lepra, herpes, impetigo, lichen, prurigo, sycosis, acne, lupus, &c, espe- 
cially in scrofulous patients. 

In frogs it destroys sensibility and voluntary motion, by acting on 
the spinal cord. It is useful in large doses to diminish the pain in cases 
of aneurism, and is also used in neuralgia, paralysis, convulsions, &c. 

The relief which it affords to the pain of aneurism is very marked, 
but it must be given in large doses, e.g., thirty grains. The benefit 
which it affords may be partly due to weakening of the circulation, 
partly to diminished sensibility by the action of the drug on the nervous 
system, and partly to beneficial alterations in the morbid condition of 
the walls of the affected vessels, which are often syphilitic in character. 

It is exceedingly useful, as already mentioned, in chronic metallic 
poisoning, e.g., by mercury or lead. 

It is used in dropsies as a diuretic, and is also employed as an 
emmenagogue. 

Potassii Bromidum, v.s.l*. andB.P. Bromide of Potassium. 
KBr. 



METALS. 521 

Characters. — In colorless cubical crystals, with no odor, but a 
pungent saline taste, readily soluble in water, less soluble in spirit. Its 
aqueous solution gives the reactions of potassium and a bromide. 

Impurity. — Iodide and bromate. 

Test — For the iodide vide p. 518. Bromate is detected by adding 
dilute sulphuric acid to the crushed crystals. They should not at once 
assume a yellow color. The acid liberates hydrobromic acid from the 
bromide, and if bromate be present the reaction between it and the hydro- 
bromic acid liberates free bromine. 5HBr -f HBr0 3 = 3H 2 -|- 3Br 2 . 

Action. — Bromide of potassium does not seem to have, like the 
iodide, any marked influence on the lymphatic system ; and although it 
has been occasionally used instead of the iodide in lymphatic swellings 
and enlargements of organs, this use of it is not general. When swal- 
lowed in small doses it produces no effect, but when taken in large 
doses for a considerable time it causes an eruption like acne upon the 
face, the complexion at the same time becoming muddy or bronzed. The 
chief symptoms are, however, impairment of the functions of the spinal 
cord and the brain. There is a great diminution of reflex action, so 
that touching the pharynx no longer produces any tendency to vomit, 
even though the touch itself be felt. There is drowsiness and heaviness, 
a great inclination to sleep and insensibility to outward impressions, the 
memory is impaired, the speech becomes hesitating and articulation 
imperfect, the intellect is less clear, the genital functions are much 
diminished, the gait becomes tottering and unsteady and the muscles 
weak. To these symptoms the name of bromism is given. 

Uses. — Its chief use is in nervous diseases for the purpose of 
producing sleep, allaying excitement, and diminishing spasm. 

Bromide of potassium is most useful as a hypnotic in cases of sleep- 
lessness due to mental excitement and worry. Some persons, after hard 
study or close attention to business, instead of sleeping at night are no 
sooner in bed than the brain seems to become doubly active, the carotids 
throb and they toss about from side to side trying in vain to get rid of 
the ideas which come in a constant train before them. In such cases 
when bromide of potassium is taken, the throbbing of the carotids and 
temporals and the fulness in the head disappear and sleep is induced. A 
dose of 10-15 grains given before bed-time may be sufficient in mild 
cases, but when the agitation is great 30 or 40 grains must be given, and 
should be assisted by cold ablution to the head and a prolonged warm 
foot-bath. The dose may be repeated, if necessary, every hour or two 
hours, until the desired effect has been obtained. One great advantage 
that bromide of potassium possesses over other hypnotics is that it can be 
pushed without fear, and the same is true of other bromides. They are 
not dangerous to life, and even when they are pushed so far as to cause 
bromism, the symptoms usually pass off rapidly when the drug is discon- 
tinued. 

It is very useful in lessening the excitability, susceptibility to worry, 
and irritability of temper from which gouty persons often suffer. It 
should be given with a considerable proportion of water. 

In delirium tremens where there is sleeplessness with fearful visions 
it may be given in doses from 20-30 grains or even more, every two 



522 INORGANIC MATERIA MEDICA. 

hours till sleep is induced. It is of most benefit in the earlier stages 
before the delirium has become furious, and is useful also at the end of 
the attack in dispelling delusions which may still remain. 

During the later months of pregnancy, women are sometimes troubled 
at night with the imagination that they have committed or are about to 
commit some great crime, such as murdering their husbands or children, 
and these delusions, according to Ringer, are removed by potassium 
bromide. 

It is also useful, he says, in the treatment of night screaming in 
children apparently allied to nightmare. They awake out of sleep 
screaming, seem very much frightened, and do not appear to recognize 
their mother or other friends who try in vain to soothe them. In the 
sleeplessness of mania it is frequently, though not always successful. It 
may be used in fevers and inflammation when sleep is absent, and whenever 
opium and belladonna or hyoscyamus fail to produce sleep or cause 
sickness. 

In convulsive nervous affections such as whooping cough, 
laryngismus stridulus and spasmodic asthma, it is very useful, and also 
to some extent in St. Vitus's dance and hysteria. 

It is especially beneficial in epilepsy, and by its use the convulsions 
can almost always be lessened if not entirely stopped. A similar result 
has been obtained in experiments on animals (p. 172). It is not so useful 
when the convulsions are violent, and is not so beneficial when there is 
only a transitory loss of consciousness as in petit mal. It is perhaps, 
however, not so much a curative as an alleviative remedy, and the fits 
are apt to return when its administration is discontinued- 
It is useful in relieving sickness, especially in pregnancy. In sea- 
sickness it is perhaps more useful than any other remedy. It should be 
taken in thirty-grain doses twice or thrice a day, for a day or two before 
the voyage begins, and should be kept up while it continues. In severe 
cases it may be necessary to push the bromide so far as to keep up a state 
of more or less somnolency and stupidity during the whole voyage. 

From its power of lessening the sexual passion it is used as an 
anaphrodisiac in priapism and nymphomania. 

It is also useful in menorrhagia, especially when this occurs in young 
women, according to Ringer, while Ganod says it is more useful in old 
women. 

It is useful in neuralgia occurring in dibilitated subjects, and some- 
times accompanied by flushed face with cold hands and feet. It has been 
used in diabetes. 

SODIUM. Na; 23. 

Sources of Soda Salts. — The chief source of soda is common salt 
obtained by the evaporation of sea-water, or from salt mines. Two 
subsidiary sources are the nitrate of soda and borax, both of which are 
found native. 

General Reaction of Soda Salts. — They are not precipitated by 
any of the ordinary reagents. The special test for them is the yellow 
color which they give to flame. The mere appearance of the yellow 
color is the test adopted by the British Pharmacopoeia, but it is improved 



METALS. 



523 



upon in the American Pharmacopoeia, which directs that the flame should 
not appear more than transiently red when observed through a blue 
glass. In this way soda salts are both more readily distinguished from 
those of potash, and the presence of the slightest impurity is easily 
observed ; for soda salts are so widely distributed in nature, and the 
yellow color which they give to the flame is so bright, that minute 
quantities of soda mixed with potash may disguise the violet color which 
the potash gives, although it should be present in much greater quantity 
than the soda. To distinguish between potash salts and soda salts, it is 
therefore necessary to look at the flame through a blue glass which cuts 
off the yellow rays emitted by the sodium of the flame, and allows thus 
the violet ones of the potassium to be seen. 



Peepaeatton of Soda Salts. 





Prepared from 


By 


Sodium sulphate. 


Sodium chloride. 


Heating with sulphuric acid in the prepa- 
ration of hydrochloric acid. 


Sodium carbonate. 


Sodium sulphate. 


Eoasting with calcium carbonate and coal. 


Dried sodium car- 
bonate. 


Sodium carbonate. 


Heating. 


Sodium bicarbon- 
• ate. 


Do. 


Mixing with dry carbonate and saturating 
with carbonic acid. 


Sodium acetate. 


Do. 


Neutralizing with acetic acid. 


Effervescent citro- 
tartrate. 


Do. 


Heating dry carbonate with tartaric and 
citric acids. 


Tartrate of soda 
and potash (soda 
tartarata). 


Do. 


Neutralizing solution with acid tartrate 
of potash, evaporating and crystallizing. 


Sodium benzoate, 
U.S.P. 


Do. 


Neutralizing a hot solution with benzoic 
acid and crystallizing. 


Sodium phosphate. 


Do. 


Decomposing bone ash with sulphuric acid, 
and saturating the acid phosphate of cal- 
cium thus obtained with sodium carbonate 


Sodium hypophos- 
phite. 


Do. 


Decomposing hypophosphite of lime with 
sodium carbonate. 


Liquor sodae chlo- 
ratae. 


Do. 


Passing chlorine through its solution. 


Sodium salicylate, 
U.S.P. 


Do. 


Neutralizing solution by salicylic acid 
with slight excess of acid and evap- 
orating. 


Sodium sulphocar- 
bolate, U.S.P. 

• 


Do. 


Decomposing by barium sulphocarbolate. 
The barium sulphocarbolate is prepared 
by mixing equal parts of carbolic and 
strong sulphuric acid, allowing them to 
stand for some days, diluting and neu- 
tralizing with barium carbonate. 


Sodium bisulphite, 
U.S.P. 


Do. 


Saturating its solution with sulphurous 
acid. 



524 



INORGANIC MATERIA MEDICA. 
Preparation of Soda Salts — (continued). 





Prepared from 


By 


Sulphite. 

Hyposulphite. 
Borax. 


Sodium bisulphite. 
Sulphite. 


Adding an equal weight of sodium car- 
bonate to the bisulphite prepared as 
above. 

Heating with sulphur. 

Found native. 

Found native. 

Fusing with arsenious acid. 




Arseniate. 


Carbonate and ni- 
trate. 



General Impurities of Sodium Salts. — As sodium carbonate is 
prepared from sodium sulphate, and the latter from sodium chloride, sul- 
phates and chlorides may be present as impurities in it. As the other 
sodium salts are chiefly obtained from the carbonate, chlorides and sul- 
phates also come to be present as impurities in them. They also occur even 
in the nitrate of soda found native. 

General Tests for Impurities in Soda Salts. — In order to dis- 
tinguish between salts of potash and soda, as well as to prove the absence 
of potash as an impurity, the U.S. P. directs that the yellow color which 
sodium salts give to the flame should not appear more than transiently 
reel, and the B.P. directs that the solutions of soda salts, when acidulated, 
should not give a precipitate with perchloride of platinum. The absence 
of chlorides and sulphates is ascertained by the usual tests, and the absence 
of metals by the want of any color or precipitate on the addition of hydro- 
sulphuric acid or ammonium sulphide. 

General Action of Sodium Salts. — Salts of sodium diffuse more 
slowly than those of potassium. They are neither absorbed nor excreted 
so readily, and have not a marked diuretic action. When locally applied 
to muscle and nerve in large doses they paralyze both, but not so 
powerfully as salts of potassium, nor have they such a paralyzing action 
upon the involuntary muscle, either of the heart or the intestine. In 
large doses they lengthen the muscular curve, and increase the length of 
the curves produced by calcium and strontium instead of shortening them 
like potassium (p. 137). 

Crate of sodium is less soluble than urate of potassium or lithium. It 
is therefore less readily excreted, and forms the nodules known by the 
name of chalk stones in gouty patients. 

Sodii Chloridum, TJ.S.P. and B.P. Chloride of Sodium. 
Common Salt. NaCl; 58-4. 

Characters and Tests. — In small white crystalline grains, or 
transparent cubic crystals, free from moisture, has a purely saline taste, 
imparts a yellow color to flame, is soluble in water. The solution gives 
the reaction of a chloride, and does not give that of potassium. 

Preparations in which Chloride of Sodium is used. 

Acidum Hydrochloricum. Hydrargyri Perchloridum. 

Hydrargyri Subchloridum. 



METALS. 525 

Actions. — Although chloride of sodium is not much used as a 
remedy, it is most important as a food. It forms a large proportion of 
the salts of the body, and no doubt plays a very important part in tissue 
change. When persons are deprived of it for a length of time, the 
longing for it becomes intense, and animals will go very great distances 
to obtain it. When mixed with water, in the proportion of 0*65 to 100, 
tlie solution does not destroy animal tissues like water alone, 
and may be mixed with blood without destroying the corpuscles. Strong 
solutions, however, are intensely irritating. When injected into the 
lymph sac of a frog it causes increased diapedesis of the red corpuscles, 
which then pass out through the vessels in considerable numbers. It is 
possible that an increase in the proportion of sodium chloride may have 
something to do with the production of scurvy, as this disease appears to be 
relieved by salts containing another base than sodium and another acid 
radical than chlorine. 

Uses. — Externally it is used as a stimulant to the skin in the form 
of baths (pp. 395 and 403). A solution of salt of J to 1 per cent, has 
been recommended by Kuhne to wash wounds and raw surfaces in place 
of water, as it does not destroy the vitality of the tissues, and a similar 
solution may be used instead of water to wash out the nasal cavities, 
either alone, or mixed with other medicaments. When taken in consid- 
erable quantities it produces vomiting, and may be used as an emetic, 
either alone or to aid the action of other emetics. Half a teaspoonful 
of dry salt, repeated until nausea is produced, is said sometimes to arrest 
haemoptysis. It appears to diminish the secretion of mucus, and may be 
given to children suffering from worms, where the intestinal mucus is 
excessive and affords a nidus for the parasites. 

After haemorrhage there is generally excessive thirst, and the addi- 
tion of chloride of sodium to the water drunk by the patient has been 
recommended in order to prevent destruction of the blood corpuscles 
which might arise from the absorption of slight amounts of pure water. 
During convalescence patients sometimes exhibit a desire for salt and 
indigestible food, which, if given, would probably derange the digestion, 
but the craving may be allayed by giving salt alone. It has been used 
in bilious diarrhoea, in doses of 10 to 60 grains, three or four times a day. 

As an enema to destroy ascarides it is frequently used. The pro- 
portion generally is 1 or 2 tablespoonfuls to the pint of water. 

Sodii Carbonas, U.S. P. ; Sodae Carbonas, B.P. CARBONATE 
of Soda. Na 2 CO 3 10H 2 O ; 286. 

Obtained from the ashes of marine plants, or produced by chemical 
decomposition with chloride of sodium. 

Characters and Tests. — In transparent, colorless, laminar crystals, 
of a rhombic shape, efflorescent, with a harsh alkaline taste and strong 
alkaline reaction. By heat it undergoes aqueous fusion, and then dries 
up, losing 63 per cent, of its weight. 

20 grains 1 , -.. (9*7 grains Citric Acid. 

Carbonate of Soda j \ 10J grains Tartaric Acid. 

Dose. — 5 to 30 grains. 



526 INORGANIC MATERIA MEDICA. 

Peepaeations. 

B.P. DOSE. 

Sodae Carbonas Exsiccata. Dried carbonate of soda (used for pills.)... 3-10 grs. 

Uses. — It is not much used as a remedy. Its chief use is in the 
preparation of other soda salts. A dilute solution of it may be used as a 
wash to the skin to remove itching. 

Soda, U.S.P. ; Soda Caustica, B.P. Soda, U.S.P. ; Caustic 
Soda, B.P. — Hydrate of soda, NaHO, 40, with some impurities. 

Characters and Tests. — Hard, grayish-white pencils or fibrous 
pieces, deliquescent in moist air, dry and efflorescent in dry air, very 
alkaline and corrosive. It gives the tests of sodium and not of potassium. 
It imparts a yellow color to flame, and its solution in water, acidulated by 
nitric acid, effervesces only slightly (limit of carbonate) and gives only 
scanty white precipitates with nitrate of silver and chloride of barium 
(limit of chlorides and sulphates). 

Impurities. — Carbonate, chlorides and sulphates. 

Peepaeation containing Caustic Soda. 
Liquor Sodse 18*8 grains in 1 fluid ounce. 

Use. — Is used as a caustic like potash, but has less affinity for 
water, and so does not take it from the tissues and destroy them so pow- 
erfully. At the same time it has less tendency to run over adjacent parts. 

Liquor Sodse, U.S.P. and B.P. Solution OF Soda. — An aqueous 
solution of hydrate of sodium (NaHO ; 40) containing about 3 per cent, 
of the hydrate, U.S.P. (44 per cent. B.P.). 

Characters. — Like those of liquor potassse, but it is not precipitated 
by tartaric acid, nor by perchloride of platinum. 

Uses. — Is used in preparing ferric oxide and in other pharmaceutical 
processes, as it is cheaper than solution of potash. Internally it may act 
on the blood, rendering it and the secretions more alkaline, but will not 
alter nutrition in the way that potassium salts do. 

Sodii Bicarbonas, U.S.P.; Sodse Bicarbonas, B.P. Bicar- 
bonate of Soda. NaHC0 3 ; 84. 

Characters and Tests. — In powder, or small opaque irregular 
scales, white, of a saline not unpleasant taste. It gives the reactions 
showing the presence of sodium, and of carbonic acid. It is distin- 
guished from carbonate by its solution in cold water giving a white and 
not a colored precipitate with solution of perchloride of mercury. 

20 grains of Bicar- ) r ( 16*7 grains of Citric Acid, or 

bonate of Soda J (17*8 grains Tartaric Acid. 

Dose. — 10 to 60 grains. 

Peepaeations containing Bicaebonate of Soda. 

U.S.P 

Bodll Bicarbonas Venalls. COMMERCIAL BICARBONATE OF Soda. — Should con- 
tain 95 per cent., of pure bicarbonate, which it resembles in appearance and tests. 

Mlsturee Bhel <t Sodee. MIXTURE of Rhubarb and Soda. — Bicarbonate of 
soda 3. fluid extract of rhubarb 3, spirit of peppermint 3, water q. s. to make 100. 






METALS. 527 

Preparations containing Bicarbonate of Soda. 

b.p. DOSE. 

Liquor SotUe Effervescens (soda water) 30 grains in 1 pint i-1 pint. 

Sodae Citro-tartras Effervescens 17 parts in 31 6 grs. to | oz. 

Trocliisci Soda? Bicarbonatis 5 grains in each lozenge.,1 to 6. 

Uses. — Bicarbonate of soda has a slight local irritant action. It 
may be used as a wash in cases of itching skin diseases, e.g., prurigo, 
and as a lotion to eczema. The strength is 2 grains to the ounce, and 
it is applied like water dressing. 

A solution of this strength when used to rinse the mouth sometimes 
relieves the pain of toothache, and also relieves headache, either tempo- 
ral or occipital, depending on decayed teeth, even though no pain should 
be felt in the tooth itself. 

It may also be used to prevent injury to the teeth from acid 
tonics. 

Mixed with tincture of opium, and introduced into the cavity of a 
decayed tooth by means of a pledget of cotton-wool, it will often arrest 
the pain of toothache. When swallowed, it stimulates the secretion of 
gastric juice, and is a most efficient remedy when given from ten minutes 
to half an hour before meals, in cases of atonic dyspepsia, where the 
patient complains of weight or pain at the pit of the stomach, pain 
between the scapulae, and much flatulence unaccompanied by constipa- 
tion. In such cases it is often advantageous to combine it with a bitter 
tonic and some carminative. As dyspepsia often occurs in persons 
engaged in business who cannot carry mixtures about with them, the 
lozenges (B.P.) are very useful, for they can be easily carried about and 
taken when necessary. 

It also relieves frontal headache, unaccompanied by constipation, 
where the headache is situated just at the junction of the forehead with 
the hairy scalp. Frontal headache, lower down, just above the eye- 
brows, is better treated by nitro-hydrochloric acid. In persons who 
suffer from great acidity after meals, it may be used as an antacid. A 
solution of J or 1 grain to the ounce of water or milk is exceedingly 
useful in the diarrhoea and marasmus of infants. 

It is also serviceable in cases of diabetes, to lessen the amount of 
sugar. It renders the bronchial secretion less tenacious, but is not so 
useful as bicarbonate of potash. The lozenges are very convenient in 
such cases. 

It seems to have less tendency than potash to produce catarrh of the 
stomach, and may be used for a longer time (p. 507). 

As soda naturally exists in large quantity in the blood, the amount 
we can add is but a small fraction of that quantity, and its alterative 
action is very slight. It will increase the alkalinity of the blood, and 
has been given instead of bicarbonate of potash in acute rheumatism, 
but it is perhaps not so good. The urate of soda is not so soluble as 
that of potash, so it is not so good in uric acid diathesis, and its diuretic 
power is also less. 

B.P. Sodae Citro-Tartras Effervescens. Effervescent 
Citro-Tartrate of Soda. 



528 INORGANIC MATERIA MEDICA. 

Characters. — A granular powder which effervesces on the addition 
of water. 

Dose. — 60 grains to \ ounce. 

Use. — If absorbed there may be some slight difference between the 
effect of this salt and of tartarated soda, which contains some potash, 
but this is very slight, and of no importance. It is used only for its 
laxative effect. It is both pleasanter to take than tartarated soda, and 
it is less likely to cause unpleasant feelings in the stomach. 

Potassii et Soclii Tartras, U.S. P.; Soda Tartarata, B.P. 

Tartrate of Potassium and Sodium, U.S. P.; Tartarated Soda, 
B.P. Rochelle Salt. NaKC 4 H 4 6 .4H 2 0; 282. 

Characters and Tests. — In colorless, transparent prisms, or halves 
of prisms, of the right rhombic order, generally eight-sided ; tasting like 
common salt. Heated with sulphuric acid it blackens, evolving inflam- 
mable gases and the odor of burnt sugar (tartrate). It imparts a yellow 
color to flame (sodium). A strong solution gives a crystalline precipi- 
tate with a small quantity of acetic acid (potassium). 

Impurity. — Bitartrate of potash. 

Test. — Entirely soluble in cold water. 

Dose. — \ to \ ounce; as diuretic, 30 to 60 grains. 

Uses. — In large doses it retains water, quickens peristalsis, acts as a 
purgative and is chiefly used as such. In small doses it is absorbed 
from the intestines, is converted in the blood into carbonate of potash 
and soda, causes diuresis and renders the urine alkaline. It may be 
used as a remote antacid. 

Soclii Acetas, U.S.P. ; Sodse Acetas, B.P. Acetate or 

Sodium, U.S.P. ; Acetate op Soda, B.P. NaC 2 H 3 2 .3H 2 0; 136. 

Characters and Tests. — In transparent colorless crystals, soluble 
in water, forming a solution which gives the reactions of sodium and an 
acetate. 

Peeparations in which Acetate of Soda is used. 
Ferri Arsenias. Ferri Phosphas. Syrupus Ferri Phosphatis. 

Use. — Is converted in the blood into carbonate. Is a less powerful 
diuretic than the corresponding salt of potash. 
Dose. — 20 to 60 grains. 

Sodii Boras, U.S.P. ; Borax, B.P. Borate op Sodium, U.S.P. ; 
Borax, B.P. Biborate of. Soda. Na 2 B 4 O 7 .10H 2 O; 382. 

A native salt. It is also made artificially by boiling together, in 
proper proportions, boracic acid and carbonate of soda. 

Characters and Tests. — In transparent, colorless crystals, some- 
times slightly effloresced, with a weak alkaline reaction; insoluble in 
rectified spirit, soluble in water. A hot saturated solution, when 
acidulated with any of the mineral acids, lets fall, as it cools, a scaly 
crystalline deposit (boracic acid), the solution of which in spirit burns 
with a green flame. 

Dose. — 5 to 40 grains. 



METALS. 529 

Preparations, 
b.p. 

Glycerinum Boracis 1 part in 6 by weight = (1 oz. in 4 fluid oz. glycerine.) 

MelBoracis 56 grains in 1 ounce. 

Uses. — Borax destroys low vegetable organisms and prevents their 
germination. It thus acts as a disinfectant. Applied to the skin, 
it removes the epidermis, and may be used for this purpose instead 
of soap. It is used as a lotion in acne. It forms a useful wash to 
remove scurf from the head, chloasma or liver spots, and to allay 
itching in urticaria, psoriasis, impetigo, and pruritus pudendi, scroti, 
and ani. As an injection it is useful in leucorrhoea and gonorrhoea. 
It is much employed in aphthous conditions of the mouth and throat, 
either alone or combined with chlorate of potash. It may be given 
simply in solution, or in the form of the honey, or glycerine. It 
has been supposed to have a special action upon the uterus, and 
has been employed in amenorrhoea, dysmenorrhoea, and puerperal fever 
and convulsions. On account of its asserted power to increase the 
uterine contraction, it ought either to be avoided or employed with 
care during pregnancy. Borax is useful in some cases of epilepsy in 
doses of 10-15 grains three times a day. It acts as a solvent to 
benzoic acid. 

Sodii Sulphas, U.S.P. ; Sodse Sulphas, B.P. Sulphate of 
Sodium, U.S. P.; Sulphate of Soda, B.P. Glauber's Salt. Na 2 
SO 4 10H 2 O; 322. 

Preparation, B.P. — May be obtained from the residue left in the 
manufacture of hydrochloric acid, by neutralizing it with carbonate of 
soda, and crystallizing from solution in water. 

Characters and Tests. — In transparent oblique prisms ; has a salt 
and bitter taste; effloresces on exposure to the air; soluble in water, 
insoluble in spirit. It gives the reactions of sodium and of a sulphate. 

Dose. — J- to 1 ounce. 

Uses. — Sulphate of soda, when introduced into the stomach, is sup- 
posed to excite peristaltic movements in it, and to have a similar action 
upon the intestine. It produces in the intestine a secretion of watery 
fluid, and acts as a purgative. It is used either alone, or mixed with 
bicarbonate of soda, in ulcer of the stomach, chronic gastritis, and dilata- 
tion of the stomach. A mixture of sulphate and bicarbonate of soda has 
been used in imitation of the Carlsbad salts obtained by evaporation of 
the natural mineral water of Carlsbad. The mixture, or the natural 
salts, ought to be taken dissolved in warm water immediately after rising, 
and it is better to sip the solution at intervals, while dressing, than to 
drink the whole off* at a draught (p. 354). One-third of a teaspoonful of 
the crystallized salts in a large tumblerful of warm water, taken imme- 
diately on rising, is frequently sufficient to produce one free action of 
the bowels after breakfast and no more. This quantity of salts, with a 
smaller quantity of water, may have no action ; and if a smaller quantity 
of water be used along with a larger quantity of salts it not unfrequently 
happens that several scanty motions occur during the day with consider- 
able discomfort in the abdomen. 
34 



530 INORGANIC MATERIA MEDICA. 

Carlsbad water, natural or artificial, is also useful in bilious disor- 
ders, and in persons of a gouty diathesis. A gentle course will often 
remove the dulness, irritability, and other symptoms which accompany 
biliary derangements or precede a gouty attack. It may be used, also, 
with advantage in chronic constipation and tendency to congestion of the 
brain or of the abdominal and pelvic organs. A continued course of the 
water is exceedingly beneficial in cases of excessive obesity, and also in 
diabetes mellitus. 

The Carlsbad waters contain a number of other salts which are not 
crystallized out, and they often prove much more efficient when drunk at 
the springs than the solution of the salts taken by patients at their own 
homes. The great benefit which is often obtained from a course of the 
waters at Carlsbad is no doubt due in great measure to the diet and 
regimen which patients will follow there in company with others, but 
which nothing would induce them to conform to while at home. 

Soclii Pliosphas, U.S. P.; Sodse Pliosplias, B.P. Phosphate 
of Sodium, U.S.P.; Phosphate of Soda, B.P. Na 2 HP0 4 .12H 2 0; 

358. 

Characters and Tests. — In transparent, colorless, rhombic prisms, 
terminated by four converging planes, efflorescent, tasting like common 
salt. It imparts a yellow color to flame. Its solution has a faintly alkaline 
reaction, it gives a yellow precipitate with nitrate of silver, the resulting 
fluid acquiring an acid reaction (phosphate). 

Dose. — As purgative J to 1 ounce. As alterative 20 to 40 grains. 

Uses. — It is used as a purgative in children and in delicate persons, 
both because it acts gently and has little or no taste. It may be easily 
given to children in a little soup without their knowing it. 

It has been used in fevers as a purgative, and in rickets in order to 
supply phosphoric acid to the bones. It has been found especially useful 
in children with hepatic derangement, as shown either by white or green 
stools, or by jaundice. The dose for them is 3 to 10 grains given in 
food or milk. 

U.S.P. Sodii Cliloras. Chlorate OF Sodium. NaC10 3 ; 106-4. 

Characters. — Colorless, transparent tetrahedrons, of the regular 
system ; permanent in dry air, odorless, having a cooling saline taste and 
a neutral reaction. Soluble in 1*1 parts of water and in 40 parts alcohol 
at 15° C. (59° F.) ; in 0*5 part of boiling water and in 43 parts of 
boiling alcohol. When heated the salt melts, and afterwards gives off a 
portion of its oxygen, finally leaving a residue of sodium chloride which 
gives the reaction peculiar to it. 

Uses. — Similar to those of chlorate of potassium. As it is more 
soluble, stronger solutions can be employed. 

Sodii Hypophospliis, U.S.P. ; Soda? Hypophospliis, B.P. 

Hypophospiiitk of Sodium, U.S.P. ; of Soda, B.P. NaH 2 P0 2 .H 2 ; 106. 

Characters. — Small, colorless or white, rectangular plates, or a 

white granular powder, deliquescent on exposure to air, odorless, having 

a sweetish saline taste and a neutral reaction. Soluble in 1 part of water 

JO parts of alcohol at 15° C. (59° F.) ; in 0*12 part of boiling 



METALS. 531 

water and in 1 part of boiling alcohol. When heated in a dry test-tube 
the salt loses water, and then evolves a spontaneously inflammable gas 
(phosphoretted hydrogen), burning with a bright yellow flame. A 
fragment of the salt imparts to a non-luminous flame an intense yellow 
color, not appearing more than transiently red when observed through a 
blue glass. On triturating or heating the salt with an oxidizing agent 
the mixture will explode. 
Dose. — 1 to 5 grains. 

Preparation. 

U.S. p. 

Syrupus Hypophosphitum. 

Uses. — It is said to have a stimulating action upon the nervous 
system, and to increase digestion and nutrition. It is chiefly given 
in the earlier stages of phthisis, and in anaemia and nervous debility. 

U.S. P. Sodii Benzoas. Benzoate of Sodium. NaC 7 H 5 2 . 
H 2 0; 162. 

Characters. — A white, semi-crystalline, or amorphous powder, 
efflorescent on exposure to air, odorless, or having a faint odor of benzoin, 
of a sweetly astringent taste, free from bitterness, and having a neutral 
reaction. 

Tests. — "When heated the salt melts, emits vapors having the odor 
of benzoic acid, then chars, and finally leaves a blackened residue of an 
alkaline reaction and exhibiting the reactions of sodium. On mixing an 
aqueous solution of the salt with a dilute solution of ferric sulphate a 
flesh-colored precipitate is produced. 

Dose. — 10 to 20 grains. 

Uses. — It has been strongly recommended as a remedy in phthisis, 
and has also been used in puerperal fever and to eliminate uric acid in gout. 

U.S.P. Sodii Bromidum. Bromide of Sodium. ISTaBr; 102-8. 

Characters. — Small, colorless, or white monoclinic crystals, or a 
crystalline powder permanent in dry air, odorless, having a saline, slightly 
bitter taste, and a neutral or faintly alkaline reaction. Soluble in 1*2 
parts of water and in 13 parts of alcohol at 15° C. (59° F.). It gives 
reactions of sodium, and if disulphide of carbon be poured into a solution 
of the salt, then chlorine water added drop by drop, and the whole 
agitated, the disulphide will acquire a yellow or yellowish-brown color 
(bromide) without a violet tint (absence of iodide). 

Dose. — 15 to 60 grains. 

Action. — Its actions are the same as those of bromide of potassium, 
but it is said to be less irritating to the stomach. 

U.S.P. Sodii Iodidum. Iodide of Sodium. Nal; 149'6. 

Characters. — Minute, colorless, or white monoclinic crystals, or a 
crystalline powder, deliquescent on exposure to air, odorless, having a 
saline and slightly bitter taste and a neutral or faintly alkaline reaction. 
Soluble in 0*6 part of water and in 1*8 parts of alcohol at 15° C. (59° F.). 
If disulphide of carbon be poured into a solution of the salt, then 
chlorine water added drop by drop, and the whole agitated, the disul- 
phide of carbon will acquire a violet color. 

Dose. — 5 to 30 grains. 



532 INORGANIC MATERIA MEDICA. 

Uses. — It is employed in place of iodide of potassium. Its physio- 
logical actions are almost exactly the same, but it appears to irritate the 
stomach less and may thus be given in larger doses. 

U.S.P. Sodii Pyropliosplias. Pyrophosphate of Sodium. 
Na 4 P 2 O 7 .10H 2 O ; 446. 

Characters. — Colorless, translucent, monoclinic prisms, permanent 
in the air, odorless, having a cooling, saline and feebly alkaline taste, 
and a slightly alkaline reaction. Soluble in 12 parts of water at 15° C. 
(59° F.) and in 1*1 parts boiling water; insoluble in alcohol. Its 
aqueous solution with excess of test solution of nitrate of silver gives a 
white precipitate and a neutral filtrate. 

Action. — Its actions in medicinal doses appear to be nearly the 
same as those of the phosphate, but probably it would have a greater 
influence on the nervous system. 

Uses. — To prepare the pyrophosphate of iron. 

XJ.S.P. Sodii Salicylas. Salicylate of Sodium. 2NaC 7 H 5 3 . 
H 2 0; 338. 

Characters. — Small, white, crystalline plates, or a crystalline 
powder, permanent in the air, odorless, having a sweetish saline and 
mildly alkaline taste and a feebly acid reaction. Soluble in 1*5 
parts of water and in 6 parts of alcohol at 15° C. (59° F.); very soluble 
in boiling water and in boiling alcohol. When heated the salt gives off 
inflammable vapor and leaves an alkaline residue amounting to between 
30 and 31 per cent, of the original weight, and which gives the reac- 
tion of sodium carbonate. 

Dose. — In rheumatism with high temperature, 10-20 grains every 
two to four hours. The addition of some aromatic spirit of ammonia, or 
alcohol in some form, tends to lessen the cardiac depression which the 
salicylate alone may cause. 

Action. — It agrees in its action with salicylic acid, excepting that 
it has no power to destroy low organisms. In febrile conditions, and 
especially in acute rheumatism, it greatly lowers the temperature and 
lessens the pain. Its use should be continued for some time after appa- 
rent convalescence, as the temperature is apt to rise again when the 
administration of the remedy ceases. In small doses it is useful in 
chronic rheumatism. In doses of J to 2J- grains every quarter or half 
hour it will often cut short headaches. The symptoms of its physio- 
logical action are the same as those of salicylic acid, ringing in the ears, 
&c. (p. 205). These symptoms may be lessened by ergot, hydrobromic 
acid, or bromides. It renders the bile more watery, and may be used 
to prevent gall stones. 

U.S.P. Sodii Santoiiinas. Santonin ate of Sodium. 2NaC 15 
H 19 4 -m 2 0; 698. 

Preparation. 

Trochisci Sodii Santoninatis. Dose — 1 grain in each. 

CHARACTERS. — Colorless, transparent, tabular, rhombic crystals, 
slowly colored yellow by exposure to light, slightly efflorescent in dry 
air, odorless, having a mildly saline and somewhat bitter taste, and a 



METALS. 533 

slightly alkaline reaction. The "aqueous solution, on the addition of 
hydrochloric acid, deposits a crystalline precipitate, which is soluble in 
chloroform, and which yields, with alcoholic solution of potassa, a scarlet- 
red liquid gradually becoming colorless. 

Dose. — 8 to 10 grains. 

Uses. — This substance has been introduced into the U.S. P. as an 
anthelmintic. It is much more easily absorbed than santonin, and it 
will therefore have a much greater action on the system. This is exactly 
what is not wanted in the case of an anthelmintic, where the medicine 
is given to kill the worm in the intestine and not for its action on the 
organism. 

U.S.P. Sodii Sulphis. Sulphite of Sodium. Na 2 So 3 .7H 2 0; 
252. 

Characters. — Colorless, transparent, monoclinic prisms, efflorescent 
in dry air, odorless, having a cooling saline and sulphurous taste, and a 
neutral or feebly alkaline reaction. Addition of diluted hydrochloric 
acid to the aqueous solution gives rise to the odor of burning sulphur, 
and the solution does not become cloudy (difference from hyposulphite). 

Dose. — 1 drachm (3-9 Grm.). 

Uses. — A solution of 1 part in 8 of water is used in cases of aphthee 
in the mouth ; it has been given also to destroy sarcinge and torulse in 
cases of yeasty vomiting. 

U.S.P. Sodii Bis ulpliis. Bisulphite of Sodium. NaHS0 3 ; 
104. 

Characters. — Opaque, prismatic crystals, or a crystalline or gran- 
ular powder, slowly oxidized, and losing sulphurous acid on exposure to 
air, having a faint sulphurous odor, a disagreeable sulphurous taste, and 
an acid reaction (distinguishing it from the sulphite). When strongly 
heated the salt decrepitates, and is converted into sulphur and sulphate 
of sodium. 

On adding hydrochloric acid to an aqueous solution of the salt sul- 
phurous vapors are evolved and the solution does not become cloudy 
(difference from hyposulphite). 

Dose. — 15 to 60 grains. 

Uses. — The same as those of the sulphite. 

U.S.P. Sodii Sulpliocarbolas. Sulphocarbolate OF Sodium. 
NaC 6 H 5 S0 4 .2H 2 ; 232. 

Characters. — Colorless, transparent, rhombic prisms, permanent in 
the air, odorless, or nearly so, having a cooling, saline, somewhat bitter 
taste, and a neutral reaction. The dilute aqueous solution of the salt is 
colored violet by test solution of ferric chloride. 

Dose. — 10 to 15 grains. 

Uses. — Used in flatulence, in dyspepsia occurring in phthisical 
patients, and in septic conditions. 

B.P. Sodae Valerianas. Valerianate OF Soda. NaC 5 H 9 2 . 

Characters. — In dry white masses, without alkaline reaction, 
entirely soluble in rectified spirit, and giving out a powerful odor of 
valerian on the addition of diluted sulphuric acid. 



534 



INORGANIC MATERIA MEDICA. 



Preparation. — B y distilling amylic alcohol with a mixture of dilute 
sulphuric acid and an aqueous solution of bichromate of potash : 2K 2 
Cr 2 7 + 8H 2 S0 4 = 2(Cr 2 3S0 4 ) + 2K 2 S0 4 + 8H 2 + 30 2 ; and C 5 H n 
HO -f 2 = HC 5 H 9 2 -f- H 2 0. The valerianic acid thus obtained 
saturated with a solution of soda and dried : 
NaC 5 H 9 2 + H 2 0. 

Dose. — J to 5 grains. 



is 



HC 5 H 9 2 



+ NaHO = 



Peepakatiox in which Valerianate of Soda is used. 
Zinci Valerianas. 



Use. — As an antispasmodic in hysteria, 
making the zinc salt. 

LITHIUM. Li: 7. 



It is chiefly used for 



Sources of Lithium. — Native silicates and phosphates of lithium 
and other metals. 

Reaction. — It is recognized by the red color which it gives to 
flame. This appears to be more brilliant when the salt is first converted 
into chloride by addition of hydrochloric acid. 





Prepakation of Lithium Salts. 


Lithium Salt 


Is prepared from 


By 


Carbonate, U.S.P. and 
B.P. 


Lithium chloride ob- 
tained from minerals 


Precipitating with carbonate of 
ammonium. 


Citrate, U.S.P. and B.P. 


Lithium carbonate. 


Dissolving in citric acid. 


Benzoate, U.S.P. 


Do. 


Neutralizing a hot solution with 
benzoic acid, filtering, and evapo- 
rating to dryness, or crystallizing. 


Salicylate, U.S.P. 


Do. 


Neutralizing hot solution with sali- 
cylic acid, filtering and evapo- 
rating. 


Bromide, U.S.P. 


Do. 


Neutralizing with sulphuric acid, 
and decomposing the sulphate 
thus obtained by bromide of 
potassium. 



General Impurities of Lithium. — Alkalies, alkaline salts, and 
metals. 

Tests. — The alkalies are detected by igniting the lithium salt and 
converting the carbonates which remain (when the acid has been an 
organic one, as citric or salicylic), into chloride by the addition of 
hydrochloric acid. On evaporating the filtered solution to dryness, 1 
part of the residue should be completely soluble in 3 parts of alcohol, 
and should give no precipitate on the addition of an equal volume of 
stronger ether, U.S.P. (Alkaline salts, if present, would give a precipi- 
tate.) A solution in water of another portion of the residue should give 
no precipitate with a solution of oxalate of ammonia (absence of alkaline 



METALS. 535 

earths), and no precipitate or color with hydrosulphuric acid or ammo- 
nium sulphide (absence of metals, U.S. P.). 

General Action of Lithium Salts. — The action of lithium upon 
muscle, nerves, and nerve-centres is very much like that of potassium, 
but is more powerful. 

Iiithii Carbonas, U.S. P. ; Litliise Carbonas, B.P. Carbonate 
of Lithium, U.S. P., or Lithia, B.P. Li 2 C0 3 ; 74. 

Characters and Tests. — In white powder, or in minute crystalline 
grains, alkaline in reaction, soluble in 100 parts of cold water, insoluble 
in alcohol. It dissolves with effervescence in hydrochloric acid ; and the 
solution evaporated to dryness leaves a residue of chloride of lithium, 
which communicates a red color to the flame of a spirit lamp, and redis- 
solved in water yields a precipitate with phosphate of soda. 

Dose. — 3 to 6 grains. 

Peepaeation. 

b.p. 

Liquor Iathiae Effervescens. Lithia Watee (10 grains in 1 pint of water satu- 
rated with carbonic acid), given in quantities of 5 to 10 fluid ounces. 

Uses. — The urates of lithia being much more soluble than those of 
either potash or soda, lithia is often employed in preference to these other 
alkalies in gout. It is given internally in order to aid in the elimination 
of uric acid by the kidneys, to prevent the gouty paroxysm, and to lessen 
the acidity of the urine, to prevent the deposit of uric acid gravel or 
calculi in the kidneys or bladder, and also to aid in their solution when 
already formed. It is applied locally to parts affected with gouty 
inflammation, in order to aid in the solution and absorption of the urate 
of soda in the tissues. For this purpose it may be applied to stiff joints 
and chalk stones, whether covered by the skin or already laid bare by 
ulceration. A solution of lithia, five grains to the ounce, is kept con- 
stantly applied to the part for several weeks together. 

Litliii Citras, U.S. P. ; Litirise Citras, B.P. Citrate OF 
Lithium, U.S. P. ; of Lithia, B.P. Li 3 C 6 H 5 7 . ; 210. 

Characters and Tests. — A white amorphous powder, deliquescent, 
and soluble in water without leaving any residue. Heated to redness it 
blackens, evolving inflammable gases ; and leaving a residue of lithium 
carbonate which gives the usual reactions. 

Dose. — 5 to 30 grains. 

Use. — It has a similar action to the carbonate, and may be used in 
its stead where we wish to avoid any local action upon the stomach itself. 

U.S. P. Lithii Benzoas. Benzoate OF Lithium. LiC r H 5 2 ; 128. 

Characters. — A white powder, or small shining scales, permanent 
in the air, odorless or having a faint benzoin-like odor; of a cooling 
sweetish taste, and a faintly acid reaction. When heated, the salt fuses ; 
at a higher temperature it chars, emits inflammable vapors having a 
benzoin-like odor, and finally leaves a black residue of an alkaline reac- 
tion, and imparting a crimson color to a non-luminous flame. On mixing 



536 INORGANIC MATERIA MEDICA. 

the aqueous solution with a dilute solution of ferric sulphate, a flesh- 
colored precipitate is produced. 

Uses. — It has been used as a remedy for gout and uric acid. 

Dose. — 15-30 grains. 

U.S.P. Litliii Bromicluin. Bromide of Lithium. LiBr; 86-8. 

Characters. — A white granular salt very deliquescent, odorless, 
having a very sharp, somewhat bitter taste, and a neutral reaction. Very 
soluble in water and in alcohol. 

Dose. — 15-30 grains. 

Action. — The same as that of bromide of potassium. It is said by 
some to have a stronger hypnotic action than the other bromides, but by 
others to be less effective than the potash salt. 

Uses. — The same as those of potassium bromide. It may be prefer- 
able to the potassium salt in the irritability of gouty subjects. 

U.S.P. Litliii Salicylas. Salicylate of Lithium. 2LiC 7 H 5 3 . 
H 2 0; 306. 

Characters. — A white powder, deliquescent on exposure to air, 
odorless or nearly so, having a sweetish taste and a faintly acid reaction. 
Very soluble in water and in alcohol. When strongly heated the salt 
chars, emits inflammable vapors, and finally leaves a black residue having 
an alkaline reaction and imparting a crimson color to a non-luminous 
flame. On super-saturating the dilute aqueous solution with hydro- 
chloric acid a bulky white precipitate is obtained, which is soluble in 
boiling water, from which it crystallizes on cooling ; also soluble in ether ; 
and producing an intense violet color with ferric salts. 

Uses. — It is used as a remedy in gout and rheumatism, and is 
intended to unite the properties of salicylic acid and lithia. It is less irri- 
tant to the stomach than salicylic acid. 

Dose.— 20-40 grains. (1-3-2-6 Grm.). 

Monad Metals. — Group II. 

AMMONIUM SALTS. Ammonia. NH 3 ; 17. 

Ammonium salts are well defined like those of potassium and sodium, 
but the base, instead of being a so-called element, is known to be a com- 
pound of nitrogen and hydrogen. They are formed by the direct union 
of ammonia, NH 3 , with acids. Thus ammonia and hydrochloric acid unite 
directly to form ammonium chloride, NII 3 -f- II CI = NH 4 C1. In the 
case of other members of the metallic group this direct union with the 
components of the acid does not occur, the metal replacing hydrogen, e.g., 
Zn -f- IIC1 = ZnCl -f H. This exception to the general rule may be 
avoided by regarding the compounds of ammonia with acids as not being 
formed by the direct union of ammonia with the acids, but by the 
replacement of hydrogen in a basylous radical ammonium NH 4 . 



In gaseous ammonia the nitrogen may be sup- ^ /H 

posed to be triad with its three affinities saturated by Vthus N~ II 

hydrogen. J H 



METALS. 



537 



In the radical ammonium the nitrogen is supposed 
to be pentad, four of its affinities being saturated by I ,-, 
hydrogen, the other being free to unite with an atom 
of some other element. 



H H 



N 



H H 



XT XT 

In ammonium 
chloride this free ^- 

affinity is saturated , 

by chlorine. H 01 H 



In liquor ammo- 
nia this free affinity 
is saturated by 
hydroxyl. 



H H 

\ / 

N 

/|\ 
H H 

i 



The atoms of hydrogen in ammonia or in ammonium can be replaced 
by organic radicals, and compound ammonias are formed. When the 
organic radical which replaces the hydrogen is of a positive nature, the 
compounds are termed amines, but if it is of a negative nature they are 
termed amides. 

Ammonium, NH 4 , does not exist in the free state, and whether the 
NH 4 
double molecule, N 2 H 8 , or I , exists separately is uncertain. 

NH 4 

It has been supposed to form an amalgam with mercury. When mer- 
cury, potassium, and sal-ammoniac are mixed, the mercury swells up 
enormously and forms a pasty amalgam. This may consist of ammonium 
and mercury, but it soon decomposes into mercury, ammonia and hydro- 
gen, so that some have supposed it to be nothing more than mercury 
which has absorbed a certain quantity of gas, as the mercury in this con- 
dition yields to pressure in the same way as froth does in other liquids. 
At all events, the salts of ammonium correspond very closely with those 
of potassium and sodium. In their general reactions they differ however 
in the fact that ammonia is volatile, whereas potassium and sodium are not. 

Sources of Ammonium Salts. — Ammonia is formed chiefly by the 
union of the nitrogen and hydrogen contained in animal or vegetable 
tissues during the processes of decomposition or destructive distillation. 
The principal commercial source of ammonium salts is the ammoniacal 
liquor from gas works, though some of it is also obtained by the dry dis- 
tillation of bones in making animal charcoal. 

General Reactions of Ammonium Salts. — Like potash and soda, 
ammonia is not precipitated by most reagents. It is recognized by its 
volatile alkaline character. It is given off from any of its salts on the 
addition of caustic potash or soda to them, and is then distinguished by 
its peculiar smell, and by its volatile alkaline character — turning a piece 
of red litmus paper blue and turmeric paper brown, when they are held 
above the test-glass in which the ammonium salt has been mixed with 
potash or soda. It also forms white fumes of ammonium chloride when 
brought near to strong hydrochloric acid. 






538 



INORGANIC MATERIA MEDICA. 
Peepaeation of Ammonium Salts. 



Is prepared 



Ammonium Chloride, 
U.S. P. and B.P. 



Ammonium Sulphate, 
TJ.S.P. 

Aqua Ammoniae for- 
tior, U.S.P. ; Liquor 
Ammoniae fortior, 
B.P. 



Aqua Ammoniae, 
U.S.P. ; Liquor Am- 
moniae, B.P. 

Ammonium Carbon- 
ate, U.S.P. and B.P. 

Ammonium Valerian- 
ate, U.S.P. 



Ammonium Iodide, 
U.S.P. 



Ammonium Bromide, 
U.S.P. and B.P. 



Liquor Ammoniae Ace- 
tatis. 

Spiritus Ammoniae 
Aromaticus, U.S.P. 
and B.P. 



Liquor Ammoniae Ci- 
tratis, B.P. 



Ammonium Phos- 
phate, U.S.P. and 
B.P. 

Ammonium Sulphide. 

Ammonium Nitrate, 
U.S.I*, and B.P. 



From 



Gas liquor. 



Do. 



Ammonium chloride, 
or sulphate. 



Do. 

Do. 
Do. 

Ammonium sulphate. 

Do. 

Ammonium carbonate 



Ammonium carbonate 
and liquor ammoniae. 



Liquor ammoniae. 



Do. 



Do. 

Liquor ammoniae or 
carbonate. 



By 



Adding hydrochloric acid and sub- 
liming in iron pots covered with 
leaden domes; or by adding sul- 
phuric acid, and subliming the 
ammonium sulphate with sodium 
chloride in the same way. 

Adding sulphuric acid and sub- 
liming. 

Heating with lime, and saturating a 
quantity of water with the gaseous 
ammonia (NH 3 ) given off: — 

2NH i Cl + CaHO = CaCl 2 + H 2 
+ 2NH 3 . 

Is simply liquor ammoniae fortior 
diluted with 2 parts of water. 



Subliming with calcium carbonate. 



Mixing with lime, and neutralizing 
valerianic acid with the ammonia 
given off. 

Decomposing by potassium iodide, 
precipitating potassium sulphate 
by alcohol, filtering, and evapo- 
rating. 

Same process as for iodide, substi- 
tuting bromide for iodide of po- 
tassium. 

Neutralizing with acetic acid. 



Distil with oil of lemon, of lavender 
flowers and of pimenta, U.S.P. 
Volatile oil of nutmeg, oil of lem- 
on, rectified spirit and water are 
the flavoring agents, B.P. 

Neutralizing with citric acid. It 
would be better prepared by neu- 
tralizing ammonium carbonate 
with citric acid. 

Neutralizing with phosphoric acid. 



Saturating with hydrogen sulphide. 

Neutralizing with dilute nitric acid, 
evaporating and fusing. 



METALS. 539 

General Impurities of Ammonium Salts. — As all the salts are 
obtained from the chloride or sulphate, chlorides or sulphates may be 
present. Iron may be present, as the chloride is usually sublimed in an 
iron pot, and if the heat employed be too great, some ferric chloride sub- 
limes along with the ammonium chloride and gives it a reddish color. 
Some lead may also be present from the leaden domes into which the 
ammonium chloride is sublimed. 

General Tests. — Lead and iron are detected by hydrosulphuric 
acid, or ammonium sulphide, and iron also by ferrocyanide of potassium. 
As the gas liquor contains many empyreumatic substances, these may 
sublime, and they are tested for in carbonate of ammonia (U.S. P.) by 
solution of permanganate of potash. The color of this ought not to alter 
after standing for five minutes. 

General Actions of Ammonium Salts. — These have already been 
described, as well as the modifications induced in them by different acid 
radicals (p. 504). The tetanus produced by ammonia and ammonium 
chloride is due to their action on the spinal cord, and not on cerebral 
centres, for it persists, like that of strychnine, after section of the cord. 
The paralyzing action of ammonium chloride on the muscles modifies 
the tetanus, in so far that after the first spasm, irritation applied to the skin 
does not cause tetanic convulsions, but only a single reflex twitch. This 
effect is usually ascribed to the paralyzing action on the motor nerves, 
but it seems really to be due to an affection of the muscles, as well as to 
a disturbance of the relation between the muscle and motor nerve. When 
a muscle has been poisoned by some ammoniacal salt, a single stimula- 
tion applied to the nerve causes a strong contraction like that of an 
unpoisoned muscle, but a second stimulus has sometimes little or no 



Muscle poisoned by \ 
ammonium sulphate. J 



Normal muscle 



Fig. 130. — Tracing to show the paralyzing action of ammonium sulphate on muscle. The first contrac- 
tion of the poisoned muscle is nearly as great as that of the unpoisoned one, but it soon becomes 
exhausted, and the curve rapidly falls during the continuance of the stimulation, while that of 
the normal muscle rather rises. 

action, and when the muscle is stimulated directly it soon becomes 
exhausted. Ammonia is a powerful muscular irritant, causing contrac- 
tion and subsequent rigor mortis when applied directly to voluntary 
muscle. 

Ammonium salts are said to increase the secretion of the mucous 
glands of the bronchi and of the intestine, as well as that of the 
sweat glands and of the kidneys. Ammonia appears to be converted 
almost entirely into urea in the blood. 

It increases the formation of glycogen in the liver. 




540 INORGANIC MATERIA MEDICA. 

Neither ammonia, nor its carbonate, nor its salts with organic acids 
diminish, but rather increase, the acidity of the urine, and in this 
ammonia differs from potash, soda, and lithia. 

Aminonii Cliloriclum, U.S.P. and B.P. Chloride of Ammo- 
nium. NH 4 C1; 53-4. 

Characters axd Tests. — In colorless, inodorous, translucent, fibrous 
masses, tough, and difficult to powder ; soluble in water and in rectified 
spirit. When heated it volatilizes without decomposition, and leaves no 
residue. Its solution in water gives the reactions of ammonia and a 
chloride. 

Peepaeatiox. U.S.P. 

DOSE. 
Troehisci Aromonii Cliloridi. 2 grains in each 1 every hour or two. 

Dose. — 5 to 20 grains. 

Actiox axd Uses. — During the process of solution in water of 
NH^Cl cold is produced, and so its solution has been used locally in 
headache, inflammation of the brain, mania, and apoplexy. A small 
dose of 5 to 7 grs. of ammonium chloride has no effect, but if taken 
frequently it causes discomfort and heat in the stomach, slight headache, 
diuresis, and an increased secretion of mucus from the intestine, although 
the stools are not more numerous. 

Large doses given to animals cause often pain and excitement, then 
collapse (no diarrhoea), convulsions, and death. The stomach is con- 
gested, the mucous membrane swollen, and the epithelial cells easily 
separated. 

The same symptoms are produced when ammonium chloride is 
applied to a wound, and the same post-mortem appearance is seen in the 
stomach. 

It thus seems to have a special action on the gastric mucous 
membrane. It is used in Germany in cases which are usually sup- 
posed to be due to a catarrhal state of the stomach — viz., when there is 
loss of appetite, sickness, bad taste in the mouth, fulness in stomach, and 
flatulence, with a coated tongue, and along with these bronchial catarrh 
without fever is present. Ammonium carbonate is preferred when there 
is much cough or the person is weak. 

It is also used alone in bronchial catarrh, when this has either come 
on without fever, or the feverish symptoms have passed off. It is sup- 
posed to have the power of increasing the secretion of mucus in the 
bronchi as well as in the intestine, and it is therefore not given when 
the expectoration is profuse, but only when it is scanty and difficult to 
bring up. 

It has been employed as a lotion to remove ecchymoses, to prevent 
discoloration in bruises and sprains, and to allay itching in prurigo. It 
has been applied locally as a dressing in abscess of the mamma, and to 
remove glandular enlargements. As a gargle, it has been used to cause 
contraction of the enlarged flabby uvula, and to relieve the cough which the 
tickling of the pharynx by the uvula often causes. It has been given to 
relieve the vomiting and heartburn occurring in cancer of the stomach. 
Tt is said to have a powerful action on the liver (p. 530), and has been 



METALS. 541 

strongly recommended in chronic congestion and hepatic abscess, as well 
as in dropsy depending upon hepatic disease. For its alterative action 
it has been given in muscular rheumatism, rheumatic pains, and neural- 
gia. In neuralgia it should be given in half- drachm doses several times 
a day ; but if the pain is not relieved after four or five doses have been 
given, it may be discontinued. It is also useful in neuralgic headaches. 

Aqua Aminonise Fortior, U.S. P.; Liquor Ammonise For- 
tior, B.P. Stronger Water of Ammonia, U.S. P.; Strong Solu- 
tion of Ammonia, B.P. 

Characters and Tests. — A colorless liquid, with a characteristic 
and very pungent odor, and strong alkaline reaction. Specific grav- 
ity, 0-891. 

Peepaeations in which Steong Solution of Ammonia is used. 

U.S. p. B.P. 

Spiritus Ammonia?. Ammonise Phosphas. 

Linimentum Camphorse Compositum. 
Liquor Ammonise. 

Citratis. 

Spiritus Ammonia? Aromaticus. 

Tinctura Opii Ammoniata. 

Action and Uses. — When applied to the nose, the vapor of strong- 
ammonia acts as a powerful irritant. It stimulates the nasal branches 
of the fifth nerve, and thus reflexly excites the vaso-motor centre and 
raises the blood-pressure. It thus tends to prevent or to remove condi- 
tions of shock and syncope. When applied for too long a time, or in 
too concentrated a form, it may produce inflammation of the mucous 
membrane and respiratory passages. Applied to the skin it quickly 
evaporates, and has but a slight rubefacient effect, but when its evapo- 
ration is prevented, it passes through the epidermis, and acts as a pow- 
erful vesicant. When swallowed in large quantities, and undiluted, it 
may produce gastro-enteritis, but on account of the vapor gaining access 
to the air passages and causing immediate suffocation, it may cause death 
in a few minutes. Along with the gastro-enteritis, there may be coma- 
tose symptoms due to the action of the drug itself on the brain after 
absorption, and in this it differs from poisoning by caustic potash or soda. 
It stimulates the circulation reflexly through the nerves of the stomach, 
and after its absorption stimulates both the respiration and circulation 
by its direct action upon the circulatory and respiratory nerve-centres. 

Uses. — Inhalation of its fumes is used to prevent drowsiness or 
fainting, or to recover persons from a faint, or from shock, or from the 
narcosis produced by opium, syncope, or the depression caused by vas- 
cular sedatives. It should not be applied for too long a time lest bron- 
chitis be induced. It is sometimes employed in a milder form to cut 
short nasal catarrh, to lessen pain in the nose and forehead, and diminish 
the expectoration in chronic bronchitis. It is used as a counter-irri- 
tant to the skin in rheumatic pains, stiffened rheumatic joints, and 
bronchitis. As a vesicant it may be employed where the use of canthar- 
ides is objectionable. A pledget of lint, somewhat larger than the blister 
desired, is moistened with ammonia, covered with a watch-glass, and 
applied to the skin until a red ring forms round the glass. The pledget 



542 INORGANIC MATERIA MEDICA. 

is then removed and a poultice applied. The poison of nettles and 
insects is frequently of an acid character, and ammonia rubbed over the 
part stung will lessen the pain and swelling. The injection often drops 
of strong liquor ammonite, diluted with three parts of water, into the 
veins, has been recommended in cases of snake-bite. It may be useful, 
possibly, in bites of less poisonous snakes, but is of no utility in bites by 
the cobra or daboia. It may be given internally, diluted, as a stimulant 
in cases of syncope, and in the depression, weakness, and faintness to 
which some women are subject. In these cases the liquor ammonite may 
be employed as a substitute for alcohol, and thus the tendency to 
contract habits of drinking may be counteracted. It may be used, like 
other alkalies, to stimulate the secretion of gastric juice, and especially 
where we do not wish to diminish the acidity of the urine or render it 
alkaline, and also where we wish to stimulate the nervous system, as 
in cases of anaemia and debility, and more especially where the stomach 
is relaxed and distended with gas. It also stimulates the intestines, 
and aids the expulsion of gas from them. It is therefore very useful in 
the flatulence and colic of children. It may be employed to lessen the 
watery discharge from the bowels where this persists after the removal 
of the irritant which has caused it. 

U.S.P. Spiritus Ammonite. Spirit of Ammonia. — In alcoholic 
solution of ammonia containing 10 per cent, by weight of the gas. 

Preparation. — By warming strong water of ammonia so as to expel 
the ammoniacal gas, passing this into cold alcohol, and diluting with 
alcohol to the necessary strength. 

Aqua Ammonite, U.S.P. ; Liquor Amnionic, B.P. Water 
of Ammonia, U.S.P. ; Solution of Ammonia, B.P. — Ammoniacal 
Gas, NH 3 ; 17 ; dissolved in water. 

Preparation. — By mixing 1 part of strong solution of ammonia 
with 2 of water. 

Prepakations. 

U.S.P. B.P. 

Spiritus Amnionic Aroinaticus. Linimentum Ammonite. 

Linimentum Ammonite. 

Dose. — 10 to 30 minims well diluted. 

Linimentum Ammonise. Liniment of Ammonia. — Water of ammonia 3, cotton- 
seed oil 7, U.S.P. Solution of ammonia 1, olive oil 3, B.P. 

Uses. — This may be used as a local application in a similar manner 
to the liquor ammonise fortior, except that it has not the same powerful 
vesicant action. It may be given internally for similar purposes. When 
mixed in the proportion of two ounces of liquor ammonise with two 
ounces of common salt and three drachms of camphorated spirit of wine 
to thirty-two ounces of water, it forms Raspail's sedative solution, for the 
treatment of headaches occurring at the menopause, or due to uterine 
derangement. 

Ammoniac Carbonas, U.S.P. and B.P. Carbonate of Ammo- 
nium, U.S.P.; Carbonate of Ammonia, B.P. NII 4 HC0 3 NH 4 NH 2 
CO,; 157. 



METALS. 543 

A volatile and pungent ammoniacal salt, produced by submitting a mix- 
ture of sulphate of ammonia or chloride of ammonium and carbonate of 
lime to sublimation. It consists of a mixture of acid carbonate of 
ammonia (NH 4 HC0 3 ), and carbamate of ammonia (NH 4 NH 2 C0 2 ). 

Characters and Tests. — In translucent crystalline masses, with a 
strong ammoniacal odor, and alkaline reaction ; soluble in cold water, 
more sparingly in spirit. It volatilizes entirely when heated, and is 
readily dissolved by acids with effervescence. 

20 grains of Carbonate ) + V I ^i grains Citric Acid 
of Ammonia j \ 25J grains Tartaric Acid. 

Dose. — 3 to 10 grains as stimulant and expectorant, 30 grains as 
emetic. 

Preparations rsr which Carbonate of Ammonia is used, 
u.s.p. B.P. 

Spiritus Ammonias Aromaticus. Liquor Amnionic Acetatis. 

Spiritus Ammonias Aromaticus. 

Uses. — Carbonate of ammonia may be used as an inhalation and 
may be given internally for similar purposes to liquor ammonige. 

It is an emetic, and may be employed in cases of bronchitis, where 
the bronchial tubes are choked with mucus, and the patient's circulation 
is weak. In smaller doses it stimulates the secretion of gastric juice, 
and may be used in atonic dyspepsia, flatulence, and colic to relieve sink- 
ing and depression, and as a substitute for alcoholic stimulants. When 
employed for this latter purpose, five to ten grains may be given along 
with ten minims of tincture of capsicum in an ounce of bitter infusion, 
to be taken whenever the feeling of sinking comes on, or the craving for 
alcoholic stimulants is experienced. 

From its power of stimulating the respiratory centre, it is employed 
as a stimulating expectorant in chronic bronchitis, in the broncho-pneu- 
monia of children, and in asthma depending on cardiac disease. It is 
also given in measles, and has been recommended as almost a specific in 
scarlet fever, in doses of three to five grains, every one, two, or three 
hours, according to the severity of the case, no acid drinks or fruits 
being allowed to the patient at the time. 

Carbonate of ammonia has been supposed to have the power of pre- 
venting iodism, when given along with iodide of potassium. 

Spiritus Animonise Aromaticus, U.S.P. and B.P. Aromatic 
Spirit of Ammonia (Sal Volatile). — It consists of carbonate of 
ammonia, and strong solution of ammonia diluted with alcohol and 
water. It is flavored with oil of lemon, oil of lavender flowers, and oil 
of pimenta in the U.S. P., and with volatile oil of nutmeg and oil of 
lemon in the B.P. 

Dose. — 20 to 60 minims in water. 

Preparations. 
Tinctura Guaiaci Ammoniata. U.S.P. and B.P. 
Valerianae Ammoniata. " 

Uses. — It is very commonly taken to relieve feelings of faintness and 
depression, and is much safer than alcohol, which might otherwise be 



544 IXORGAISIC MATERIA MEDICA. 

employed. It may be used also for other purposes instead of carbonate 
of ammonia, to which it has a similar action. 

Liquor Amnioniae Acetatis, U.S. P. and B.P. SOLUTION OF 
Acetate of Ammonia. — Acetate of Ammonia, or NH 4 C 2 H 3 2 , dissolved 
in water. 

Dose. — 2 to 6 fluid drachms. 

Preparation. — Vide p. 538. 

Uses. — It is used as an eyewash, and as a lotion to inflamed parts. 
When given internally it acts as a diaphoretic, if the body be kept warm, 
or as a diuretic if it be cool. As a diaphoretic it is given when the skin 
is hot and dry, and is very frequently used, especially combined with 
spirit of nitrous ether, whenever a feverish condition is present, 
whether its cause be known or not. It is especially used in the exanthe- 
mata, in influenza and catarrh. 

B.P. Liquor Ammonise Citratis. SOLUTION OF ClTRATE OF 
Ammonia. — Citrate of Ammonia, or 3NH 4 .C 6 H 5 7 , dissolved in water. 
Dose. — 2 to 6 fluid drachms. 
Preparation. — Vide p. 538. 
Uses. — Like the solution of the acetate, but more agreeable. 

Ammonite Oxalas, (NH 4 ) 2 C 2 4 H 2 0. 

Properties. — Colorless prismatic crystals, no smell; soluble in 
water. 

Uses. — Used to test for lime, and to separate it from magnesia. 

Ammonii Phosphas, U.S. P. ; Ammoniae Phosphas, B.P. 

Phosphate of Ammonium, U.S. P.; of Ammonia, B.P. (NH 4 ) 2 
HPO,; 132. 

Characters and Tests. — In transparent colorless prisms. Solu- 
ble in water, insoluble in rectified spirit. The aqueous solution gives 
the reactions of ammonia, and of a phosphate. 

Dose. — 5 to 20 grs. freely diluted. 

Uses. — It has been used as a remedy in cases of gout, in order to 
eliminate urate of soda from the system, the theory of its action being 
that it decomposes the insoluble urate of soda, converting it into soluble 
urate of ammonia and phosphate of soda. 

Ammonii Bromidum, U.S. P. and B.P. Bromide of Ammo- 
nium, NH 4 Br; 97-8. 

Characters and Tests. — In colorless crystals, which become 
slightly yellow by exposure to the air, and have a pungent saline taste. 
Its solution gives the reactions of ammonia and a bromide. 

Impurity. — Iodide. 

Test.— Vide?. 496. 

Dose. — 2 to 20 grains. 

Uses. — The bromide of ammonium has been employed for the same 
purposes as the bromide of potassium. It may be used in cases where 
the bromide of potassium appears to cause depression, either instead of 
the potassium salt, or mixed with it, and the mixture of bromide of 
potassium with bromide of ammonium has been supposed to have a better 
action than either salt alone. 



METALS. 545 

U.S. P. Ammonii Iodidum. Iodide of Ammonium. NH 4 I; 
144-6. 

Characters. — A white granular salt, or minute crystalline cubes, 
very deliquescent and soon becoming yellow or yellowish-brown on 
exposure to air ; odorless when white, but emitting a slight odor of 
iodine when colored, having a sharp saline taste and a neutral reaction. 

Uses. — A solution of J drm. in an ounce of glycerine has been used 
as an application to enlarged tonsils. An ointment containing 20 to 60 
grs. of the iodide to 1 oz. lard has been used in cases of lepra and 
psoriasis. It is chiefly used internally for syphilis, scrofula, and glan- 
dular enlargements, either instead of or along with iodide of potassium. 
A mixture of the two iodides has been thought by some to be more effi- 
cacious than either used singly, and the iodide of ammonium prevents 
the depressing action often exerted by the iodide of potassium alone. 

Aminonii Mtras, U.S. P. ; Ammonise Nitras, B.P. Nitrate 
of Ammonium, U.S. P. ; Nitrate of Ammonia, B.P. NH 4 N0 3 ; 80. 

Characters. — Colorless crystals, generally in the form of long, thin, 
rhombic prisms, or in fused masses, somewhat deliquescent, odorless, 
having a sharp bitter taste and a neutral reaction. When gradually 
heated, the salt melts at 165° to 168° C. (329° to 331° F.), and at 
about 185° C. (365° F.) it is decomposed into nitrous oxide gas and 
water, leaving no residue. The aqueous solution of the salt, when heated 
with potassa, evolves vapor of ammonia. On heating the salt with sul- 
phuric acid, it emits nitrous vapors. 

Use. — It is only used for the preparation of nitrous oxide. 

U.S. P. Ammonii Sulphas. Sulphate of Ammonium. (NH 4 ) 2 
S0 4 ; 132. 

Characters. — Colorless transparent rhombic prisms, permanent in 
the air, odorless, having a sharp saline taste, and a neutral reaction. 

Uses. — It is not used internally, but is only employed for the 
preparation of other salts of ammonium, of sulphate of iron and ammonia 
(U.S. P.) and ammonia alum (B.P.). 

U.S.P. Ammonii Valerianas. Valerianate of Ammonium. 

NH 4 C 5 H 9 2 ; H9. 

Characters. — Colorless or white quadrangular plates, deliquescent 
in moist air, having the odor of valerianic acid, a sharp and sweetish taste, 
and a neutral reaction. Very soluble in water and in alcohol. When 
heated the salt fuses, gives off vapor of ammonia and of valerianic acid, 
and is finally dissipated without leaving a residue. 

Uses. — It is chiefly used, like valerian, in cases of hysteria. 

Dose.— 2 to 8 grs. (0-13 to 0-52 gm.) 

U.S.P. Ammonii Benzoas. Benzoate of Ammonium, NH 4 
C 7 H 5 2 ; 139. 

Characters. — Thin white four-sided laminar crystals, permanent in 
the air, having a slight odor of benzoic acid, a saline, bitter, afterwards 
slightly acrid taste, and a neutral reaction. When strongly heated the 
salt melts, emits vapors having the odor of ammonia and of benzoic acid, 
and is finally wholly dissipated. 
35 



546 INORGANIC MATERIA MEDICA. 

Uses. — It is used as a diuretic, and to render the urine acid where 
there is tendency to phosphatic deposits. 

B.P. Sulphide of Ammonium. — Test Solution. 
Preparation. — Saturate a solution of NH 3 by H 2 S. 

Properties. — Greenish-yellow transparent liquid, disagreeable pun- 
gent odor. S.G. 0-999. 

Actions. — In small doses increases secretion, especially of bronchi 
and skin, so used as sudorific and expectorant in chronic skin diseases, 
rheumatism, and bronchitis ; in large doses it causes giddiness, drowsi- 
ness, faintness, and nausea. Little given. 

It is chiefly used as a test. 

Dose. — 3 minims, cautiously increased. 



CHAPTER XXV. 

METALS— (continued ). 

Class II.— DYAD METALS. 

Group I. — Metals of the Alkaline Earths. 
Calcium, Strontium, Barium. 

Appendix. — Metals of the Earths. 

Aluminium (? triad), Bert/Ilium (dyad), Zirconium (tetrad), Niobium 
(tetrad), Cerium, Lanthanum, Didymium, Yttrum, Erbium (triads). 

Group II. — Magnesium. 

Group III. — Copper, Zinc, Silver, Cadmium. 

Group IV. — Mercury. 

This large class contains a number of metals which have widely 
different characters and reactions. Yet it will be seen from the follow- 
ing table that the successive addition of four reagents divides the metals 
tolerably nearly into those groups which agree in their physiological 
action. In some respects Groups I. and II. of Class II. are perhaps 
more closely connected with the alkaline metals than with the heavy 
metals. 



METALS. 

-Reactions of the Metals in Class II. 



547 





Hydrochloric 
Acid. 


Sulphuretted 
Hydrogen. 


Ammonium 
Sulphide. 


Ammonium 
Carbonate. 


Ammonia 

and 

Sodium 

Phosphate. 


Group I. 


No precipitate. 
Do. 
Do. 

Do. 
Do. 


Noprecipitate. 
Do. 
Do. 

Do. 
Do. 


No precipitate. 
Do. 
Do. 

White (hydrate). 
Do. 


White precipitate. 
Do. 
Do. 












(Appendix). 

Aluminium 

All other earthy ) 
metals j 




Group II. 


Do. 


Do. 


No precipitate. 


No precipitate. 


White ppt. 
(phosphate). 




Group III. 


Do. 

Do. 

Do. 
White curdy ppt. 
Soluble in am- } 
monia. J 


Do. 
Black ppt. 
Yellow ppt. 
Black ppt. 


White (sulphide). 














Silver 




Group IV. 
Mercury as sub- \ 

salt j 

Do. as persalt 


White ppt. 
No precipitate. 


Black ppt. 
Black ppt. 









It must be borne in mind that the above reagents are used succes- 
sively, and each remains in the solution. Thus when ammonium sulphide 
is added part of it is decomposed by the hydrochloric acid and ammonium 
chloride is formed. It is on account of the presence of the ammonium 
chloride in the liquid that magnesium is not precipitated by the ammo- 
nium sulphide while aluminium is. 

Class II. — Group I. 

General Action. — In regard to the action on the nervous system 
of the chlorides of calcium, strontium, barium, beryllium, didymium, 
erbium, and lanthanum, these substances fall into two groups — 

(a) Containing beryllium, calcium, strontium, and barium ; 

(b) Containing yttrium, didymium, erbium, and lanthanum. 
Group a has a tendency to increase reflex action, as evidenced 

by spasm or tremor in the frog. 

With group b reflex action in the cord appears to be little affected, 
but its members appear to have a tendency to paralyze motor centres 
of the brain in the frog. 

Group a all paralyze motor nerves to some extent. Lanthanum 
has also a slight paralyzing action, but the other members of group b 
have not, agreeing in this respect with sodium and rubidium, and differ- 
ing from all the others. 

In regard to their action on muscle these substances cannot be divided 
into sub-groups. Their action on muscle has been already described 
(p. 131). 



548 INORGANIC MATERIA MEDICA. 

The lethal activity, on frogs, of the chlorides of the alkalies and earths 
is not in proportion to their atomic weight. It is as follows, potassium 
being most powerful, and calcium least powerful : — potassium, beryllium, 
rubidium, barium, ammonium, caesium, lithium, lanthanum, didymium, 
erbium, strontium, yttrium, sodium, calcium. 

Barium causes contraction of the ventricle of the frog's heart in much 
the same way as veratrine, and by its local action on the walls of the 
vessels causes them to contract. When injected into the circulation it 
causes enormous rise of blood-pressure at first, followed by stoppage of 
the heart and consequent fall of pressure. It causes contraction also of 
the involuntary fibres of the bladder and intestine, so that the lumen of 
the latter may be almost completely obliterated. The symptoms of poison- 
ing in mammals are probably due to its action on the involuntary muscles 
of the intestines, heart, and vessels, on the voluntary muscles, and on the 
nervous system. They are vomiting, colic, diarrhoea, muscular weakness 
and cramp, ringing in the ears, tightness over the heart, and general 
convulsions. Injection of sulphate of soda into the veins appears to coun- 
teract the effect of barium, 1 and the simultaneous injection of potash salts 
will prevent death from an otherwise lethal dose of barium. 2 The action 
of barium on muscles and on the heart is abolished by heat in the same 
way as that of veratrine (p. 126), and the inhabitants of southern 
climates tolerate much larger doses of barium than those of northern. 3 

Metals of the Alkaline Earths. 
Calcium, Strontium, Barium. 

The only one of these whose preparations are used internally is cal- 
cium. At present barium is only used as a test, though possibly it may 
yet prove useful in muscular tremor. 

CALCIUM. Ca; 40, or 39-9. 

Sources of Lime Salts. — The chief source is the carbonate, found 
native as chalk or limestone. 

General Test of Lime Salts. — Calcium oxalate is very insoluble, 
and forms a white precipitate on the addition of oxalate of ammonia to 
lime salts. It is soluble in hydrochloric, but insoluble in acetic acid. 



1 Hermann, Lehrbuch d. experimental Toxicologic, p. 191. 

2 Brunton and Cash, Centralblatt d. med. Wissenschaften, 1884, p. 545. 

3 Lisfranc, quoted by Lewin, Nebenwirkungen d. Arzneimittel, p. 74. 



METALS. 

Geneeal Pkepaeation of Salts of Calcium. 



549 



Is prepared 


From 


By 


Creta prseparata. 


Chalk. 


The process of elutriation, which consists 
in stirring with water, pouring off the 
liquid containing fine particles in sus- 
pension, and allowing them to subside. 


Quicklime (calx). 


Chalk or lime- 
stone. 


Calcining; CaC0 3 = CaO + C0 2 . 


Slaked lime (calcis 
hydras). 


Quicklime. 


Slaking with water. 


Calcium chloride. 


Limestone or chalk 
(carbonate) . 


Neutralizing with hydrochloric acid; Ca 
C0 3 + 2HC1 = CaCl 2 + H 2 + C0 2 . 


Precipitated carbo- 
nate. 


Calcium chloride. 


Precipitating with excess of carbonate of 
soda ; CaCl + Na 2 C0 3 = CaC0 3 + 2NaCl. 


Chlorinated lime 
(calx chlorata). 


Slaked lime. 


Exposing lime to chlorine gas until satu- 
rated : thus is formed chlorinated lime, 
consisting of a mixture of calcium chlo- 
ride and calcium hypochlorite. 


Calcium hypophos- 
phite. 


Lime and phos- 
phorus. 


Heating together with water ; removing 
excess of lime by C0 2 ; and evaporating. 


Calcium phosphate 


Bone ash. 


Dissolving in diluted hydrochloric acid, 
precipitating with ammonia, and drying. 



General Impurities. — The chief impurities are alumina and mag- 
nesia. 

Tests. — These are usually detected by converting the lime salt into 
chloride by hydrochloric acid, and evaporating to dryness so as to drive 
off all excess of acid. The residue is redissolved in water and the tests 
applied to the solution. On the addition of saccharated solution of 
lime, alumina and magnesia will be precipitated. The test used in the 
U.S. P. to detect alumina is water of ammonia; and to detect magnesia, 
water of ammonia and phosphate of sodium. These reagents should not 
give more than a faint turbidity with dilute solutions of lime salts. The 
B.P. states that only a very scanty precipitate should occur, showing 
that only traces of magnesia and alumina are present. 

B.P. Marmor Album. White Marble. CaC0 3 . 
Hard white crystalline native carbonate of lime, in masses. Used in 
producing carbonic acid gas. 

Calx, IT.S.P. and B.P. Lime. CaO ; 56. 

An alkaline earth, CaO, with some impurities, obtained by calcining 
chalk or limestone, so as to expel carbonic acid. 

Characters and Tests. — In compact masses of a whitish color, 
which readily absorb water, and which, when rather less than their weight 
of water is added, crack and fall into powder with the development of 
much heat. The powder obtained by this process of slaking, when 



550 INORGANIC MATERIA MEDICA. 

agitated with distilled water, gives, after filtration, a clear solution which 
has an alkaline reaction, and is shown by the appropriate tests to contain 
lime and only traces of alumina and magnesia. 

Preparations, 
tj.s.p. . B.P. 

Liquor Calcis. Calcis hydras. 

Potassa curn Calce (p. 34). 
Syrupus Calcis. 

B.P. Calcis Hydras. Slaked Lime. 

Hydrate of lime, CaH 2 2 ; 78; with some impurities, recently pre- 
pared by pouring 1 pint of water over 2 lbs. of lime in a metal pot. 

Characters. — It dissolves in water, but only sparingly, 11 grs. being 
dissolved by a pint of water at 60° F. ; and, contrary to the usual course 
of things, its solubility is increased by cooling the water and diminished by 
heating it. 

Its solubility is greatly increased by the addition of sugar, as in the 
Syrupus Calcis, U.S. P., or Liquor Calcis Saccharatus, B.P. 

Preparations. 
Liquor Calcis. Liquor Calcis Saccharatus. 

Syrupus Calcis, TJ.S.P. ; Liquor Calcis Saccharatus, B.P. SYRUP OF LlME, U.S.P. ; 

Saccharated Solution of Lime, B.P. 

Preparation. — U.S.P. Mixing lime (5) and sugar (30) with boiling water 
(50) ; diluting with an equal volume of water, filtering and evaporating to 100 
parts. B.P. Like lime-water, mixing 1 ounce of lime with 2 of sugar and using 
them instead of 2 of lime. This contains 7 11 grains of lime in 1 fluid ounce. 

Dose. — 15 to 60 minims. 

Liquor Calcis, U.S.P. and B.P. SOLUTION OF LlME. LlME- WATER. 

Preparation. — U.S.P. 2 ounces of slaked lime are first washed with ordinary 
water, and afterwards stirred well in 1 gallon of distilled water in a stoppered 
bottle, for two or three minutes. After 12 hours the excess of lime will have 
subsided, and the clear solution may be drawn off with a siphon as it is required for 
use, or transferred to a green glass bottle furnished with a well-ground stopper. In 
the B.P. 2 ounces of slaked lime are shaken with 1 gallon of distilled water, without 
previous washing. The other details of the process are the same as in the U.S.P. 

It is a saturated solution, and contains a little over half a grain to an ounce. 

Dose. — 1-4 fl. oz. 

Preparations. 

U.S.P. B.P. 

L-inimentum Calcis. Ianimentum Calcis. 

Argenti Oxidum. 
Lotio Hydrargyri Flava. 
Nigra. 

Liniuientum Calcis, U.S.P. and B.P. LINIMENT OF LlME. 

Preparation. — By mixing equal parts of lime-water and cotton-seed oil, U.S.P., 
or olive oil, B.P. 

Uses. — When applied to the surface either of the skin or of a 
mucous membrane from which a watery discharge is issuing, lime seems 
to act as a slight astringent, possibly because it combines with the 
albumen. 

Lime-water is therefore sometimes used as a lotion for cracked nip- 
ples and as a dressing to eczematous surfaces, where it eases the smarting 
and tingling. It is often mixed with oil or glycerine for this purpose. 



METALS. 551 

It is also used as an injection to lessen discharges from the ears, 
urethra, vagina or vulva, in otorrhoea, gleet, and leucorrhcea, while active 
inflammation is still present, and as an enema to destroy ascarides in the 
rectum. It may also be used as a wash to the mouth in ulceration. In 
croup it has been recommended as a solvent for the false membrane. It 
is either applied as spray or by a camel's hair pencil. When taken into 
the stomach it will act as an antacid. It is especially useful in pre- 
venting vomiting, and a mixture of milk and lime-water will often be 
retained by the stomach and digested when no other food can be borne. 
In children suffering from chronic vomiting and diarrhoea, where the 
milk is vomited in hard lumps instead of small flakes, lime-water proves 
very useful. 

In typhoid fever it tends to prevent milk from forming hard undi- 
gested lumps which may irritate the intestine, while it has at the same 
time an astringent action. 

It is very useful as an astringent in diarrhoea, more especially in 
slight cases of diarrhoea in children. When the child is at the breast 
about one teaspoonful of lime-water mixed with an equal quantity of 
milk should be given to it every three hours, and when it is brought up 
by hand the lime-water is just mixed with the milk which the child 
ordinarily takes. It has been used in diarrhoea in adults depending on 
ulceration of the intestine, with the view of healing the ulcers by form- 
ing a coating over them by combining with the albumen on their surface, 
but it is not so efficient as other remedies for this purpose. 

There is not much absorbed by the intestine, and so but little passes 
into the blood ; yet a small quantity does so ; and, after it has been used 
for a little, the urine becomes alkaline from the lime being excreted by 
the kidneys. Lime-water has been used in cases of stone, and with con- 
siderable benefit. It has been supposed to dissolve stones in the bladder ; 
but the good effects which result from its use are probably not due to 
this cause, which is still problematical. They are most probably pro- 
duced by the lime lessening the irritating qualities of the urine, and at 
the same time acting as an astringent on the walls of the bladder and 
rendering it less irritable. 

Linimentum Calcis, better known, perhaps, under the name of 
Carron oil, is used as an application to burns and scalds. It derives its 
name of Carron oil from its being so extensively used by the workmen 
in the foundries at Carron. 

It was formerly made with linseed oil, and this preparation is less 
fluid, and is often preferable to that made with olive or cotton-seed oil. 
It is useful not only in burns and scalds, but as a dressing to the face in 
small-pox, and in some cases of eczema affecting a large extent of skin. 

Syrupus Calcis, U.S. P., or Liquor Calcis Saccharatus, B.P., may be 
given in milk instead of liquor calcis, when it is desired simply to get 
the effect of the lime and it is unadvisable to dilute the milk, as admix- 
ture with liquor calcis would necessarily do. It has been used also in 
acute rheumatism. 

Creta Pr separata, U.S. P. and B.P. Prepared Chalk. 

Preparation. — Prepared chalk is simply chalk freed from sand and 
other impurities by elutriation (p. 549). 



■} 



552 INORGANIC MATERIA MEDICA. 

Properties. — It is a white powder, or small lumps which break into 
powder readily on pressure. It has no taste or smell. It is insoluble in 
water, but it dissolves in acids such as acetic acid. While doing so it 
effervesces strongly, showing that it is a carbonate, and the solution gives 
the reactions of lime. 

Impurities. — Silica, barium, strontium, magnesium, iron. 

Test. — The solution in acetic acid should give no precipitate with 
test solution of sulphate of calcium (absence of strontium and barium), 
and the tests for magnesium and iron should not indicate more than 
traces of these substances, U.S. P. It should dissolve without leaving 
any residue in hydrochloric acid (absence of silica), B.P. 

Officinal Preparations. 

U.S.P. DOSE. 

Mistura Cretan Chalk mixture. 1 * 2 fl 

Compound chalk powder (20), cinnamon water (40), water (40) J 2 " ' z * 
Pulvis Cretae Compositus. Compound chalk powder. \« «n (i i^l 

Prepared chalk (30), powdered acacia (20), sugar 50 j-3-ougr.^-igm.j 

Trocliisci Cretae. Chalk lozenges. } 

4 grains in each Y Ad lib. 

Chalk is also contained in Hydrargyrum cum Creta,U.S.P.and B.P. J 

B.P. 
Mistura Cretae. Chalk mixture. 

Chalk (1) suspended in cinnamon water (30) by means of \ 1-2 fl. oz. 

gum (1) and sweetened with syrup (2) , 

Pulvis Cretae Aromaticus. Aromatic powder of chalk. 1 

Cinnamon (8), cardamoms (2), cloves (3), nutmeg (6), saffron f 10-60 grs. 

(6), sugar (50), chalk (22) J 

Pulvis Cretae Aromaticus cum Opio. Aromatic powder of chalk ) 

thoroughly mixed with powdered opium. [■ 10-40 grs. 

1 part of opium in 40 J 

Action. — Carbonate of lime or chalk possesses the astringent powers 
of lime itself, and is without its irritating qualities. It can therefore be 
given in much larger doses, and so chalk is used, instead of liquor calcis, 
in the diarrhoea of adults accompanied by acidity. 

Uses. — Chalk may be used as a dusting powder to the skin in exco- 
riations, burns, and ulcers. It forms a useful tooth-powder. Internally 
it serves to arrest diarrhoea, and is often given, whatever be the cause of 
the diarrhoea ; but when the disease depends upon some irritating sub- 
stance in the intestine, the irritant should be removed by a dose of castor 
oil previous to the administration of the chalk. In the form of whiting, 
chalk forms a useful antidote in cases of poisoning by acids, and espe- 
cially by oxalic acid. 

Calcil Chloridum, U.S.P. and B.P. Chloride of Calcium. 
CaCl 2 ; 110-8. 

Characters. — Colorless, slightly translucent, hard and friable 
masses, very deliquescent, odorless, having a hot, sharp, saline taste, and 
a neutral or faintly alkaline reaction. Soluble in 1*5 parts of water, 
and in 8 parts of alcohol at 15° C. (59° F.). The aqueous solution 
yields the reactions of calcium and of a chloride. 

USES. — It is occasionally used in cases of chronic glandular enlarge- 
ment, but is not muclrused in medicine. It has a great affinity for water, 



METALS. 553 

and is used to remove water from other substances in pharmacy, e.g., in 
the preparation of absolute alcohol or ether. 

Officinal Peepaeation. 

b.p. 

Solution of Chloride of Calcium consists of 1 ounce of CaCl dissolved in 10 of 

water. It is used as a test for tartrates, citrates, and oxalates. Saturated solution 

of chloride of calcium is used for determining the percentage of nitrous ether in 

spirit of nitrous ether. 

Calcii Carbonas Prsecipitatus, U.S. P. ; Calcis Carboiias 
Precipitata, B.P. Precipitated Carbonate of Calcium, U.S. P. ; 
Precipitated Carbonate of Lime, B.P. CaC0 3 ; 100. 

Characters. — A very fine white impalpable powder, permanent in 
the air, odorless and tasteless, and insoluble in water or alcohol. Wholly 
soluble in hydrochloric, nitric, or acetic acid, with copious effervescence. 

A neutral solution of the salt in acetic acid yields the reactions of 
calcium. 

Use. — It may be used as an astringent in the same way as chalk. 

U.S.P. Calcii Bromidum. Bromide or Calcium. CaBr 2 ; 199-6. 

Characters. — A white granular salt, very deliquescent, odorless, 
having a pungent saline and bitter taste, and a neutral reaction. An 
aqueous solution of the salt yields the reactions of calcium and a bromide. 

Dose. — 15 to 30 grains (1 to 2 Gm.). 

Uses. — The same as those of potassium bromide. It is said not to 
depress like the potassium bromide. 

Calcii Pliosphas Prsecipitatus, U.S.P. ; Calcis Pliosplias, 

B.P. Precipitated Phosphate of Calcium, U.S.P.; Phosphate 
of Lime, B.P. Ca 3 (P0 4 ) 2 ; 310. 

Characters. — A light, white, amorphous powder, permanent in the 
air, odorless, tasteless, and insoluble in water or alcohol. Wholly solu- 
ble in nitric or hydrochloric acid without effervescence (absence of car- 
bonate). A solution of the salt in diluted nitric acid, after being mixed 
with an excess of acetate of sodium, yields a white precipitate with test 
solution of oxalate of ammonium (lime), and a lemon-yellow precipitate 
with test solution of ammonio-nitrate of silver (phosphate). 

Officinal Peepaeatioxs. 
u.s.p. b.p. dose. 

Syrupus Calcii Lactophosphatis. It is contained in Pulvis 1-4 fl. dr. (7 "5-15 cc.) 

Antimonialis. 

U.S.P. Syrupus Calcii Lactophosphatis. SyEUP OF LACTOPHOSPHATE OF LlME. 
Made by dissolving freshly precipitated phosphate in lactic acid, and mixing with 
orange-flower water and sugar (22 parts phosphate in 1000). 

Action. — Phosphate of lime is an important constituent of the body, 
and occurs in considerable quantity wherever active cell-growth, either 
normal or pathological, is going on. It forms a large proportion of 
bones, and Chossat found that when animals were fed on food containing 
no lime salts, the bones were soft. During pregnancy, fractures unite 
slowly, and Milne Edwards found that when animals were supplied with 
abundance of phosphate of lime fractures united more quickly. 



554 INORGANIC MATERIA MEDICA. 

It has been supposed that the constant use of fine flour tends to cause 
premature decay of the teeth, owing to the want of sufficient proportion 
of lime salts. The decay of the teeth amongst Americans has been 
attributed to the perfection of their machinery, which completely sepa- 
rates the external parts of the grain and makes the flour exceedingly 
fine and white. 

Uses. — It frequently lessens or removes toothache. It is useful in 
cases of chronic diarrhoea in children. It has been recommended in 
cases of rapid growth or deficient repair, as in growing children, anaemia, 
and debility from overwork, child-bearing, suckling, or diseases such as 
chronic abscess, diarrhoea, leucorrhoea, bronchitis, and phthisis. It is 
frequently given in rickets with considerable benefit, although here it is 
well to combine it with cod-liver oil. It is often advantageously given, 
along with iron, in the form of Parrish's Chemical Food, containing two 
and a half grains of phosphate of lime and one grain of phosphate of iron 
in every drachm. 

Calcii Hypopliospliis, U.S. P. ; Calcis Hypopkospliis, B.P. 

Hypophosphite of Calcium, U.S. P. ; of Lime, B.P. CaH 4 (P0 2 ) 2 ; 170. 

Characters. — Colorless or white six-sided prisms, or thin flexible 
scales, of a pearly lustre ; permanent in dry air, odorless, having a nause- 
ous, bitter taste and a neutral reaction. The aqueous solution yields the 
reactions of calcium. 

Dose. — 1 to 5 grs. 

Officinal Peepaeation. 
u.s.p. DOSE. B.P. 

Syrupus Hypophosphitum 1-2 fl. dr. (375 to 7*5 c.c.) None. 

u.s.p. Syrupus Hypopiiospnitum. Syeup of Hypophosphites. Consists of the 
hypophosphites of lime (35), of sodium (12), and of potassium (12) ; citric acid (1), 
spirit of lemon (2), sugar (500), water q.s. to make 1000. 

Uses. — Hypophosphite of lime is useful in the early stages of phthisis 
and in nervous debility consequent upon over-work or worry. It may 
be given between two thin slices of bread and butter, if no irritability of 
the stomach be present. It is well to begin with a dose of two grains 
and gradually increase it, as otherwise it is apt to cause derangement of 
the digestion. 

Calx Chlorata, U.S.P. and B.P. Chlorinated Lime; vide 
Chlorine (p. 467). 

U.S.P. Calx Sulphurata. Sulphurated Lime. A mixture 
(commonly misnamed sulphide of calcium) consisting chiefly of sulphide 
of calcium [CaS ; 72] and sulphate of calcium [CaS0 4 ; 136], in varying 
proportions, but containing not less than 36 per cent, of absolute sul- 
phide of calcium. 

Pb EPARATION. — Mix lime in very fine powder (100), and precipitated 
sulphur (90), intimately; pack the mixture with gentle pressure in a 
crucible so as nearly to fill it, and having luted down the cover, expose 
the crucible for one hour to a low red heat, by means of a charcoal fire 
so arranged that the upper part of the crucible shall be heated first. 



METALS. 555 

Then remove the crucible, allow it to cool, rub its contents to powder, 
and at once transfer the latter to small glass-stoppered vials. 

Characters. — A grayish-white or yellowish-white powder, gradu- 
ally altered by exposure to air, exhaling a faint odor of hydrosulphuric 
acid, having an offensive, alkaline taste and an alkaline reaction. Very 
slightly soluble in water, and insoluble in alcohol. On dissolving sul- 
phurated lime with the aid of acetic acid, hydrosulphuric acid is abun- 
dantly given off, and a white precipitate (sulphate of calcium) is thrown 
down. The filtrate yields, with test solution of oxalate of ammonium, a 
white precipitate soluble in hydrochloric, but insoluble in acetic acid. 

If 1 Gm. of sulphurated lime be gradually added to a boiling solution 
of 1*25 Gm. of sulphate of copper in 50 c.c. of water, the mixture 
digested on a water-bath for fifteen minutes, and filtered when cold, no 
color should be imparted to the filtrate by 1 drop of test solution of ferro- 
cyanide of potassium (presence of at least 36 per cent, of real sulphide 
of calcium). 

Dose,— ^4 gr. 

Action. — In large doses it is an irritant to the stomach, but medici- 
nal doses usually cause no trouble, or at most slight discomfort, sometimes 
giving rise to eructations of sulphuretted hydrogen, and perhaps to some 
looseness of the bowels. 

Use. — It is used chiefly for its effect on the process of suppuration, 
hastening the discharge of pus if already formed, and checking its forma- 
tion if the inflammation be still in its early stage. 

Class II. 

Group I. — Appendix. 
Aluminium. Cerium. 

ALUMINIUM. Al; 27'5. 

General Sources of Alum Salts. — Aluminium is very widely 
distributed in nature clays, being silicates of alumina. Two kinds of 
clay, Kaolin and fuller's earth, being inert powders, are used as 
demulcents (pp. 307 and 385), and Kaolin as a pill basis. 

General Preparation. — It is prepared on a large scale from a 
kind of clay-slate called alum-schist. This contains a quantity of ferric 
sulphide. It is first roasted and moistened and exposed to air. The 
sulphur is thus converted into sulphuric acid, and ferrous sulphate and 
aluminium sulphate are formed. These are separated by lixiviation with 
water and ammonium chloride is added. This forms ammonium sulphate, 
which combines with aluminium sulphate to form alum ; ferrous chloride 
remaining in solution. 

General Reactions of Alum Salts. — Salts of aluminium give a 
white gelatinous precipitate of hydrate with caustic potash or soda, soluble 
in excess ; with ammonia, a similar precipitate, insoluble in excess. The 
insolubility of the precipitate with ammonia in excess of the reagent 
readily distinguishes aluminium from zinc, which also gives a white precip- 
itate with ammonium sulphide. Carbonates of potash, soda and ammonia 



556 INORGANIC MATERIA MEDICA. 

also precipitate the hydrate, which is insoluble in excess; ammonium 
sulphide also gives a white precipitate of hydrate. 

General Impurities of Aluminium Salts. — The chief is sulphate 
of iron coming from the schist. 

General Tests. — Alum should give no blue with either ferro- or 
ferricyanide of potassium. 

Alumen, U.S. P. and B.P. Alum. — A sulphate of aluminium 
and potassium, U.S. P. K 2 A1 2 (S0 4 ) 4 24H 2 0; 948. A sulphate of ammo- 
nia and alumina, NH 4 A1(S0 4 ) 2 .12H 2 0, crystallized from solution in 
water, B.P. 

Characters and Tests. — U.S. P. Large, colorless, octahedral 
crystals, acquiring a whitish coating on exposure to air, no smell, sweet, 
astringent taste, and acid reaction. It is distinguished from the ammonia 
alum of the B.P. by no ammonia being evolved on the addition of potash. 
B.P. In colorless, transparent crystalline masses, exhibiting the faces 
of the regular octahedron, and having an acid sweetish astringent taste. 
Its aqueous solution gives with caustic potash or soda a .white precipitate 
soluble in an excess of the reagent (alumina), and the admixture evolves 
ammonia, especially when heated. The aqueous solution gives an imme- 
diate precipitate with chloride of barium (sulphate). 

Impurity. — Iron. 

Test. — The solution in water does not acquire a blue color from the 
addition of yellow or red prussiate of potash. 

Dose.— 10 to 20 grains. 

Peepaeation. 

u.s.p. and b.p. 

Alumen exsiccatum. 

Alumen Exsiccatum, U.S.P. and B.P. Dried Alum. — 

K 2 SO 4 Al 2 (80 4 ) 516, U.S.P.; NH 4 A1S0 4 , B.P. 

Preparation. — Water of crystallization is driven off by heat. 

Properties. — Dry white powder with the taste and other properties 
of alum. 

Action. — Alum precipitates albumen and gelatin. It has no 
action on the unbroken skin, but when applied to parts from which the 
epidermis has been removed, it causes a film of coagulated albumen to 
form on the surface, and produces contraction on the tissues and vessels 
below. It thus lessens the supply of blood to the part, relieves congestion, 
diminishes the swelling, lessens the discharge from inflamed surfaces, and 
therefore acts as an astringent. By causing contraction of vessels and 
aiding the formation of coagula it arrests haemorrhage, and is therefore 
used either as a strong solution, or, if this prove insufficient, in the form 
of powder as a styptic. Dried alum abstracts water from the tissues and 
acts as a slight caustic. When swallowed in large quantities alum pro- 
duces gastro-enteritis. In smaller doses it acts as an emetic. It is not 
so powerful as a caustic, astringent, styptic, or emetic as the salts of zinc 
or copper. 

Uses. — Dried alum is sometimes used to check exuberant granula- 
tions in ulcers. Bleeding from the nose may be stopped by sniffing up 
or injecting :i solution of alum into the nostrils, and if the solution be 



METALS. . 557 

ineffectual, powdered alum may be blown up by means of a paper funnel. 
As an astringent alum is used in both purulent and simple ophthalmia, but 
on account of its solvent action on the cornea it may lead to perforation, 
and should therefore be avoided (p. 196). It is used as a lotion in 
otorrhoea; as a wash to the mouth in ptyalism, aphthae and ulceration of 
the mouth and gums ; as a gargle for sore throat, and congestion of the 
pharynx, elongation of the uvula, as well as for the tickling, violent 
coughs which depend upon them, and are often accompanied by retching 
(p. 222). Dried alum has been applied in powder to remove the false 
membrane from the throat in croup and diphtheria. 

Alum may be employed as a spray to the larynx in coughs and 
hoarseness depending upon chronic laryngeal catarrh. As a wash it may 
be used in inflammation of the vulva in children, to relieve itching in 
pruritus vulvae, and to prevent the recurrence of prolapsus ani. It is use- 
ful as an injection in gonorrhoea and leucorrhoea. When swallowed it 
will act upon the stomach as an astringent, and is useful in preventing 
the vomiting of phthisis. It is not improbable that the vomiting which 
occurs usually after paroxysms of coughing is due to the congestion pro- 
duced in the stomach by the cough, and that the alum prevents the 
vomiting by lessening this congestion (p. 329.) When given in larger 
quantities alum is an emetic, acting promptly and producing little depres- 
sion. A teaspoonful of powdered alum proves a very useful emetic in cases 
of croup, and may be given to children mixed with honey. In the intestine 
alum acts as an astringent also, and is useful in diarrhoea ; but, curiously 
enough, in lead colic it will act as a purgative, relieving the pain and 
opening the bowels. Its utility in lead-poisoning probably depends, to a 
considerable extent, on its being a sulphate, and thus precipitating any 
lead salts it may meet in the intestine in the form of insoluble lead sul- 
phate, and preventing absorption from the intestinal canal. In typhoid 
fever, and in chronic dysentery and diarrhoea, it is said to be useful in 
checking the discharges from the bowels. 

After its absorption into the blood it is supposed to exercise an as- 
tringent action, and is given to check sweating. 

As a styptic it is employed locally in bleeding from the nose, mouth, 
throat, gums, haemorrhoids, and uterus. Internally, to check bleeding 
from the stomach, intestines, lungs, uterus, or kidneys. 

Dose. — As an astringent, 10 to 40 grs.; as an emetic, 30 to 60 grs. 
For a lotion or gargle, 4 to 20 grains to an ounce of water. 

Antidote. — Give tepid water with small doses of carbonate of soda 
to decompose the alum, and empty the stomach by the stomach-pump or 
emetics. 

TJ.S.P. Aluminii Hydras. Hydrate OF Aluminium. AL(HO) 6 ; 
156. 

Characters. — A white, light, amorphous powder, permanent in dry 
air, odorless and tasteless, and insoluble in water or alcohol. Soluble 
without residue in hydrochloric, or in sulphuric acid, also in solution of 
potassa or of soda. 

Uses. — It is feebly astringent and desiccant. Is used externally as a 
powder in inflammatory diseases of the skin. 



558 INORGANIC MATERIA MEDICA. 

U.S. P. Aluminii Sulplias. Sulphate of Aluminium. A1 2 (S0 4 ) 3 - 
18H 2 0; 666. 

Characters. — A white, crystalline powder, permanent in the air, 
odorless, has a sweet, and afterwards an astringent taste, and an acid 
reaction. Soluble, without leaving more than a trifling residue, in 1*2 
parts of water at 15° C. (59° F.), and very soluble in boiling water; 
almost insoluble in alcohol. The aqueous solution of the salt yields the 
reactions of aluminium and of a sulphate. 

Uses. — It is a powerful antiseptic. A saturated solution has been 
used as a mild caustic in enlarged tonsils, nasal polypi, nsevi, scrofulous 
and cancerous ulcers, diseases of the os uteri, and various chronic enlarge- 
ments. "Weaker solutions are used as lotions to ulcers, and as injections 
in foetid discharges from the vagina. A solution of the sulphate 
dissolves recently precipitated gelatinous alumina, and thus a benzoated 
solution of alumina can be prepared by saturating with gelatinous alum- 
ina 8 oz. of the sulphate in 1 pint of water, adding 6 drms. of powdered 
benzoin, keeping it at a temperature of 150° F. for six hours, and putting 
in a cool place for several days to deposit crystals. This solution is 
remarkable for its sweet odor and astringent balsamic taste. In the pro- 
portion of 2 to 5 fl. drms. to the pint of water it is useful as an injection 
in leucorrhoea, and in ulcerations of the neck of the uterus accompanied 
by foetid discharges. 1 

CERIUM. Ce; 92. 

It is a rare metal. 

Its salts are supposed to resemble those of bismuth and silver in their 
action. 

Cerii Oxalas. Oxalate of Cerium, U.S. P. and B.P. Ce(C 2 4 ) 3 
9H 2 0; 708; U.S.P.; CeC 2 4 .3H 2 0, B.P. 

Preparation. — Is prepared by precipitating a soluble salt of cerium 
with oxalate of ammonia. 

Characters. — It is a white granular powder, insoluble in water. 
At a red heat it is decomposed into a reddish-brown powder, which dis- 
solves completely in boiling hydrochloric acid without effervescence 
(oxide). 

The resulting solution gives a white crystalline precipitate of double 
sulphate of potassium and cerium when a saturated solution of sulphate 
of potash is added to it. 

Impurities. — Alumina, carbonates, and metals. 

Test. — When the salt is boiled with caustic potash and filtered the 
filtrate is not affected by chloride of ammonia, showing that no alumina 
is present: but when supersaturated with acetic acid it gives, with cal- 
cium chloride, a white precipitate of oxalate of lime. The absence of 
carbonates and metals is ascertained by the usual tests. 

Dose. — 1 to 10 grains. Large doses may succeed when small ones fail. 

Uses. — It was introduced by the late Sir James Simpson as a remedy 
to check the vomiting of pregnancy, and for this purpose is sometimes 



United States Dispensatory, 15th ed., p. 167. 



METALS. 



559 



useful. It has also been employed in cases of chronic bronchitis and 
dyspnoea, and has been used also in nervous cough and nervous palpita- 
tion. It has been given, but with doubtful utility, in chorea and epilepsy. 

Class II. 

Group II. — Magnesium. 



MAGNESIUM. Mg ; 24. 

Sources. — The chief source is dolomite, or mountain limestone, 
which consists of carbonates of magnesium and calcium. Magnesium is 
also found native as carbonate and silicate. 

General Reactions of Magnesium Salts. — They give a gelati- 
nous white precipitate with potash, soda, or ammonia, insoluble in excess, 
but soluble in a solution of ammonium chloride. They likewise give a 
white precipitate with potassium and sodium carbonates, but none with 
ammonium carbonate. 

The characteristic test of magnesium is the formation of a precipitate 
of triple phosphate on the addition of ammonia and a soluble phosphate 
to a solution of a magnesium salt. Caustic ammonia itself throws down 
a precipitate of magnesium hydrate insoluble in excess, but soluble in 
ammonium chloride. As it is easier to prevent the precipitation of 
hydrate than to redissolve it when down, it is usual to add ammonium 
chloride first, then the ammonia, and lastly the phosphate of soda. 

General Preparation of Salts of Magnesium. 



Is prepared 



Magnesium sul- 
phate, U.S.P. and 
B.P. 

Magnesium carbon- 
ate (heavy), B.P. 

Ditto (light),U.S.P. 
and B.P. 

Magnesia (heavy), 
U.S.P. and B.P. 



Ditto (light), U.S.P. 
and B.P. 

Granulated citrate 
of magnesia,U.S . P . 



Magnesium s u 1 
phite, U.S.P. 



From 



Dolomite. 



Magnesium sul- 
phate. 

Ditto. 



Magnesium car- 
bonate (heavy). 



Ditto (light). 
Ditto. 



Magnesia. 



By 



Dissolving in sulphuric acid ; when sol- 
uble magnesium sulphate and insoluble 
calcium sulphate are formed. 

Precipitating with sodium carbonate, 
using hot concentrated solutions. 

Ditto, using dilute solutions in the cold. 



Calcining until all the carbonic acid is 
driven off, as shown by some taken from 
the centre of the crucible no longer effer- 
vescing on the addition of acid. 

Calcining like the heavy magnesia. 



Mixing with citric acid and water, drying 
and powdering. The powder is mixed 
with sugar, sodium bicarbonate, and 
citric acid, damped with alcohol, passed 
through a sieve, so as to form a coarse 
powder, and dried. 

Suspending in water and adding excess of 
sulphurous acid. 



560 INORGANIC MATERIA MEDICA. 

General Impurities. — The chief impurities in the sulphate are the 
lime and iron from dolomite. Other alkaline earths and alkalies may 
also be present. The sulphuric acid employed may be impure, or the 
sulphate may have been prepared by a process in which hydrochloric 
acid is used, and thus chlorides may occur. In the carbonate prepared 
from the sulphate the same impurities may occur, as well as unchanged 
sulphate. In magnesia these may all occur, and carbonate as well. 

Tests. — The absence of iron and other metals is ascertained by the 
aqueous solution giving no color or precipitate with ferrocyanide of 
potassium, hydrogen sulphide, or ammonium sulphide. Chloride of 
ammonium prevents the precipitation of magnesia by ammonia and 
ammonium carbonate, but it does not prevent the precipitation of other 
alkaline earths, and their absence is ascertained by the solution remain- 
ing clear after the addition of these three reagents. 

General Action of Magnesia. — When administered by the mouth 
the difference between absorption and excretion is not great enough to 
allow magnesium salts to accumulate in the blood sufficiently to produce 
any toxic effects. When injected into the blood, sulphate of magnesia, 
in doses of about 5 grs. per pound weight of body, paralyzes the respira- 
tion and heart in cats (Hay), and has a similar effect in other animals also. 

Magnesii Sulphas, U.S. P. ; Magnesia?, Sulphas, B.P. Sul- 
phate of Magnesium, U.S. P.; of Magnesia, B.P. Epsom Salts. 
MgS0 4 ,7H 2 0; 246. 

Properties. — In minute, colorless, transparent, acicular crystals, 
whose form is a rhombic prism. They look exactly like sulphate of 
zinc. Its taste is bitter, and it is called in Germany Bittersalz. This 
distinguishes it from the zinc salt, which has a strong metallic taste. It 
readily dissolves in water, and the solution gives the reactions of magne- 
sium and a sulphate. 

Impurities. — Lime and iron. 

Tests. — Its aqueous solution is not precipitated at ordinary temper- 
atures by oxalate of ammonia (no lime), nor does it give a brown precip- 
itate with chlorinated lime or soda (no iron). 

Dose. — As a purgative, half an ounce to an ounce and a half for a 
single dose. In repeated doses, especially if taken fasting, 60 to 120 
grains. As a diuretic, 20 to 60 grains. 

Officinal Preparations. 

u.s.p. B.P. 

Infusum Serinse Compositnm. Enema Magnesia? Sulphatis. 

Mistura Senna? Composita. 

B.P. Enema Magnesiae Sulphatis. ENEMA OF SULPHATE OF MAGNESIA (Enema 
Catkarticumj. — Sulphate of magnesia 1, olive oil 1, starch mucilage 15. 

Action. — In moderate doses it causes a copious secretion from the 
intestinal mucous membrane, and acts as a purgative. It does not stim- 
ulate the muscular coat of the bowels much. It thus causes little griping, 
but neither does it accelerate peristaltic action. Thus a part of the fluid 
poured out into the intestine may be reabsorbed as it passes slowly along. 
It is therefore usual when we wish to produce free purgation to combine 



METALS. 561 

the salts with some purgative which will stimulate the muscular coat of 
the bowel, such as senna. When given alone it is apt to produce much 
flatulent distention of the abdomen and rumbling, and a carminative is 
therefore often given along with it. Its objectionable bitter taste may 
be covered by dissolving it in acid infusion of roses and adding spirit of 
chloroform. It may be employed as a purgative enema. When absorbed 
into the blood it acts as a diuretic if the skin be kept cool, and as a 
diaphoretic if the skin be kept warm or moderate exercise taken. It is 
absorbed more readily when given in small quantities, but a little is also 
taken up when purgative doses are employed, and it is therefore a useful 
purgative in febrile states. 

Uses. — Sulphate of magnesia is one of the most common and useful 
saline purgatives. For its mode of action and uses, vide pp. 341-344. 
On account of its great solubility it may be used in very concentrated 
solution to remove dropsy (p. 344) when less soluble salts cannot. 
Repeated small doses are very serviceable in biliousness. 

U.S.P. Magnesii Carbonas. Carbonate of Magnesium, 
(MgC0 3 ) 4 .Mg(HO) 2 .5H 2 0; 484. This corresponds to the two kinds 
mentioned in the B.P. 

B.P. Mag-nesise Carbonas. Carbonate of Magnesia, (MgCG 3 ) 
3 MgO,5H 2 0. 

B.P. Magnesise Carbonas Levis. Light Carbonate of 
Magnesia. 

Both light and heavy magnesia have the same chemical composition, 
and differ only in their weight. 

Preparation. — Both are prepared by precipitating a solution of 
sulphate of magnesia by a solutiou of carbonate of soda ; removing the 
resulting sulphate of soda, washing the carbonate, and drying it at a 
temperature not exceeding that of boiling water so as not to decompose it. 

In preparing the heavy carbonate, concentrated boiling solutions are 
used, the mixture evaporated to dryness, and the sulphate of soda removed 
by subsequent digestion with water. In preparing the light carbonate, 
dilute solutions are employed; they are mixed cold; boiled for fifteen 
minutes ; and the sulphate of soda separated by filtration. 

Properties. — A white granular powder almost tasteless. It is 
recognized as a carbonate by dissolving with effervescence in hydrochloric 
acid, and the magnesia is detected by the appropriate tests in the result- 
ing solution. The two carbonates are distinguished by their weight. 

Action. — When swallowed, carbonate of magnesia will have a less 
stimulating effect upon the mucous membrane than potash or soda, as it 
is nearly insoluble ; but on this very account it is to be preferred to them 
for neutralizing acid in the stomach after meals, inasmuch as it will only 
neutralize the excess of acid without rendering the fluids alkaline. In 
the intestine it acts as a laxative, and is partly excreted in the faeces and 
partly converted into magnesium salts which are absorbed and pass out 
in the urine. 

Uses. — As an antacid and laxative, especially in children; in heart- 
burn, in dyspepsia, and vomiting during pregnancy ; and in cases where 
36 



562 ixorgajSTc materia medica. 

it is desirable to render the urine alkaline, as in gouty persons, where 
potash and soda disagree. 

Dose. — As antacid, 5 to 20 grains; as a laxative, 10 to 60 grains. 
It may be conveniently given in milk. 

Officinal Peepaeations. 
b.p. DOSE. 

Liquor Magnesias Carbonatis, as antacid 1-4 fl. dr., as laxative 1-2 fl. oz. 
" " Citratis, as laxative... 5-10 fl. oz. 

B.P. Liquor Magnesias Carbonatis. SOLUTION OF CAEBONATE OF MAGNESIA. 
— It is a solution of carbonate of magnesia in water containing carbonic acid. It 
contains about 13^ grains in the fluid ounce. It is a pleasant laxative for children; 
and laxative and antacid for women, especially useful during pregnancy. 

B.P. Liquor Magnesias Citratis. SOLUTION OF ClTEATE OF MAGNESIA. — 
Dissolve citric acid 200 grains in 2 ounces of water, add carbonate of magnesia 100 
grains, and stir until it is dissolved. Filter the solution into a strong half-pint 
bottle, add syrup of lemons J fl. oz. and enough water nearly to fill the bottle; then 
introduce bicarbonate of potash in crystals 40 grains, and immediately close the 
bottle with a cork, which should be secured with string or wire. Afterwards shake 
the bottle until the bicarbonate of potash has dissolved. 



CHAPTER XXVI. 

METALS— (continued). 

Class II.— DYAD METALS— (continued). 

General Actions of Heavy Metals. — The heavy metals form 
compounds with albumen, known as albuminates. These are sparingly 
soluble, and in consequence of this, white of egg is a useful antidote 
in poisoning with heavy metals. Albuminates of copper have been 
obtained by Harnack in which the proportion of copper is definite, and 
is either 1-35 or 2-64 per cent. On account of their affinity for albumen 
the heavy metals combine with the albuminous constituents of the tis- 
sues, and act as powerful astringents (p. 308), irritants (pp. 302 and 
345), or caustics (pp. 301 and 306), according to the strength of the 
application. Their action is comparatively slight when they are applied 
to the unbroken skin, as the epidermis forms an obstacle to their action, 
but it is strongly marked where the epidermis is absent, as in wounds or 
ulcers, and on mucous surfaces where the epithelium is soft. In addition 
to their astringent action on the fluids and tissues, two metals — lead and 
silver — cause contraction of the blood-vessels (p. 309). In consid- 
ering the action of the heavy metals belonging to this group and those 
belonging to Classes III.- VIII., on the organism, it is necessary to dis- 
tinguish carefully between — 

(1) The local action upon the surface of the body or upon the ali- 
mentary canal, with the reflex effects upon the nervous, respiratory 
and circulatory systems consequent on this local action, and — 



METALS. 563 

(2) The effects produced on the various organs of the body by the 
metal after its absorption. Thus, a large dose of corrosive subli- 
mate when swallowed may produce the ordinary symptoms of poisoning, 
causing vomiting and purging by its local action on the stomach and 
intestine, and producing reflexly general collapse with feeble circulation 
and respiration. Yet if the treatment be prompt, none of the metal may 
be absorbed, and thus the symptoms which would be produced by its 
action on the various organs when carried to them by the circulation 
may be absent. 

In considering the effects produced by a metal after its absorption, 
we must remember that the nature of its action differs according to 
the quantity present in the blood at any one time, and that this quantity 
depends on the relation between the rapidity of absorption and 
excretion. 

The proportion between absorption and excretion depends greatly on 
the channel of introduction, and therefore the same drug may pro- 
duce quite different effects according to the mode of its administration. 
Thus solution of perchloride of iron, when injected directly into the 
veins, will cause almost immediate death from coagulation of the blood. 
Other salts of iron which have no coagulating action, if injected into the 
circulation, produce paralysis of the central nervous system and of 
the vaso-motor nerves, causing loss of voluntary motion, an enormous 
fall of the blood-pressure, and death. When injected subcutaneously 
iron is absorbed, but it enters the blood less rapidly than when injected 
into the veins, the quantity present in the blood at any one time is less, 
and these symptoms are not produced. Nevertheless absorption takes 
place from the subcutaneous tissue so rapidly that enough iron enters 
the blood to produce a toxic action. But this action, instead of affecting 
the nervous, is chiefly exerted on the excreting system, and inflammation 
of the kidneys occurs. When taken into the intestinal canal iron is 
absorbed very slowly, and only a very small quantity appears in the urine. 
It is hard to say whether the slight headache which is apt to come on from 
the administration of iron is due to the direct action of the metal on the 
nerve-centres after its absorption, or is merely reflex and due to the action 
of the metal on the intestine. No injury is done to the kidneys of 
healthy persons, though the effect of the iron upon these organs may be 
manifested by diminution of albumen in cases of renal disease. 

The form in which metals are absorbed from the intestinal canal 
is probably that of albuminates, or, perhaps, more properly, of peptonates. 

The only heavy metals which are rapidly absorbed from the healthy 
intestinal canal are lead, mercury, and arsenic. Copper, zinc, silver, tin, 
iron, manganese, nickel and cobalt are absorbed very slowly indeed. This 
is shown by the fact that when given internally only mere traces of them 
appear in the urine. That their absence from this secretion is due to 
non-absorption, and not to their retention in the blood or tissues, is 
proved by the fact that when they are injected subcutaneously they pass 
readily through the kidneys. 

Contrary to one's expectation, it has been found that metals are much 
more readily absorbed by the gastro-intestinal mucous membrane when it 
is in a catarrhal condition than when it is in a healthy state. When 



564 INORGANIC MATERIA MEDICA. 

large doses of metallic salts are given at once they are very apt to pro- 
duce acute catarrh of the intestinal canal, and they are then readily 
absorbed, and appear in large quantity in the urine. If small doses are 
given at first, instead of large ones, they may be gradually increased 
without producing any catarrh, and then absorption into the blood and 
excretion by the urine does not occur, or only to a slight extent, although 
the dose finally reached may be large. 

The therapeutic bearing of this fact is that if we wish to affect the 
kidneys by metallic remedies, e.g., by iron in cases of albuminuria, the best 
method of administering the remedy is to begin with large doses at once. 

After absorption into the "blood the metals probably remain to a 
great extent, if not entirely, in the plasma, and do not become combined 
with the corpuscles, or only to a very slight extent. 1 

They are. carried to all parts of the body, and probably unite with 
certain tissues. They remain in combination with the tissues for a 
greater or less length of time, modifying their nutrition and functional 
activity, and then, being again set free, they become excreted. 

The heavy metals have all a powerful, poisonous action on muscles, 
nerves, nerve-centres, and glands. The slightness of the action 
which they exert on these structures when administered by the alimen- 
tary canal is due to their slow and sparing absorption by it. But their 
poisonous power at once becomes evident, as in the case of iron, when 
they are injected either subcutaneously or directly into the circulation in 
the form of double salts or organic compounds, which produce no local 
irritation at the point of injection, nor coagulation of the blood when 
they are introduced directly into the vessels. The alterations in the 
spinal cord in acute poisoning by some of them, e.g., lead and mercury, 
and also by arsenic, have the characters of acute central myelitis, the 
gray substance being chiefly affected. In more chronic poisoning the 
white substance is affected as well, so that the alterations resemble those 
of diffuse myelitis. The nervous symptoms produced by heavy metals 
are probably due to such alterations in the nerve-centres, and sometimes 
to peripheral alterations in the nerves also. 

Metals are excreted chiefly by the bile (p. 352), by the kidneys, by 
the mucous membranes of the stomach and intestine, and probably to a 
slight extent by the skin. Elimination by these channels may commence 
very soon after the metal has entered the blood. 

During the process of elimination the metals may irritate the elimi- 
nating organs (Fig. 3, p. 40), and may cause vomiting by their action 
on the stomach (p. 325), diarrhoea by their action on the intestine, and 
albuminuria by their action on the kidneys, although they have been 
injected into the veins, or subcutaneously, and only reach these organs 
through the blood. 

On account of the quantity of metal which is eliminated by the bile 
and intestinal mucous membrane, purgatives are useful agents in the 
treatment of chronic metallic poisoning (pp. 334 and 519). 



1 This is best shown by separating the corpuscles and plasma in a centrifugal 
machine and analyzing them separately, so as to ascertain the amount of metal in 
each. 



METALS. 565 

When metals have entered the blood in considerable quantities, the 
kidneys become inflamed during the process of their excretion, and 
undergo changes which affect both the tubules and the glomeruli. The 
tubules are affected first, and the epithelial cells, both of the convoluted 
and straight tubules, take up the metal and become gradually disinte- 
grated. They are partly thrown out as casts, and partly block up the 
tubules, causing secondary degeneration of the glomeruli. Both tubules 
and glomeruli become atrophied. These effects appear to be produced by 
all the heavy metals. 

The possible effect of mercury on the kidneys should be borne in mind 
when prescribing a very prolonged mercurial course, and it would be 
interesting to inquire how far albuminuria in apparently healthy persons 
is caused by mercurials. 

Group III. — Zinc, Copper, Cadmium, and Silver. 

General Actions. — They combine with albumen and form insol- 
uble albuminates, and have thus an astringent action. 

With the exception of salts of silver, which form a compound with 
the epidermis, they have no action on the epidermis, but they may pass 
through the pores, especially chloride of zinc. This salt produces inflam- 
mation, or even mortification, acting by its affinity both for water and 
for albumen. It is used as a caustic for destroying the surface of 
unhealthy sores and producing a more healthy action. The other prepa- 
rations of the metals in this group act in the same way, but are less 
powerful, and are applied to ulcers and to chronic skin diseases. 

They are applied for their astringent action to the eye in gon- 
orrhoeal ophthalmia, ulcerations or opacity of the cornea, and to the 
mucous membranes of the urethra and vagina in gonorrhoea and 
leucorrhoea. 

Insoluble preparations, such as oxide of zinc, have little action on the 
skin, but are applied as powder or ointment to raw and excoriated sur- 
faces, where protection from external influences with very slight stimula- 
tion is wished, as in intertrigo. 

In the mouth they combine with the albumen of the tongue and 
cheeks, and produce a very disagreeable metallic taste. Notwithstanding 
this they are employed, especially sulphate of copper, for ulcers of the 
mouth or fauces. 

Zinc chloride has been recommended for carious teeth. 

In the stomach they unite with albumen in its walls, producing 
irritation and consequent nausea, accompanied by muscular relaxation. 
They have been used as nauseants in spasmodic affections, as epilepsy, 
chorea, hysteria, &c. 

In a somewhat larger dose they produce vomiting, which is speedy 
and complete, especially in the case of zinc and copper, which are conse- 
quently much used in cases of poisoning, where we wish the stomach 
emptied with all possible speed. They are preferred in such cases to 
tartar emetic, as they do not produce so much depression, nor are they 
so liable to cause diarrhoea ; and to ipecacuanha, because their action is 
more rapid and certain. 



566 INORGANIC MATERIA MEDICA. 

The compounds of zinc or copper with albumen or peptones will pro- 
duce vomiting, either when given by the mouth or when injected into the 
veins, but they are classed as local emetics (p. 326). 

Their emetic action when injected into the veins may be due to a 
direct action on the vomiting centre in the medulla (p. 323) ; but it may 
also be that they are carried to the stomach by the blood and act 
reflexly from it (vide Fig. 4, p. 56, and cf. p. 325). 

The albuminates of copper and zinc, and probably those of the other 
metals, undergo changes both in the stomach and intestine before absorp- 
tion which we do not perfectly understand. Albumen is not simply dissolved 
and absorbed in the intestinal canal, but is converted into peptone. Albu- 
minate of copper has been introduced into a gastric fistula in a dog, and 
the blue color was seen to disappear at the edges, and finally all copper 
was removed from it before the albumen was itself completely digested. 
"Whether or not the copper was removed in combination as a peptone 
we cannot as yet say. Copper salts combine with peptone, forming 
easily soluble precipitates. 

In the intestine small doses lessen the frequency of the stools, and 
have been thus used in chronic diarrhoea and dysentery, but larger doses 
have an irritant effect and cause diarrhoea. The insoluble salts, as oxide 
and carbonate of zinc, have a much weaker action than the soluble ones, and 
thus a large quantity has the same action as a small one of the soluble salts. 

Chronic poisoning- by copper is said to have occurred in conse- 
quence of the use of copper salts to give a bright green color to tinned 
peas or other vegetables, as well as from the employment of imperfectly- 
cleansed copper pans. Some doubt has been thrown on the possibility 
of producing chronic poisoning by the internal administration of copper 
in small doses, as in some experiments it was given to animals for a 
length of time without injury. More recent experiments show, however, 
that at least in ruminants chronic poisoning may be produced. The 
symptoms are loss of appetite, imperfect rumination, periodical constipa- 
tion, imperfect nutrition, muscular weakness, languor, jaundice, albuminu- 
ria, and towards the end hemoglobinuria or hematuria. On post-mortem 
examination granular degeneration of the muscles and heart, enlarged 
spleen, fatty degeneration of the liver, dark brown color of the blood, 
and granular deposits of methaamoglobin in the renal tubules along with 
hemorrhagic parenchymatous nephritis are found. 

Chronic poisoning by copper may occur among coppersmiths, or in 
families where copper pans have been used. The symptoms are a 
metallic taste, a feverish state, with symptoms of subacute gastro-enteritis, 
not unfrequently jaundice, trembling of limbs, and cramps. A purple 
line is said to form on the gums. 

ZINC. Zn; 65-2. 

Sources of Zinc. — The chief are native carbonate or calamine 
(ZnC0 3 ) and zinc blende (ZnS). 

General Reactions of Zinc Salts. — The most characteristic test 
is that it forms a white sulphide, which is precipitated on the addition 
of ammonium sulphide to a solution, and which is insoluble in caustic 
alkalies. Caustic potash, soda, or ammonia, give a white precipitate of 



METALS. 



567 



hydrate, soluble in excess ; ammonium carbonate gives a similar precipi- 
tate, soluble in excess ; but sodium and potassium carbonate give a white 
precipitate, insoluble in excess. 

General Preparation of Zinc Salts. 



Prepared 



From 



Zinc, U.S.P. and B.P. 



Granulated zinc, B.P. 

Zinc chloride, U.S.P. 
and B.P. 



Zinc blende or cala- 
mine. 



Zinc. 
Zinc. 



»Zinc sulphate, U.S.P. 
and B.P. 



Zinc carbonate, U.S.P. 
and B.P. 

Zinc acetate, U.S.P. 
and B.P. 

Zinc oxide, U.S.P. and 
B.P. 

Zinc valerianate,U.S.P. 
and B.P. 

Zinc bromide, U.S.P. 



Zinc iodide, U.S.P. 
Zinc phosphide, U.S.P. 



Zinc. 

Zinc sulphate. 
Zinc carbonate. 

Do. 
Zinc sulphate. 

Do. 

Zinc. 



By 



Koasting, to drive off sulphur or 
carbonic acid, and then distilling 
the oxide with charcoal. 

Melting and throwing into water. 

Dissolving in hydrochloric acid 
(Zn 2 + 4HC1 = 2ZnCl 2 + 2H 2 ) : 
it is then purified from lead or 
iron by passing chlorine through 
it, and adding carbonate of zinc, 



2FeCl 2 

Ferrous 
chloride. 



Cl 2 
Chlorine. 



Fe 2 Cl 6 + 3ZnC0 3 
Ferric Carbonate 

chloride. of zinc. 



Ferric 
hydrate. 



Chloride of 
zinc. 



PbCl 2 + Cl 2 - 
Chloride of Chlorine, 
lead. 

Pb0 2 

Peroxide of Chloride of 
lead. zinc. 



Fe 2 Cl e 

Ferric 
chloride. 



+ 3C0 2 . 
Carbonic 
acid gas. 

2ZnC0 3 = 
Carbonate, 
of zinc. 



Carbonic 
acid gas. 



Dissolving in sulphuric acid, and 
purifying in the same way as 
chloride. 

Precipitating with carbonate of 
soda. 

Dissolving in acetic acid. 



Calcining. 



Mixing with sodium valerianate. 



Mixing with hot solution of potas- 
sium bromide, precipitating potas- 
sium sulphate by alcohol, filtering, 
and evaporating. Or by acting 
on zinc with bromine. 

Digesting with iodine in water and 
evaporating. 

Passing phosphorus vapor in dry 
hydrogen over melted zinc. 



568 INORGANIC MATERIA MEDICA. 

General Impurities of Zinc Salts. — Iron, lead, copper, and 
arsenic. 

General Tests. — A solution of zinc salt acidulated with hydro- 
chloric acid gives no precipitate with sulphuretted hydrogen (absence of 
lead, copper, or arsenic). The absence of copper is further ascertained 
by ammonia giving with a solution of zinc salts a white precipitate, solu- 
ble in excess without color. If copper be present the solution would be 
blue. Solutions should give no blue with ferro- or ferri-cyanide of potas- 
sium, nor any black color with tincture of galls (absence of iron). 

General Action of Salts of Zinc. — They combine with albu- 
men and coagulate it. The chloride of zinc thus acts as an escliarotic 
after the epidermis has been previously removed by caustic potash. 
Neither it, nor the sulphate, nor acetate of zinc has any action on the 
unbroken skin, but when applied to mucous membranes they will act as 
irritants in large, and as astringents in small doses. 

Sulphate and acetate of zinc are prompt emetics, causing rapid 
evacuation of the contents of the stomach with little nausea or depression. 

The mode of action of zinc salts as emetics has not been perfectly 
determined. It is probably partly due to the local effect upon the 
stomach, and partly to the stimulant action upon the vomiting centre 
in the medulla oblongata after absorption into the circulation. 

Vomiting is produced by the injection of zinc salts into the circu- 
lation, but this may be partly due to irritation of the stomach by the zinc 
salts during the process of excretion by its mucous membrane, as well as 
to the action upon the medulla. 

In small doses zinc salts act also as nervine tonics, and lessen 
sweating. 

Zincum. U.S. P. and B.P. Zinc ; 64*9. Metallic zinc in the 
form of thin sheets or irregular granulated pieces, U.S. P. Zinc of Com- 
merce, B.P. 

Characters. — A bluish white metal having the sp. gr. 6*9. When 
treated with warm diluted sulphuric acid it is almost completely dissolved, 
forming a colorless liquid which yields a white precipitate with test solu- 
tion of ferro-cyanide of potassium, or of sulphide of ammonium. U.S. P. 

Preparations containing Zinc. 

U.S. p. B.P. 

Liquor Zinci Chloridi. Liquor Zinci Chloridi. 

Unguentum Zinci Oxidi. Unguentum Zinci. 

Zinci Acetas. Zinci Acetas. 

" Bromidum. " Carbonas. 

" Carbonas Prrccipitatus. " Chloridum. 

" Chloridum. " Oxidum. 

'' Iodidum. " Sulphas. 

" Oxidum. " Valerianas. 

" Phosphidum. Zincum Granulatum. 

" Sulphas. 

" Valerianas. 

r,.i\ Zincum Granulatum. Granulated Zinc — (Zinc fused and poured into 
water). 

Impurities. — Very frequently it contains sulphur or arsenic. 



METALS. 569 

Tests. — Zinc is chiefly used for preparing hydrogen, and these 
impurities are tested by adding pure dilute hydrochloric or sulphuric acid 
to it and holding over it a piece of paper dipped in acetate of lead. If 
sulphur be present the paper is blackened. If the piece of paper be 
wetted with solution of nitrate of silver, a brown or black stain is pro- 
duced if arsenic is present. On lighting the hydrogen and depressing a 
piece of porcelain on it, a black stain is produced if arsenic be present. 

Zinci Oxiclum, U.S.P. and B.P. Oxide of Zinc. ZnO. 809. 

Characters. — A soft, nearly white, tasteless and inodorous powder, 
becoming pale-yellow when heated. 

Impurities. — Undecomposed carbonate, chloride, sulphates, iron 
and copper. 

Tests. — Dissolves without effervescence in diluted nitric acid, forming 
a solution, which is not affected by chloride of barium or nitrate of silver, 
and gives with carbonate of ammonia a white precipitate which dissolves 
entirely (no iron) without color (no copper) in an excess of the reagent, 
forming a solution which is precipitated white by sulphide of ammonium. 

Dose. — 2 to 10 grains. 

Officinal Prepakations. 
u.s.p. B.P. 

Unguentum Oxidi Zinci. Unguentum Zinci. 

TJ.S.P. Unguentum Oxidi Zinci. OINTMENT OF OXIDE OF ZlNC. — Oxide of zinc 
20, benzoated lard 80, or 1 in 5. 

B.P. Unguentum zinci. Zinc Ointment. — Oxide of zinc 80 grs., benzoated lard 
1 oz., or 1 in 6£ nearly. 

Uses. — Oxide of zinc is sparingly soluble in the stomach. It dis- 
solves to a slight extent, too little to act as an emetic, but sufficient to 
produce the action of small doses of soluble zinc salts as a nervine tonic 
and astringent. 

It may be used as a dusting powder in intertrigo, and the zinc oint- 
ment is one of the most efficacious remedies we possess for application to 
excoriated surfaces and eczema. It has been given in whooping-cough, 
epilepsy, hysteria, nervous headache, and to check profuse sweating in 
phthisis, and profuse secretion from the bronchi in bronchitis. In the 
sweating of phthisis it is frequently combined with hyoscyamus, and it 
is somewhat difficult to say how much of the beneficial action is due to 
the hyoscyamus. 

Zinci Carbonas Prgecipitatus, U.S.P. ; Zinci Carbonas, B.P. 
Precipitated Carbonate of Zinc, U.S.P. Carbonate of Zinc, 
B.P. (ZnCo 3 ) 2 .3Zn(HO) 2 ; 546-5, U.S.P. ; ZnCOs(ZnO) 2 .3H 2 0, B.P. 

Characters and Tests. — White, tasteless, inodorous, insoluble 
in water ; soluble, with effervescence and without residue, in diluted nitric 
acid. This solution gives the reactions of zinc. 

Dose. — 1 to 10 grains. 

Uses. — Used sometimes in skin diseases instead of oxide, and pre- 
ferred to it by some. Formerly native carbonate was used as calamine 
cerate or Turner's cerate, corresponding to the ointment of the oxide. 

Zinci Chloridum, U.S.P. and B.P. CHLORIDE OF ZlNC. 
ZnCL; 135-7. 



570 INORGAXIC MATERIA MEDICA. 

Characters and Tests. — Colorless opaque rods or tablets very 
deliquescent and caustic : soluble almost entirely in water, alcohol and 
ether. The watery solution gives the reactions of zinc and of a chloride. 

Prepaeation Containing Chloride of Zinc. 
Liquor Zinci Chloridi 366 grains in 1 fluid ounce. 

Idquor Zinci Chloridi, U.S.P. and B.P. SOLUTION OF CHLORIDE OF ZlNC. ZnCl 2 ; 
1357, U.S.P. Prepared like the solid, but not so much evaporated. 

Uses. — It is a powerful caustic, distinguished by its property of 
burning deeply and not spreading sidewise like many others. It is 
applied, in substance, or made into a paste with starch or gypsum, to 
cancers, sloughing or unhealthy sores, and nsevi. Diluted it is applied 
to ulcers. 

It has been used to destroy the exposed pulp in decayed teeth, warty 
growths, condylomata, syphilitic sores, and lupus. In the proportion of 
one to two grains in a pint of water it has been recommended by Ringer 
as an injection in gonorrhoea. 

Burnett's (Sir W.) disinfectant and deodorizing solution is solution 
of chloride of zinc (of sp. gr. 2), and it is by the accidental use of this 
that most cases of zinc poisoning occur. 

Zinci Sulphas, U.S.P. and B.P. SULPHATE OF ZlNC. ZnS0 4 . 
7H 2 0; 288-9. 

Characters and Tests. — In colorless transparent prismatic crystals 
with a strong metallic styptic taste. Its solution in water gives the reac- 
tions of zinc and of a sulphate. 

Dose. — 1 to 3 grains (as a tonic); 10 to 30 grains (as an emetic). 

Uses. — Sulphate of zinc is used as an astringent to lessen dis- 
charges from mucous membranes ; it is employed as a lotion in gonorrhoea 
and leucorrhoea ; as a wash to the eye in ophthalmia ; and, mixed with 
honey, in gangrene of the mouth in children. It is used as a gargle to 
the throat in relaxed sore throat, pendent uvula, and enlarged tonsils. 

As an emetic it is chiefly employed in narcotic poisoning, where 
the rapidity of its action, unaccompanied by any depressing influence on 
the circulation, is very serviceable. It is sometimes used, also, to cause 
vomiting in croup. It is employed as an astringent in chronic diar- 
rhoea and dysentery. It has also been used as a tonic in flatulence and 
flatulent distention of the colon. After absorption into the blood it has 
a tonic action on some parts of the nervous system, and is used in the 
treatment of convulsive diseases, such as chorea, epilepsy, hysteria, as 
well as in spasmodic affections of involuntary muscular fibre, such as 
angina pectoris and spasmodic asthma. 

Zinci Acetas, U.S.P. and B.P. Acetate of Zinc. Zn 
(C 2 II 3 O a .) 2 3H a O; 236-9, U.S.P.; Zn (C 2 H 3 2 ) 2 .2II 2 0, B.P. 

CHARACTERS and Tests. — Thin, translucent and colorless crystalline 
plates, of a pearly lustre, with a sharp, unpleasant taste ; soluble in water ; 
the solution gives the reactions of zinc, and evolves acetic acid when 
decomposed by sulphuric acid. 

Dose. — 1 to 2 grains (as a tonic); 10 to 20 grains (as an emetic). 



METALS. 571 

Uses. — It is used for much the same purposes and in the same doses 
as the sulphate. An unchemical but useful injection for gonorrhoea, gleet, 
and leucorrhoea, consists of six grains of sulphate of zinc, with four ounces 
of the dilute solution of sub-acetate of lead. In this mixture the sulphate 
of lead which is precipitated has probably a beneficial action in keeping 
apart the surfaces of the mucous canal into which it is injected (p. 385). 

U.S.P. Zinci Bromidum. Bromide of Zinc. ZnBr 2 ; 224-5. 

Characters. — A white, or nearly white, granular powder, very 
deliquescent, odorless, having a sharp saline metallic taste, and a neutral 
reaction. Very soluble in water and in alcohol. The aqueous solution 
of the salt yields the reactions of zinc and of a bromide. 

Uses. — In large doses it is irritant and emetic, like other salts of zinc. 
It has been recommended in epilepsy with the idea of combining the 
actions of bromine and zinc. 

Dose. — 2 to 8 grains given in syrup. 

U.S.P. Zinci Iodiclum. Iodide OF Zinc. Znl 2 ; 318*1. 

Characters. — A white, or nearly white, granular powder, very 
deliquescent, odorless, having a sharp saline and metallic taste, and an 
acid reaction. Very soluble in water and in alcohol. The aqueous solution 
yields a white precipitate with test solution of ferrocyanide of potassium 
or of sulphide of ammonium, a yellow precipitate with test solution of 
acetate of lead, and a red one with test solution of mercuric chloride 
(iodide). 

Uses. — Locally it has been used in solution as an application to 
enlarged tonsils. An ointment, 1 part to 8 of lard, has been used in place 
of the ointment of iodide of potassium or of cadmium to reduce swellings. 
A solution of 2 grains to 1 oz. has been used in gonorrhoea. Internally 
it has been used in scrofula, chorea, and hysteria. It is best administered 
in the form of syrup. 

Dose. — J to 2 grains. 

Zinci Valerianas, U.S.P. and B.P. Valerianate of Zinc. 

Zn(C 5 H 9 2 ) 2 ; 284-9. 

Characters. — In brilliant, white, pearly, tabular crystals, with a 
feeble odor of valerianic acid, and a metallic taste ; scarcely soluble in 
cold water or in ether, soluble in hot water and alcohol. Heated to red- 
ness in an open crucible it leaves a residue, which, when dissolved in 
diluted sulphuric acid, yields with ammonia a precipitate which entirely 
dissolves in an excess of the reagent, and the resulting solution gives a 
white precipitate with sulphide of ammonium (zinc). 

Preparation. — Mixing hot aqueous solutions of sulphate of zinc 
and valerianate of soda, evaporating at a gentle heat, and crystallizing. 
The crystals are washed with water until free from sulphate. 

Impurities. — Sulphate and butyrate of zinc from imperfect prepa- 
ration. 

Tests. — Its solution in hot water is not precipitated by chloride of 
barium (no sulphate). It gives when heated with diluted sulphuric acid 
a distillate, which, when mixed with the solution of acetate of copper, 
does not immediately aifect the transparency of the fluid, but forms after 



572 INORGANIC MATERIA MEDICA. 

a little time oily drops, which gradually pass into a bluish-white crystal- 
line deposit (no butyrate). 

Dose. — J-4 gr. ; the dose may be increased till some nausea is 
produced. 

Uses. — Valerianate of zinc has been supposed to combine the nervine 
tonic action of zinc with the antispasmodic effect of valerian, but it is 
much better to use valerian itself or its oil along with a salt of zinc, as- 
the acid has no important physiological action. It is used in chorea, 
especially when occurring in hysterical persons, and should not be dis- 
continued until symptoms of nausea begin to make their appearance. It 
is also employed in epilepsy and neuralgia. 

U.S. P. ZinciPhospliidum. Phosphide oe Zinc. Zn 3 P 2 ; 256*7. 

Characters. — Minutely crystalline friable fragments, having a 
metallic lustre on the fractured surfaces, or a grayish-black powder, per- 
manent in the air, having a faint odor and taste of phosphorus, insoluble 
in water or alcohol, but completely soluble in hydrochloric or sulphuric 
acids with evolution of phosphoretted hydrogen. 

Uses. — Its action is similar to that of phosphorus, and it is used in 
place of it. Each grain contains nearly J grain of phosphorus. 

Dose. — Not more than ■£$ grain at first. 

COPPER. Cu; 63-4. 

Sources. — Its chief source is copper pyrites, which is a double 
sulphide of copper and iron. 

General Reactions.— Ammonia throws down a pale blue precipi- 
tate of hydrate, which is soluble in excess, forming a deep blue solution. 
Potassium ferrocyanide gives a maroon red precipitate. 



Prepared 


From 


By 


Copper. 


Copper pyrites. 


Roasting with sand and coal. 


Copper sulphate. 


Copper. 


Heating copper or its oxide with 
sulphuric acid. 


Copper acetate. 


Copper sulphate. 


Precipitating with acetate of lead. 



General Impurity. — Iron. 

General Test. — If an aqueous solution of a copper salt be mixed 
with twice its volume of chlorine water, any iron present is converted 
into a ferric salt. If solution of ammonia be now added, cupric hydrate 
will fall as a precipitate of a pale blue color, but is redissolved by excess, 
forming a deep blue solution. If iron be present it will be precipitated 
by the ammonia and not redissolved. 

Cuprum. = Cu t>3*5., B.P. Copper. — Fine copper wire, about 
No. 25. 

CFsb. — To detect the presence of metals, as silver, mercury, and 
arsenic, by their being precipitated on its surface and forming a stain. 



METALS. 573 

It is employed in the preparation of sulphate of copper and of spirit of 
nitrous ether. 

Cupri Sulphas, U.S. P. and B.P. Sulphate of Copper. Cu 
S0 4 .5H 2 0; 249-2. 

May be obtained by heating sulphuric acid and copper together, dis- 
solving the soluble product in hot water, and evaporating the solution 
until crystallization takes place on cooling. 

Characters and Tests. — A blue crystalline salt, in oblique prisms, 
soluble in water, forming a pale blue solution which strongly reddens 
litmus. The aqueous solution gives the reactions of copper and a sulphate. 

Dose. — As an astringent, J grain to 2 grains ; as an emetic, 5 to 
10 grains. 

B.P. Sulphate of Copper, Anhydrous. CuS0 4 . Sulphate of copper deprived of 
its water by a heat of 400°. 

Characters. — A yellowish-white powder, which becomes blue when moistened 
with water. 



Action. — Sulphate of copper has little or no action on the skin cov- 
ered by epidermis, but when applied to the denuded skin it combines with 
the albuminous constituents of the tissues, forming an albuminate of 
copper. It thus acts as a mild caustic, and is an astringent. It has 
a similar astringent action on mucous membranes, and when swallowed 
in large doses it acts as a powerful emetic, like the sulphate of zinc, 
and in smaller doses as an astringent. Like sulphate of zinc, it proba- 
bly exerts its action partly on the stomach itself and partly on the vomit- 
ing centre. Small doses absorbed into the blood appear to have a tonic 
action on some parts of the nervous system, and to exert an astringent 
action on mucous membranes. The copper is excreted by the mucous 
membrane of the intestine, by the bile, sweat, and kidneys. It is 
probable that its effect as an emetic when injected into the blood is par- 
tially due to the action it produces upon the stomach or intestines in the 
process of elimination (p. 56). Its action as an astringent upon other 
mucous membranes is probably due to a similar cause. 

Uses. — Sulphate of copper in substance is used as a mild caustic to 
the edges of sores, to repress exuberant granulations, and as a styptic to 
arrest the blood from leech bites. When mixed with honey it may be ap- 
plied to the mouth in cancrum oris. In solution it may be applied to 
indolent ulcers, and to remove warts and parasitic skin diseases, and as 
an injection into the nose to stop epistaxis. It is used as a wash to the 
eyes in ophthalmia, as an injection in gonorrhoea and leucorrhoea, and as 
a gargle in sore throat. It is an efficient and rapid emetic in cases of 
narcotic poisoning, in phosphorous poisoning, and in croup. It is a pow- 
erful astringent in chronic diarrhoea, dysentery, and colliquative diarrhoea 
of phthisical patients. It is employed, like zinc, in chorea, epilepsy, and 
hysteria, but seems less useful than zinc. 

B.P. Test Solution of Amnio nio -Sulphate of Copper. 

Used as a test for arsenious acid, forming with it Scheele's green. 

B.P. Subacetate of Copper of Commerce. Cu.CuO 
{C 2 H 3 2 ) 2 . Verdigris, Aerugo. — Used in solution as a test. 



574 INORGANIC MATERIA MEDICA. 

B.P. Test Solution of Acetate of Copper. 

Use. — In testing for butyric acid in valerianates. 

U.S.P. Cupri Acetas. Acetate of Copper. Cu (C 2 H 3 2 ) 2 H 2 ; 
199-2. 

Characters. — Deep green, prismatic crystals, yielding a bright 
green powder, efflorescent on exposure to air, odorless, having a nauseat- 
ing metallic taste and an acid reaction. 

Tests. — If the aqueous solution of the salt be treated with hydrosul- 
phuric acid until all the copper is precipitated, the nitrate should leave 
no residue on evaporation (alkalies, alkaline earths, or iron). If the 
aqueous solution be heated to boiling with solution of soda in excess, it 
will yield a filtrate which should not be clouded by hydrosulphuric acid 
(absence of lead and zinc). 

Uses. — Same as those of sulphate of copper. Not used internally. 

CADMIUM. Cd; 112. 

It is a somewhat rare metal occurring in certain zinc ores. It is more 
volatile than zinc, and when the native zinc carbonate or calamine is 
heated with charcoal the cadmium volatilizes first. It is like tin, but is 
rather harder. 

B.P. Cadinii Iodidum. Iodide oe Cadmium, Cdl 2 . 

Preparation. — It is prepared by acting on cadmium with iodine in 
the presence of water. 

' Characters. — It forms white micaceous crystals, which have a pearly 
lustre. When heated to 600° they melt and form an amber-colored fluid. 
When the heat becomes dull red they give off violet fumes, showing that 
iodine is present in them. The presence of cadmium is shown by adding 
H 2 S or 2s H 4 S to the solution in water when the yellow sulphide, so much 
used in painting under the name of cadmium yellow, is precipitated. This 
precipitate is insoluble in excess of sulphide of ammonium, and is thus 
distinguished from antimony and arsenic, whose sulphides are soluble. 
The solution also gives a white gelatinous precipitate with potash, insol- 
uble in excess. 

Impurities. — It might be contaminated with tin and zinc. 

Tests. — These are detected by adding ammonium sulphide to the 
filtrate after the cadmium has been precipitated by potash from the 
aqueous solution. 

Officinal Peepaeation. 

B.P. Vngnentum Cadmii Iodidi. OINTMENT OF IODIDE OF CADMIUM (62 grs. 
to 1 oz. of simple ointment). 

Use. — "When applied to the skin, iodide of cadmium acts as a rubefa- 
cient, and has been used to promote the absorption of glandular enlarge- 
ments. Its advantages over iodine and iodide of lead are that it does not 
cause poisoning like lead, and it does not stain the skin, and may 
therefore be applied to cause absorption of glands in the neck, where 
stains would be unsightly. 

ARGEXTUM. Silver. 
Argentum Purificutum, B.P. PtEFIXED SILVER. 
Pure metallic silver. 



METALS. 575 

Impurities. — Gold, copper, and lead. 

Test. — If ammonia be added in excess to a solution of the metal in 
nitric acid, the resulting fluid exhibits neither color nor turbidity. 
Preparation. — Argenti Nitras. 

Argenti Xitras, U.S.P. and B.P. NlTRATE OF SILVER. — 
AgNo 3 ; 169-7. 

Preparation. — By dissolving silver in nitric acid, evaporating and 
crystallizing. 

Characters. — In colorless tabular crystals, the primary form of 
which is the right rhombic prism ; or in white cylindrical rods ; soluble 
in distilled water, and in rectified spirit. The solution gives with hydro- 
chloric acid a curdy white precipitate, which darkens by exposure to 
light, and is soluble in solution of ammonia. A small fragment heated 
on charcoal with the blow-pipe, first melts, and then deflagrates, leaving 
behind a dull white metallic coating. 

Impurities. — Nitrate of potash, metallic impurities. 

Tests. — Ten grains dissolved in two fluid drachms of distilled water 
give with hydrochloric acid a precipitate, which, when washed and 
thoroughly dried, weighs 8*44 grains. The filtrate when evaporated by 
a water-bath leaves no residue. 

Dose. — ^ to J grain. 

Administration. — As an application to the eyes or injection it is 
used of various strengths, but an ordinary safe one is 2 grains to the 
ounce. When made into pill it must not be mixed with tannin, which 
reduces the silver to the metallic condition and becomes converted into 
gallic acid with evolution of carbonic acid gas. It is best made up into 
pill with kaolin and a very little tragacanth. As a draught it may be 
made up with dilute nitric acid, syrup, and mucilage. 

U.S.P. Arg-enti Nitras Fusus. Moulded Nitrate oe Silver. 

Prepared by fusing together nitrate of silver 100 parts, hydrochloric 
acid 4 parts, and pouring into suitable moulds. 

Characters. — A white, hard solid, generally in form of pencils or 
cones, of a fibrous fracture, becoming gray or grayish-black, on exposure 
to light in presence of organic matter. 

U.S.P. Argenti Nitras Dilutus. Diluted Nitrate of Silver. 

Preparation. — Prepared by fusing together equal parts of nitrate 
of silver and nitrate of potassium. 

Characters. — A white, hard solid, generally in the form of pencils 
or cones, of a finely granular fracture, becoming gray or grayish-black 
on exposure to light in presence of organic matter. 

Tests. — An aqueous solution of 1 Grm., acidulated with nitric acid, 
when completely precipitated by hydrochloric acid should yield not less 
than 0-84 Grm. of dry chloride of silver. The filtrate separated from 
the precipitate, when evaporated to dryness, leaves a residue which is 
completely soluble in water, and which yields a white crystalline precip- 
itate with a concentrated solution of bitartrate of sodium (potassium). 

General Action of Silver Salts. — Soluble silver salts, such as 
the nitrate of silver, have a strong affinity for the cement by which 



576 INORGANIC MATERIA MEDICA. 

epithelial or endothelial cells are united, and are therefore much used in 
staining microscopic preparations. They also unite with albumen, form- 
ing albuminates of silver. When applied to the skin, nitrate of silver 
produces a white mark which rapidly becomes blackened by exposure to 
light, and the epidermis, either alone or with a slough varying in depth 
according to the strength of the application, is thrown off. Locally, it 
causes greater contraction of the vessels than other metals. In the 
mouth it has an unpleasant astringent taste, corrugates the mucous 
membrane, and acts as an irritant or caustic. In the stomach, in small 
doses, it acts as an astringent, and occasionally lessens vomiting, but in 
larger doses it acts as an irritant, and causes vomiting and symptoms of 
irritant poisoning (p. 346). In the intestine small doses are astringent, 
and, when absorbed from the blood, appear, like zinc or copper, to have 
a tonic action on some parts of the nervous system. When taken for 
a length of time it is apt to cause a livid discoloration of the skin. This 
discoloration appears to depend upon the amount of silver taken inde- 
pendently of the time during which its administration has been continued, 
so that it is advisable, when administering nitrate of silver to a patient, 
to inquire whether he has previously taken it or not, as the silver remain- 
ing in the system, together with that administered in the second instance, 
might cause a darkening of the skin which the quantity employed in the 
second course alone would not have produced. When taken for a long 
time, silver salts appear to produce fatty degeneration of the tissues. 
They are probably very slowly eliminated by means of albuminous 
secretions, such as bile. 

Uses. — Nitrate of silver may be applied to destroy parasitic fungi 
and remove tinea ; to destroy the epidermis itself or epidermic structures, 
such as warts, and to check the bleeding from leech bites. In solution 
it relieves the itching of pruritus and of lichen. When sponged over the 
skin it hardens the epidermis and may prevent the formation of bed-sores. 
It is said to arrest vesication in herpes if painted over the surface as soon 
as the vesicles begin to form. It is also said that the pitting of small- 
pox is prevented by opening the vesicle and touching the surface beneath 
with a solution of the salt, or even by painting the solution over the skin. 
It has been recommended as a remedy in erysipelas, and is applied either 
by painting the strong solution over and beyond the inflamed surface, or 
by drawing a line with solid nitrate of silver upon the skin a little way 
beyond the margin of the inflammation. The alteration produced in the 
tissues underneath this line is said to prevent the extension of the inflam- 
mation beyond the limit thus formed. It is of little use in poisoned 
wounds, such as the bite of a mad dog (p. BOG). Dilute solutions may 
be applied to the eye in tinea tarsi and conjunctivitis. In the mouth it 
may be used as an application to ulceration of the tongue, soft palate or 
tonsils, and is often employed for this purpose on account of the readiness 
with which it can be applied. In thus applying it care should be taken 
that it is well fixed in the holder, as otherwise a quick motion of the 
patient may break oft" the portable stick of nitrate of silver which will 
probably fall into the pharynx, be swallowed, and may produce symptoms 
of irritant poisoning. The treatment of poisoning is to give common 
salt in order to form insoluble, and therefore inert, chloride of silver. 



METALS. 577 

Where the stick of nitrate of silver has been swallowed in substance this 
treatment has not always proved efficacious, and salt should therefore 
then be administered in combination with mucilaginous substances, such 
as porridge and gruel, along with an emetic, so that the stick of silver 
may be at once evacuated from the stomach, while the mucilaginous 
envelope prevents it from doing any harm to the oesophagus on its way. 
It has been used to destroy the false membrane in croup, and as a useful 
application to the larynx in laryngeal phthisis. It may be applied either 
in solution, by means of a brush, or in the form of lycopodium, which, 
after being dipped in the solution and then dried, may be blown by a 
curved tube into the larynx. It is sometimes used as an injection in 
gonorrhoea. Internally, it may be employed in irritable stomach, and 
also as an astringent in chronic diarrhoea and dysentery, and as a nervine 
tonic in chorea and epilepsy. 

Argenti Oxidum, U.S.P. and B.P. OxiDE OF SILVER. 
Ag 2 0; 213-4. 

Characters and Tests. — An olive-brown powder, which at a low 
red heat gives off oxygen, and is reduced to the metallic state. It dis- 
solves completely in nitric acid without the evolution of any gas, forming 
a solution which has the characters of nitrate of silver. 29 grains heated 
to redness leave 27 grains of metallic silver. 

Dose. — J grain to 2 grains. 

Uses. — It has been used internally in neuralgic pain in the stomach, 
irritable dyspepsia, and pyrosis. Another drug not unfrequently given 
in similar affections is creasote, but creasote and oxide of silver are 
incompatible, as the former becomes oxidized at the expense of the silver 
oxide, and the mixture may undergo spontaneous combustion. It has 
been used in haemorrhage from the stomach and lungs, and has been 
highly recommended in monorrhagia. 

U.S.P. Argenti Cyanidum. Cyanide of Silver. AgCN; 
133-7. 

Characters. — A white powder, permanent in dry air, but gradually 
turning brown by exposure to light, odorless and tasteless and insoluble 
in water or alcohol. Insoluble in cold, but soluble in boiling nitric acid 
with evolution of hydrocyanic acid ; also soluble in water of ammonia and 
in solution of hyposulphite of sodium. When heated the salt fuses, gives 
off cyanogen gas, and on ignition metallic silver is left. 

Officinal Preparation. 

U.S.P. 
Acidum Hydrocyanicum Dilutum. 

U.S.P. Arg-enti Iodidum. Iodide of Silver. Agl; 234-3. 

Characters. — A heavy, amorphous, light-yellowish powder, unal- 
tered by light if pure, but generally becoming somewhat greenish-yellow, 
without odor and taste, and insoluble in water, alcohol, diluted acids or 
in solution of carbonate of ammonium. Soluble in about 2500 parts of 
stronger water of ammonia. It is dissolved by an aqueous solution of 
cyanide of potassium and the resulting solution yields a black precipitate 
with hydrosulphuric acid or sulphide of ammonium (silver). If a small 
37 



578 



INORGANIC MATERIA MEDICA. 



quantity of chlorine water be agitated with an excess of the salt, the 
filtrate acquires a dark blue color on the addition of gelatinized starch 
(iodide). 

Dose. — 1 to 2 grains. 

Use. — It has been used instead of nitrate of silver in irritability of 
the stomach, dysmenorrhea, and epilepsy. 

Class II. — Group IV. 



MERCURY, Hg; 200. 

Mercury is a liquid metal. It forms two series of compounds, viz., 
mercurous, in which it is univalent, e.g., Hg 2 Cl 2 ; and mercuric, in which 
it is bivalent, e.g., HgCl 2 . In constitution these salts are analogous to 
the cuprous and cupric salts. 

General Sources. — The chief source is native sulphide or cinnabar. 

Metallic mercury is prepared from this by roasting it either alone or 
with lime or iron. 

General Reactions of Salts of Mercury. — They are all either 
volatile or decomposed by heat with the liberation of free mercury. The 
soluble salts are decomposed by stannous chloride; the mercuric salts 
giving first a white precipitate, changing into black, and the mercurous 
salts a black one of finely divided mercury at once. Mercurous salts are 
most readily distinguished from mercuric salts by their reactions with 
alkaline carbonates with ammonia, or with potassium iodide. The differ- 
ences will be readily seen from the following table. The difference 
between the reactions of potash and ammonia with mercuric salts is 
noteworthy. 

General Reactions of Salts of Mercury. 



Reagent. 


Mercurous Salts. 


Mercuric Salts. 


Stannous chloride. 


Black ppt. (finely- 
divided mercury). 


White ppt. , turning black (calomel 
changing into mercury). 


Caustic soda or potash. 


Black ppt. 


Yellow ppt. (oxide). 


Carbonates of ditto. 


White ppt., turning 
black. 


Red-brown ppt. 


Ammonia. 


Black ppt. 


White ppt. (double salt of mercury 
and ammonia). 


Ammonium carbonate. 


White ppt., turning 
black. 


White ppt. 


Potassium iodide. 


Greenish-yellow ppt. 


Bright scarlet ppt., soluble in ex- 
cess either of mercuric chloride 
or of potassium iodide. 



General IMPURITIES. — Other metals, especially lead, arsenic, and 
antimony, may be present. But there is such an enormous difference 



METALS. 579 

between the activity of the mercurous and the mercuric salts, that the 
latter form the most important impurities of the former. Corrosive sub- 
limate, for example, is so active that a slight trace of it as an impurity 
in calomel might cause a medicinal dose of the latter to produce poison- 
ous effects. 

General Test. — Mercuric salts are readily soluble in alcohol, and 
especially in ether, and also in a solution of sodium chloride, while mer- 
curous salts are not. The presence of mercuric compounds as an impurity 
in mercurous preparations can be ascertained by shaking them with a solu- 
tion of common salt (U.S. P.), or with ether (B.P.), filtering, and testing 
the filtrate for mercury. If no mercuric salt has been present, neither 
the ether nor salt solution will dissolve anything, and so the test will show 
the absence -of mercury. When ether or alcohol is used, the absence of 
mercury may be ascertained by evaporating it and finding that no residue 
remains. 

General Action. — Metallic mercury, mercurous salts and mercuric 
salts all have actions differing from each other as far as their local effect 
is concerned, but agreeing together in their general result after absorp- 
tion into the system. When applied locally to the skin, mercury, either 
in a state of vapor or when finely subdivided in the form of ointment, 
will pass through the epidermis without exciting any local irritation, and 
be absorbed into the circulation, where it will produce the general effects 
of the drug. Taken in the form of vapor into the lungs, it will have a 
similar action. The mercurous salts are also absorbed in the same 
way as metallic mercury. They have a slightly more stimulating effect 
than it, but do not produce the same intense irritation that the mercuric 
salts cause. The mercuric salts unite with albumen, forming albu- 
minates. They have little action on the epidermis, but when applied to 
the denuded skin, or to a mucous membrane, they precipitate the albumen, 
and, when used in a concentrated form, produce a slough. When swal- 
lowed, they cause the symptoms of gastro- enteritis produced by other 
irritant poisons, but these may be quickly succeeded by the symptoms of 
special mercuric poisoning from the absorption of the substance into the 
circulation. 

The general effects on the body which are produced alike by mercury 
and its salts are termed mercurialism. 

The first symptoms produced by mercury, however it is applied, are 
almost always connected with the alimentary canal, and more especially 
the mouth. A metallic, unpleasant taste is observed in the mouth, 
along with a feeling of heat ; the saliva is somewhat increased and the 
breath has a most unpleasant smell. The teeth feel sticky, as if their 
edges were glued together with some adhesive substance, when the patient 
tries to separate them ; they feel as if they were longer than usual. The 
gums are red and swollen and tender, and chewing is painful. The 
tongue is covered with a thick coating, and the appetite is small. The 
medicinal administration of mercury is generally stopped when 
the gums become sore and salivation begins. In children salivation 
occurs with difficulty, and mercury may be discontinued when the breath 
becomes fcetid. When the administration of mercury is continued the 
symptoms increase : the gums become still more inflamed, their edges are 



580 INORGANIC MATERIA MEDICA. 

covered with a white, sticky substance, and they bleed on the slightest 
touch; the teeth become loosened in their sockets, and the salivation 
becomes still greater. 

In still worse cases ulcers form on the gums and inside of the cheeks, 
the tongue itself becomes swollen so that articulation becomes difficult, 
mastication is so painful as to be nearly impossible, the foetor of the 
breath is insupportable, and the saliva pours from the mouth in great 
quantities. 

Along with these symptoms there is a certain amount of fever, 
which, indeed, sometimes is present before any local symptoms have 
appeared. There is general depression, chilliness, and even rigors, 
followed by a rise of temperature, a feeling of heat, thirst, loss of appe- 
tite, quick pulse, weight or pain in the epigastrium, nausea, belching, 
vomiting, and purging, sometimes bloody, or more rarely, constipation. 
These last several days and then decrease, sweating occurring at this 
time, or salivation if the fever has preceded it. Mercurial fever occurs 
most readily after a lengthened application of blue ointment. 

When the administration of mercury is stopped the symptoms decrease, 
though in the case of broken-down individuals necrosis of the jaw and 
even death has occurred. 

Occasionally it has happened that even healthy individuals, instead 
of recovering after profuse salivation, have become permanently dyspeptic. 

These symptoms appear in adults, generally with great regularity, 
when a similar quantity of mercury has been taken in a similar time, 
though the effect is modified by various conditions, as age, sex, &c. 

When persons are exposed for a long time to the fumes of mercury, 
and the metal is thus taken in in very small quantities for a lengthened 
period, a different effect is sometimes produced. This is called mercu- 
rial cachexia. In this condition the appetite is lost, the gums become 
livid and bleed easily, the breath is fcetid, and a tendency to diarrhoea is 
often present. In bad cases vomiting and purging generally occur. 

The lips become pale, the complexion earthy, the person becomes 
emaciated, the hair sometimes falls out, the muscles become weak and 
small. The person is easily affected by changes of weather; there is a 
tendency to fainting, uneasiness, and anxiety ; the pulse and respiration 
become quick ; the pulse is also small and intermittent ; and palpitation 
becomes very troublesome. The intellect is dull, and rheumatic pains 
are felt in the muscles of the extremities, more rarely in those of the trunk. 

These symptoms go on increasing, and new ones also appear. Mer- 
cnrial tremors occur in the muscles, beginning generally in the upper 
extremities, and gradually extending till the patient cannot execute any 
movement, and the speech itself becomes stammering. 

Mercurial paralysis of muscles or groups of muscles occasion- 
ally occurs. Generally this is confined to the muscles of the upper 
extremities, but sometimes affects other muscles, such as those of the 
larynx, causing mercurial aphonia. These paralyses generally occur in 
the later stages of mercurial erethism, and rarely occur before the other 
symptoms. 

The mental qualities become also affected. Ill-humor, irritability, 
melancholy, and fear of death occur in some persons, and in others, 



METALS. 581 

though very rarely, idiocy, and still more rarely, furious mania. In some 
instances epilepsy has been observed. 

Mercury in the form of organic compounds appears to have a special 
action on the brain. The symptoms are those of impairment of the 
special senses, sight, taste, hearing, of motor power, and of the cerebral 
functions. Two chemists who were engaged in the preparation of mer- 
curic methide during three months suffered from weakness and dimness 
of vision, and one of them from some soreness of the gums, nausea, and 
vomiting. At the end of this time the symptoms became much worse, 
deafness and numbness came on, and were succeeded by a semi-comatose 
condition with great restlessness. In the one who had not previously 
suffered from soreness of the gums, this now appeared, along with foe tor 
of the breath; the urine was albuminous,* Cheyne-Stoke's breathing was 
observed, the evacuations were passed involuntarily, and he died coma- 
tose a fortnight after the symptoms became severe. Sensibility was 
retained nearly to the last. In the other patient, impaired sensation, 
loss of power to direct movement, and muscular feebleness were succeeded 
by involuntary passage of evacuations, an idiotic condition with restless- 
ness, and violent muscular movements, especially when he was touched. 
After remaining in an idiotic state for a year he died of pneumonia. 

The action of mercury may be modified by sex, age or idiosyncrasy. 
Women, as a rule, are more easily affected than men, whilst children may 
take mercury in considerable quantities without showing any symptom of 
salivation. In certain persons large quantities of mercury may be admin- 
istered for a length of time without producing much more effect than 
in children, but in others exceedingly injurious results may follow very 
minute doses. A case of salivation from as little as a grain and a half of 
calomel has been recorded, and from one-eightieth of a grain of corrosive 
sublimate. In typhus it is very hard to produce salivation, but in per- 
sons suffering from Bright's disease, although mercury may be useful as 
a purgative, it requires to be given with caution, on account of the violent 
effects which may follow even small doses. 

Mercury combines with albumen, and forms albuminate of mercury, 
which is insoluble in water, but is easily soluble in excess of albumen or 
in chloride of sodium. This compound may be formed in the stomach or 
intestines, and a compound of mercuric oxide with albumen is probably 
the form under which mercury, however administered, circulates in the 
blood. When taken into the stomach, mercuric salts are powerful irri- 
tants, and, when given in large quantities, cause gastro-enteritis, vomit- 
ing, and purging. Finely divided metallic mercury and mercurous salts 
are less irritating, and act simply as purgatives. 

A good deal of discussion has arisen regarding the action of mercury 
on the liver. It has long been ranked as a cholagogue, and there can 
be no question whatever, that mercury and its compounds are very bene- 
ficial in cases of so-called bilious disorder characterized by feelings of 
laziness and apathy, inability to think, dislike of exertion, not unfre- 
quently combined with irritability of temper, deranged digestion, and 
slight yellowish tinge of the eyes. When bile was supposed to be formed 
in the blood, and to be only excreted by the liver, the beneficial effect of 
mercury was attributed to a stimulating action on the liver, whereby it 



582 INORGANIC MATERIA MEDICA. 

increased the rapidity of the secretion, and thus removed the bile more 
quickly from the blood. But it was found on experiment by Dr. Scott 
that mercury does not increase the rapidity of the biliary secretion, and 
this result was confirmed by a committee of the British Medical Associa- 
tion, the chief members of which were Hughes, Bennett, Rutherford, and 
(xamgee, and also by later experiments made by Rutherford alone. As 
we now know that bile is formed from the liver, and not merely separated 
by it from the blood, we can understand that the real action of mercury 
as a cholagogue consists, not in its stimulating the liver to form more 
bile, but in removing more readily from the body the bile which is already 
present in excess. It appears to perform this function by stimulating 
the upper part of the small intestine, and thus causing the evacuation of 
the bile before time has been allowed for its reabsorption. For the liver 
does not merely form bile, it also excretes bile which has been previously 
formed and reabsorbed from the intestine. The bile may thus serve 
several times over. It is formed, passes from the liver into the duodenum, 
is reabsorbed and carried by the portal blood to the liver, where it is 
again excreted and poured out through the bile-duct a second time 
(p. 351). Part of it, however, is carried down the intestine, decomposed, 
and evacuated, and to supply the place of this a certain amount of new 
bile is constantly being formed, which is poured into the intestine along 
with the old. It is evident that any drug which acts upon the lower part 
of the intestine will have little power to remove the bile, as this will have 
undergone absorption already in the upper part of the digestive tract. 
But any drug acting upon the duodenum will cause the bile to be rapidly 
moved on, and its absorption to be prevented. More especially will this be 
the case if the cholagogue be combined with a saline purgative, which, 
by causing a profuse secretion of watery fluid, will wash the bile out. 
This action on the upper part of the small intestine is probably possessed 
by mercury, and the reasons for this supposition are : (1) that it is so 
beneficial in bilious disorders ; (2) that it does cause the appearance of 
bile in the stools, for Buchheim has found by analysis that the green 
stools which occur after purgation by calomel actually owe their color to 
bile ; and (3) that in the stools passed after mercurial purgatives, leucin 
and tyrosin, the products of pancreatic digestion, have been found. Mer- 
cury acts as a disinfectant of the intestinal contents. 

After the absorption of mercury into the blood, it is said, in small 
doses, to increase the number of blood corpuscles; in larger doses, how- 
ever, it produces anaemia, but how far these results are dependent upon 
the improvement or disturbance of the digestion, and how far upon the 
action of the mercury itself upon the blood, has not been ascertained. 
Albuminate of mercury, when added to blood out of the body, gradually 
destroys the corpuscles. 

Mercury appears to have the power of causing absorption of fibri- 
nous exudations, for the fibrinous adhesions observed in syphilitic 
iritis have been Been to disappear as the patient was brought under the 
influence of mercury. When mercury is used for a long time, it appears 
to lessen greatly the force of tlie pulse, and large doses of mercuric prepa- 
rations, when brought into contacl with a frog's heart, will arrest its 
pulsations immediately. The respiration is affected in persons who 






METALS. 583 

have been taking too much mercury, and becomes labored and accompa- 
nied by a feeling of constriction. The temperature is rarely affected, 
excepting secondarily, in consequence of local inflammations which the 
mercury may excite, although sometimes mercurial fever (p. 580) pre- 
cedes any marked local change. 

Mercury is excreted by the saliva, bile, urine, sweat, and milk. 
The salivation which it produces is probably due in part to reflex ex- 
citement of the salivary glands by the irritation of the tongue, but it is 
no doubt also in part due to irritation of the nerves of the gland, or of 
the gland structure itself, by the mercury. The urine is said to be some- 
what increased, and it is stated that the addition of a little mercury to 
digitalis and squill greatly increases the diuretic action of these drugs. 

Hydrargyrum, Hg\; TJ.S.P. and B.P. Mercury; 192-t. 

Characters and Tests. — A metal, fluid at common temperatures, 
brilliantly lustrous, and easily divisible into spherical globules. Volatilizes 
at a heat below that of visible redness, leaving no residue. 

Peepaeations containing Meecuey. 1 

I. — In the metallic state. 

Hydrargyrum, Mercury, U.S.P. and B.P. 

Emplastrum Ammoniaci cum Hydrargyro, U.S.P. and B.P. Plaster of ammo- 
niac with mercury. 

Emplastrum Hydrargyri, U.S.P. and B.P. Plaster of mercury. 

Hydrargyrum cum Creta, U.S.P. and B.P. Mercury -with chalk. 

Massa Hydrargyri, U.S.P.; Pilula Hydrargyri, B.P. Mass of mercury; mer- 
curial pill ; blue pill. 

Unguentum Hydrargyri, U.S.P. and B.P. Mercurial ointment. 

B.P. Linimentum Hydrargyri. Liniment of mercury. 

B.P. Suppositoria Hydrargyri. Mercurial suppositories. 

B.P. Unguentum Hydrargyri Compositum. Compound ointment of mercury. 

II. — Oxidized. 

B.P. Lotio Hydrargyri Nigra. Black mercurial lotion (mercurous oxide). 
Hydrargyri Oxidum Rubruru, U.S.P. and B.P. Eed oxide of mercury ; red 

precipitate. 
Unguentum Hydrargyri Oxidi Eubri, U.S.P. and B.P. Ointment of red oxide 

of mercury ; red precipitate ointment. 
Hydrargyri Oxidum Flavum, U.S.P. and B.P. Yellow oxide of mercury. 
B.P. Lotio Hydrargyri Flava. Yellow mercurial lotion. 
U.S.P. Unguentum Hydrargyri Oxidi Flavi. Ointment of yellow oxide of 

mercury. 
U.S.P. Oleatum Hydrargyri. Oleate of mercury. 

III. — Sulphuretted. 

U.S. P. Hydrargyri Sulphidum Rubrum. Red sulphide of mercury ; cinnabar. 

IV. — As Mercurous Chloride. 

Hydrargyri Chloridum Mite, U.S.P. ; Hydrargyri Subchloridum, B.P. Mild 
chloride of mercury ; mercurous chloride ; calomel. 

Pilulse Antimonii Compositse, U.S.P. ; Pilula Hydrargyri Subchloridi Compo- 
site, B.P. Compound pills of antimony ; compound pills of calomel ; Plum- 
mers' pills. 

U.S.P. Pilulse Catharticse Compositse. Compound cathartic pills. 

V. — As Mercuric Chloride. 

Hydrargyri Chloridum Corrosivum, U.S.P.; Hydrargyri Perchloridum, B.P. 
Corrosive chloride of mercury; corrosive sublimate. 



1 Altered from the United States Dispensatory, p. 773. 



584 IXORGAXIC MATERIA MEDICA. 

Preparations containing Mercury — (continued). 

V. — As Mercuric Cliloride — (continued). 

Hydrargyrum Ammorriatum, U.S.P. and B.P. Ammoniated mercury; white 
precipitate. 

Unguentum Hydrargyri Ammoniati, U.S.P. and B.P. Ointment of ammoni- 
ated mercury ; white precipitate ointment. 

B.P. Liquor Hydrargyri Perchloridi. Solution of perchloride of mercury. 
VI. — Combined with Iodine. 

Hydrargyri Iodidum Rubrum, U.S.P. and B.P. Red iodide of mercury; 
mercuric iodide. 

U.S.P. Liquor Arsenii et Hydrargyri Iodidi. Solution of iodide of arsenic 
and mercury; Donovan's solution. 

B.P. Unguentum Hydrargyri Iodidi Rubri. Ointment of red iodide of 
mercury. 

Hydrargyri Iodidum Viride, U.S.P and B.P. Green iodide of mercury ; mer- 
curous iodide. 

VII. — Combined -with Cyanogen. 

U.S.P. Hydrargyri Cyanidum. Cyanide of mercury. 

VIII — Oxidized and combined with Acids. 

Liquor Hydrargyri Nitratis, U.S.P. ; Liquor Hydrargyri Nitratis Acidus,- B.P. 

Solution of nitrate of mercury ; mercuric nitrate. 
Unguentum Hydrargyri Nitratis, U.S.P. and B.P. Ointment of nitrate of 

mercury ; citrine ointment. 
B.P. Hydrargyri Sulphas. Sulphate of mercury ; mercuric sulphate. 
U.S.P. Hydrargyri Sulphas Flava. Yellow sulphate of mercury ; Turpeth 

mineral ; mercuric oxysulphate. 

Impurities. — Other metals. 

Tests. — The presence of other metals is ascertained by their being 
left behind as a residue when the mercury is volatilized. It is indicated 
by the formation of a gray scum or dust on the surface of the metal after 
exposure to air, and by the mercury forming globules which are not 
spherical but elongate to a tail when allowed to run over a piece of paper. 
They are also recognized by shaking the mercury in a perfectly dry 
bottle, when a gray powder will be formed if they are present. 

On boiling 5 grms. of distilled water with 5 grms. of mercury and 
4*5 grms. of hyposulphite of sodium in a test-tube for a minute, the 
mercury should not lose its lustre nor acquire more than a slightly yel- 
lowish shade (absence of more than a trace of other metals, U.S.P.). 

Purification. — Other metals may be separated by distillation, or by 
mixing the mercury with strong sulphuric acid and letting it stand in the 
cold for twenty-four hours. The other metals will be converted into 
sulphates, but mercury is only attacked by sulphuric acid when it is aided 
by heat. The mercury is then washed with water to remove the sul- 
phates, and dried with blotting-paper. Mercury is freed from dust and 
mechanical impurities by pressing it through chamois leather or filtering 
it through a paper filter in the apex of which several small holes have 
been made with a needle or pin. 

CTe ES. — Metallic mercury in mass has no action whatever on the body. 
As much as a pound has been taken without producing any physiological 
effect. Such a dose as this is sometimes given in cases of intestinal 
obstruction in the hope that the weight of the mercury may carry the 
obstruction before it. The theory of its action formerly held was purely 
mechanical: that the mercury passed from the stomach to the intestines 
and meeting with the obstruction drove it on, but latterly Traube has 



METALS. 585 

supposed that the mercury remains chiefly in the stomach, and by pulling 
on it excites the intestines reflexly to peristaltic action. Whatever the 
correct theory may be, however, it is certain that the mercury does not 
always stay in the stomach but does get down into the intestine, and 
consequently some precautions must be observed in its administration, 
and it is never given except when all other measures fail. The precau- 
tions are not to give it in cases of intussusception, as it may very prob- 
ably render this worse ; nor in cases where the intestine is considerably 
inflamed, as the tissues being weak are then easily torn ; nor in hernia, 
as better means, viz., external means, can be employed. 

Hydrargyrum cum Creta, U.S.P. and B.P. MeECTJEY WITH CHALK. 

Peepaeations. — By rubbing up mercury (38), chalk (50), and sugar of milk (12) 
together, moistening them with a mixture of equal parts of ether and alcohol, U.S.P. 
By rubbing up chalk (2) and mercury (1) together, B.P. 

Chaeactees and Tests. — A powder of light-gray color; free from grittiness; 
insoluble in water ; partly dissolved by diluted hydrochloric acid, leaving the mer- 
cury in a finely divided state. 

Impueity .— Mercuric oxide. 

Test. — The solution formed with hydrochloric acid is not precipitated by the 
addition of chloride of tin. 

Dose. — 3 to 8 grains. 

Uses. — It has been much recommended by Ringer as a remedy in 
many diseases both of adults and of children. In simple tonsillitis, or 
the inflamed throat of scarlatina, or in mumps, he recommends a third of 
a grain every hour, and the same dose three or four times a day will, he 
says, clean the tongue, remove the disagreeable taste from the mouth, 
and improve appetite and digestion in the dyspepsia occurring in chronic 
disease or of commencing convalescence. A similar dose will cut short 
an attack of jaundice, with vomiting and pale stools, occurring in nervous 
persons after exposure to cold, fatigue, or excitement ; and half a grain 
thrice a day will restore the color to the stools and remove the dyspepsia 
in patients suffering from acidity, flatulence, and vomiting in the morn- 
ing. Diarrhoea in children, accompanied by pale, offensive motions, or 
by muddy, or green-colored, or curdy stools, whether accompanied by 
sickness or not, is successfully treated by similar doses of this remedy. 
It may also be used to produce the general action of mercury combined 
with opium or Dover's powder. 

Piluia Hydrargyri, B.P. Meecueial Pill ; Blue Pill. — Contains mercury (2), 
confection of roses (3), powdered liquorice root (1). 3 grs. contain 1 of mercury. 
Dose. — 3 to 8 grains. 

Uses. — Blue pill may be given either for its local action upon the 
intestines or to produce the action of mercury upon the system. This 
pill is one of the most effectual remedies for the condition usually termed 
biliousness. The patient complains of being dull, heavy, and often 
sleepy, suffers from occasional headache, has little appetite, and occa- 
sionally feels sick. The complexion is often of a dirty yellow, muddy 
color, and the white of the eyes likewise. The use of blue pill in such 
conditions was recommended by Mr. Abernethy. Five grains of blue 
pill are given overnight and a draught of salts and senna in the morn- 
ing. This is very effective, but the disadvantage of it is said to be that 



586 IXORGA-STC MATERIA MEDICA. 

the bilious state is more apt to return, and that when a patient has once 
become habituated to the use of mercurials no other medicine will do 
instead. 

It is one of the best preparations for producing mercurialisni : 5 
grains with J a grain of opium are given in the morning, and 5 or 10 
also with J a grain of opium in the evening. 

The addition of a small quantity of blue pill to digitalis and squill 
sometimes increases their efficacy in cases of cardiac disease. 

B.P. Suppositoria Hydrargyri. MERCURIAL SUPPOSITORIES. — Each contains 60 
grs. of ointment of mercury, benzoated lard and white wax each 20 grs., oil of theo- 
broma 80 grs. 

Uses. — They are employed where we wish to produce mercurial 
action without the risk of interfering with the digestion. 

Ungnentum Hydrargyri, U.S.P. and B.P. MERCURIAL OINTMENT, U.S.P. ; OINT- 
MENT of Mercury, B.P. — Contains 1 lb. each of mercury and prepared lard. As 
this would be too soft, 1 oz. of prepared suet is added. 

Preparations. — Linimentum Hydrargyri ; Suppositoria Hydrargyri ; Unguen- 
tum Hydrargyri Compositum. 

Uses. — It may be used either for its general or its local action. 
When employed to produce the general action of mercury in the 
system, it is rubbed into some part of the body where the skin is thin, 
as the armpits or the sides of the thighs. If it is rubbed in by another 
person, and not by the patient himself, it is advisable to protect the 
operator's hand by a piece of bladder soaked in oil, in order to prevent 
absorption through the palm. In cases of congenital syphilis, the mer- 
curial ointment may be put upon a flannel roller, and bound round the 
child's belly. 

It has been applied locally in inflammation of the skin, as ery- 
sipelas ; of the veins in phlegmasia dolens ; or of the genital organs, as 
in ovaritis, orchitis, and indurated testicles. 

B.P. Unguentum Hydrargyri Compositum. COMPOUND OINTMENT OF MER- 
CURY. — Contains mercurial ointment (6), yellow wax (3), olive oil (3), and camphor 

The compound ointment is used to cause absorption of effusion or 
thickening around joints in cases of disease or injury after the inflam- 
mation has subsided. It ought to be combined with pressure and rest. 

Emplastrum Hydrargyri, U.S.P. and B.P. MERCURIAL PLASTER. 

Preparation. — Rub mercury with olive oil and resin, U.S.P., or sulphur, B.P., 
and add lead plaster to give it consistency. Sulphur and resin are used to extin- 
guish the globules of mercury, i.e., make them so small as to be invisible. 

Emplastrum Ammoniaci cum Hydrargyro, U.S.P. and B.P. AMMONIAC PLAS- 
Ti:i: wmi RlERCUBY, U.S.P.; AMMONIACUM AND MERCURY PLASTER, B.P. 

PBEP \ RATION.— U.S.P. Mercury 180 is extinguished with sulphur 1 and olive 
oil 8 as in the B.P. process. Animoniacum 720 is digested with diluted acetic acid 
1000, strained, evaporated until it hardens on cooling. It is then added while hot 
to the mercury and mixed. Then enough red plaster previously melted is added to 
make up to 1000 parts. B.P. By rubbing mercury 3 oz. with warm olive oil 1 fl.dr., 
and sulphur 8 grs. until the globules of mercury are no longer visible, then adding 
melted ammoniacmn 12 oz. and mixing. 

Both plasters are used to promote the absorption of glandular 
enlargements, buboes, nodes, and arc applied over the liver in chronic 
enlargement and induration. 



METALS. 587 

B.P. Iiinimentum Hydrargyri. LlNlMENT OF MEECUEY. — Contains equal parts 
of mercurial ointment, solution of ammonia, and camphor liniment. 

Used for similar purposes as the plaster or ointment. It is more 
irritating than either on account of the ammonia it contains. 

It is said to cause salivation more readily than mercurial ointment, 
as the camphor and ammonia with which it is mixed assist its absorption. 

B.P. Hydrargyri Sulphas. SULPHATE OF Mercury. HgS0 4 . 
Preparation. — Heat mercury 20 oz. with sulphuric acid 12 fl. oz. 
in a porcelain vessel, stirring constantly until the metal disappears, then 
continue the heat until a dry, white salt remains. 

Characters. — A white crystalline heavy powder, rendered yellow 
by affusion of water. Entirely volatilized by heat ; subsulphate formed 
by water. 

Preparations in which Sulphate of Meecuey is used. 
Hydrargyri Perchloridum. Hydrargyri Subchloridum. 

U.S.P. Hydrargyri Subsulphas Flavus. Yellow SuBSUL- 
phate of Mercury. Hg(HgO) 2 S0 4 ; 727-1. 

Characters. — A heavy lemon-yellow powder, permanent in the air, 
odorless and almost tasteless, insoluble in water or in alcohol, but soluble 
in nitric or hydrochloric acid. When heated the salt turns red, becom- 
ing yellow again on cooling. At a red heat it is volatilized without 
residue, evolving vapors of mercury and of sulphurous acid. 

Tests. — As it is a mercuric oxysulphate, it should be soluble in 20 
parts of hydrochloric acid without residue (no mercurous salt). 

Uses. — The yellow oxysulphate has been used under the name of 
Turpeth mineral as an errhine in chronic ophthalmia. It is a prompt 
emetic, and is sometimes preferred to other emetics in croup, as it is 
quick and certain, and does not produce depression nor purging. The 
dose for a child two years old is 2-5 grains (0-13-O33 Gm.), repeated in 
fifteen minutes if necessary. It may also be used as an alterative. 

Hydrargyri Chloridum Mite, U.S.P. ; Hydrarg-yri Subchlo- 
ridum, B.P. Mild Chloride of Mercury, U.S.P. ; Subchloride 
of Mercury, B.P. Calomel. Hg 2 Cl 2 ; 470-2. 

Preparation. — Calomel is prepared by rubbing up mercury with 
sulphate of mercury moistened with water till globules are no longer 
visible, adding sodium chloride, mixing the whole by trituration, and 
subliming the mixture into a large chamber. 

The mercury and mercuric sulphate form mercurous sulphate, and this, 
with sodium chloride, forms calomel and sulphate of soda, HgS0 4 -f Hg 
+ 2NaCl = 2HgCl + Na 2 S0 4 . 

When the calomel is sublimed into a small receiver it forms a thin 
crystalline crust which adheres to the sides, but when sublimed into a 
large chamber, as directed in the B.P., it falls as a powder on the floor. 
As some corrosive sublimate is often formed, the powdered calomel is 
washed with water till all the sublimate is removed, as shown by the 
water no longer giving a precipitate with ammonium sulphide. 

It is then dried under 212°, and kept in a well stoppered and dark 
bottle. 



588 INORGANIC MATERIA MEDICA. 

Characters. — A dull-white, heavy and nearly tasteless powder, ren- 
dered yellowish by trituration in a mortar ; insoluble in water, spirit, or 
ether. It is very heavy, and can be distinguished by its weight from 
almost every other white powder. Its weight is noticed more distinctly 
by giving the bottle an up-and-down shake. Digested with solution of 
potash it becomes black (mercurous oxide) ; and the clear solution, acidu- 
lated with nitric acid, gives a copious white precipitate with nitrate of 
silver (chloride). Contact with hydrocyanic acid also darkens its color. 

Adulterations. — Chalk, sulphate of lime, sulphate of baryta, car- 
bonate of lead, corrosive sublimate. 

Tests. — It is entirely volatilized by a sufficient heat (no earthy 
impurities). Warm ether which has been shaken with it in a bottle 
leaves, on evaporation, no residue (no corrosive sublimate). 

Dose. — J grain to 5 grains. 

Peepaeations in which Subchloeide of Meecuey is used. 

u.s.p. 
Pilulre Antimonii composite. 
Pilulse Catharticse composite. 

B.P. 

Lotio Hydrargyri Nigra 3 grains to 1 fluid ounce. 

Pilula Hydrargyri Subchloridi Composita 1 part in 5. 

Unguentuin Hydrargyri Subchloridi, Calomel 1 ^ , . rt1 , 

Ointment^yith prepared lard) } * P art ln 6 * nearl y- 

Pilulse Antiinonii Compositse, U.S.P. ; Pilula Hydrargyri Subchloridi Composita, 

b.p. Compound Pills of Antimony, U.S.P. ; Compound Pill of Subchloeide 
of Meecuey, B.P. Compound Calomel Pill. Plummee's Pill. — Contains sul- 
phurated antimony (50), mild chloride of mercury (5), guaiac (100), mucilage of 
tragacanth (q.s.), U.S.P. Subchloride of mercury (1), sulphurated antimony (1), 
guaiacum resin, in powder (2), made up with castor oil, B.P. 
Dose. — 5 to 10 grains. 

Uses. — Calomel may be employed as a dusting powder to remove 
condylomata from the skin, and condylomatous patches from the tongue, 
throat, and larynx. As an ointment it may be applied to relieve the 
itching in pruritus ani, and pityriasis of the scalp, and to heal strumous 
sores and lupus in children. Internally it may be given in cases of 
biliousness, and followed by a saline purgative in the same manner as is 
recommended under "Blue Pill." In some cases of diarrhoea it is very 
useful in combination with opium (p. 107). 

It may also be used to produce the general action of mercury in 
syphilitic patients, and for this purpose may either be given internally, 
in combination with opium, or applied to the skin in the form of calomel 
fumigations (p. 404). 

Calomel ointment is useful in allaying the itching of many skin 
affections. In pruritus ani and pruritus scroti it often removes the 
itching at once. In pruritus pudendi it is also of service, though not 
quite so much as in the other cases (Ringer). It should not be applied in 
large quantities, lest so much of it be absorbed as to cause its physio- 
logical action. 

Lotio Hydrargyri Nigra, B.P. Black Mercurial Lotion. 
Blace W ish. — Consists of half a drachm of calomel mixed with half a 
pint of lime-water. 



METALS. 589 

Uses. — It contains suboxide of mercury. It is a good application to 
varicose ulcers, and is used as an application to syphilitic ulcerations, as a 
wash to the mouth in syphilitic sore throat, and in cancrum oris. The 
compound pill of subchloride of mercury may be used in cases of bilious- 
ness, gout, or rheumatism. 

Hydrargyri Cliloridum Corrosivum, U.S. P.; Hydrargyri 
Perchloriduin, B.P. Corrosive Chloride of Mercury, U.S. P. ; 
Perchloride of Mercury, B.P. HgCl 2 ; 270-5. 

Preparation. — By mixing mercuric sulphate with sodium chloride 
and subliming into a small chamber. To prevent the formation of any 
calomel some peroxide of manganese is added. 

Characters and Tests. — In heavy colorless masses of prismatic 
crystals, possessing a highly acrid metallic taste ; more soluble in alcohol, 
and still more so in ether, than in water. Its aqueous solution gives the 
reactions of mercuric salts and of a chloride. 

Dose. — ^ to -J- grain. In cholera this dose may be given every 
quarter of an hour, half-hour, or hour. 

Officinal Peepaeation. 
u.s.p. B.P. 

None. Liquor Hydrargyri Perchloridi. 

B.P. Liquor Hydrargyri Perchloridi. SOLUTION OF PEECHLOEIDE OF MEE- 
cuey. — Contains J grain of perchloride of mercury in 1 oz. of water, with 1 grain 
of ammonium chloride to keep it in solution and prevent precipitation. 

Dose. — ^ fluid drachm to 2 fluid drachms. 

Uses. — When mixed with albumen, corrosive sublimate precipi- 
tates it, forming a mercuric albuminate. It is one of the most powerful 
antiseptics known (p. 96). It may be applied to the skin to destroy 
vegetable and animal parasites present upon it, such as the fungus in 
pityriasis versicolor, sycosis and favus, the acarus in scabies and the 
pediculus pubis. It is useful in allaying the itching of pruritus scroti 
and pudendi, prurigo and urticaria. It may be employed as a wash in 
ophthalmia, as a gargle in syphilitic sore throat, and as an injection in 
gonorrhoea, gleet and leucorrhoea. When swallowed in strong solution 
it sometimes causes an irritant poisoning- ; and if this should pass off, 
it may be succeeded by intense salivation due to the absorption of the 
drug. The treatment in such cases is to give albuminous substances, 
such as white of egg or milk, in order to form mercuric albuminate in 
the stomach, and thus prevent its irritant action on the mucous mem- 
brane. If the irritation which the drug itself produces is not sufficient 
to cause vomiting, the stomach should be emptied by an emetic or a 
stomach-pump, in order to prevent digestion and absorption of the mer- 
curic albuminate and the poisoning which might occur from its absorp- 
tion. In small doses it is useful in dysenteric diarrhoea of adults or 
children, and in cholera, its utility probably depending, to a great extent 
at least, on its antiseptic power, which is not destroyed, like that of other 
antiseptics, by considerable admixture with organic matter, such as the 
faecal contents of the intestine (p. 107). After its absorption it has the 
same effect as the other salts of mercury, and may be used for this pur- 
pose in syphilitic cases. 



590 INORGANIC MATERIA MEDICA. 

B.P. Lotto Hydrargyri Flava. YeLLOTT TV ASH. 

Peepaeatiox. — By mixing 18 grs. of corrosive sublimate with half a pint of 
lime-water. 

Uses. — It is used as a stimulating application to syphilitic sores in cases where 
the black wash is not sufficiently powerful. 

Hydrarg-yri Oxidum Flavum, U.S.P. and B.P. Yellow 
Oxide of Mercury. HgO; 215*7. 

Characters. — A light orange-yellow, heavy, impalpable powder, 
permanent in the air, and turning darker on exposure to light ; odorless 
and tasteless, insoluble in water or alcohol, but wholly soluble in nitric 
or hydrochloric acid. When strongly heated it assumes a red color ; at 
a higher temperature it is decomposed, giving off oxygen and separating 
metallic mercury, and is finally volatilized without residue. When 
digested on a warm bath for fifteen minutes with a strong solution of 
oxalic acid, it forms mercuric oxalate of a white color (difference from 
red mercuric oxide). 

Peepaeations. 
r.s. p. 
Oieatum Hydrargyri (yellow oxide 10, oleic acid 90, parts). 
Ungnentiun Bydrargyri Oxidi Flavi (1 in 10 of Unguentum). 

Hydrargyri Oxidum Rubrnm, U.S.P. and B.P. Red Oxide 
of Mercery. HgO ; 215*7. 

Preparation. — Triturate nitrate of mercury and metallic mercury 
together and heat. Hg2N0 3 + Hg = 2HgO + N 2 4 . 

Characters. — An orange-red powder readily dissolved by hydro- 
chloric acid, yielding a solution which, with caustic potash added in 
excess, gives a yellow precipitate, and with solution of ammonia a white 
precipitate. 

Impurity. — Undecomposed nitrate. 

Test. — Entirely volatilized by a heat under redness, being at the 
same time decomposed into mercury and oxygen. If this be done in a 
test-tube, no orange vapors are perceived. 

Peepaeations. 
u.s.p. and b.p. 

^(STntm™ »& of Merfu"')' } J ^ fa 10 > U ' S - P - i » * 8 ' PB ' 
With ointment, U.S.P.; with yellow wax and olive oil, B.P. 

Uses. — The red oxide is rarely given internally. The ointment may 
be used in ophthalmia and conjunctivitis in the same way as the nitrate 
of mercurial ointment, and as an application to the auditory meatus in 
otorrhcea occurring after scarlet fever. It is also useful in scaly skin 
diseases, syphilitic sores on the skin, and in ulcers within the margin of 
the anus. 

Hydrargyrum Ammoiiiatum, U.S.P. and B.P. Ammoniated 
Mercury. White Precipitate. ]S T H 2 HgCl; 251*1. 

Preparation. — By dissolving corrosive sublimate in water, and 
precipitating by ammonia. 

Cii.aracters. — An opaque white powder on which cold water, alcohol 
and ether have no action. Digested with caustic potash, it evolves 



METALS. 591 

ammonia, acquiring a pale yellow color, and the fluid, filtered and acid- 
ulated with nitric acid, gives a white precipitate with nitrate of silver. 
Boiled with a solution of chloride of tin it becomes gray, and affords 
globules of metallic mercury. 

Impurities. — Chalk, sulphate of lime, baryta, lead, carbonates, 
mercurous salts. 

Tests. — Entirely volatilized at a heat under redness (no chalk, etc.). 
It should dissolve in hydrochloric acid without residue (no mercurous 
salt) and without effervescence (no carbonate). 

Prepaeation. 
u.s. p. and b.p. 

Uuguentum Hydrargyri Aminoniati 1 part in 10, U.S. P. ; 1 in 8, B.P. 

With benzoated lard, U.S. P. ; with simple ointment, B.P. 

Uses. — Not used internally. The ointment is used in order to 
destroy parasitic fungi, but more especially to kill pediculi in the hair 
or on the body. It is also useful in lichen, pityriasis, herpes and other 
skin diseases. 

Liquor Hydrargyri Nitratis Acidus, U.S. P. and B.P. Acid 
Solution oe Nitrate of Mercury. (HgN0 3 ) 2 ; 327*7. 

Characters and Tests. — A colorless and strongly acid solution, 
which gives a yellow precipitate with solution of potash added in excess 
(mercuric oxide). If a crystal of sulphate of iron be dropped into it, in 
a little time the salt of iron, and the liquid in its vicinity, acquire a dark 
color (nitrate). 

Uses. — It is a powerful caustic, and is used as such in lupus. It is 
to be applied with a camel's-hair brush to the extent of a crown piece 
over the ulcers, tubercles, and scars which are soft and ready to break. 
The part is then covered with lint moistened in the solution. It soon 
becomes white, a kind of erysipelatous inflammation sets in around it, 
and it falls off as a yellow scab. The solution is also applied to the os 
uteri when there are large ulcers with flabby, unhealthy granulations 
upon it. It has been used in cancer and in chancres, condylomata, syph- 
ilitic and scrofulous ulcers, favus, and obstinate psoriasis. If applied often 
it may cause mercurialism, and indeed salivation has occurred after one 
application to the os uteri. To prevent this it should be washed off 
immediately after being applied. 

Unguentum Hydrargyri Nitratis, U.S. P. and B.P. OINT- 
MENT of Nitrate of Mercury. Citrine Ointment. 

Preparation. — By mixing a hot solution of mercury in nitric acid 
with lard oil, U.S. P. ; or with lard and olive oil, B.P. 

Characters. — It has a fine lemon-yellow color and a consistence 
like butter. It is apt to become decolorized when mixed with metals or 
deoxidizing powders, and hence an excess of acid is used in order that it 
may reoxidize them as necessary. It should be spread with a wooden or 
ivory spatula. 

Uses. — This ointment was made in imitation of Singleton's golden 
eye ointment, and it is of remarkable service in ophthalmia tarsi. It 
should be mixed with its own weight of almond oil and applied to the lids. 



592 INORGANIC MATERIA MEDICA. 

It is also applied to phagedenic ulcers and syphilitic sores, and soon 
destroys the parasitic fungi on which ringworm, &c 3 depend. 

Hydrargyri Iodiduiu Tiride, U.S. P. and B.P. Green 
Iodide of Mercury. Hg 2 I 2 ; 652-6. 

Preparation. — By rubbing iodine and mercury together in a porce- 
lain mortar, occasionally moistening with a few drops of spirit. 

Characters and Tests. — A dull green powder, insoluble in water, 
which darkens in color upon exposure to light. When it is shaken in a 
tube with ether nothing is dissolved. Gradually heated in a test-tube, 
it yields a yellow sublimate, which, upon friction, or after cooling, 
"becomes red, while globules of metallic mercury are left in the bottom of 
the tube. 

Dose. — 1 to 3 grains. 

Uses. — It is employed for the purpose of combining the action of 
iodine with that of mercury, as in cases of secondary and tertiary syphilis 
occurring in persons of a scrofulous constitution, and especially in the 
syphilis of children. 

Hydrargyri Iodidum Bubrum, U.S. P. and B.P. Red Iodide 
of Mercery. 

Preparation. — By mixing solutions of corrosive sublimate with 
potassium iodide in the proper proportions. 

Characters and Tests. — A crystalline powder of a vermilion color, 
"becoming yellow from an alteration in its crystalline form when gently 
heated over a lamp on a sheet of paper, and again becoming red when 
placed on a sheet of paper and rubbed with a smooth substance. It is 
almost insoluble in water, dissolves sparingly in alcohol, but freely in 
ether, or in an aqueous solution of iodide of potassium. When digested 
with solution of soda it assumes a reddish-brown color (mercuric oxide) ; 
and the fluid cleared by filtration and mixed with solution of starch, gives 
a blue precipitate on being acidulated with nitric acid (iodide). Entirely 
volatilized by a heat under redness. 

Dose. — ^ to J grain. 

Preparation, b.p., not in u.s.p. 

TJnguentum Hvtlrarg3'ri Ioclidi Rubri... 1 1 + • OP 

(Ointment of Red Iodide of Mercury) J X part ln M ' 
With yellow wax and almond oil. 

Uses. — It may be used for the same purposes as the green iodide, 
but, like all the mercuric salts, it is much more powerful than the corres- 
ponding mercurous one. It is a powerful local irritant, and is used in 
the form of ointment in cases of goitre. The mode of employing it is to 
rub the ointment upon the tumor, and afterwards to expose the patient 
either to the heat of the sun or of a fire as long as he can bear it. This 
iodide was first used in India. In this country, where the sun's rays are 
not so powerful, the heat of a fire has been employed, but has not been 
found so efficacious 

It is useful in obstinate skin diseases, especially in lupus. It is fre- 
quently given in syphilis, one of the most common ways of prescribing it 
being to give \- 1 drachm of the solution of the perchloride with several 



METALS. 593 

grains of potassium iodide. The periodide is thus formed, and is dis- 
solved in excess of the potassium iodide. 

U.S.P. Hydrargyri Cyanidum. Cyanide of Mercury. 
Hg(CN) 2 ; 251-7. 

Characters. — Colorless or white prismatic crystals, becoming dark- 
colored on exposure to light ; odorless, having a bitter metallic taste, and 
a neutral reaction. When slowly heated the salt decomposes into metallic 
mercury and cyanogen gas, which is inflammable, burning with a purplish 
flame. On further heating, the blackish residue containing globules of 
metallic mercury is wholly dissipated. On adding hydrochloric acid to 
the aqueous solution, hydrocyanic acid vapor is evolved. 

Tests. — A 5 per cent, aqueous solution of the salt, when mixed with 
a dilute aqueous solution of iodide of potassium, should not yield a red or 
reddish precipitate soluble in excess of either liquid (absence of mercuric 
chloride). 

Dose.: — ^ to -J- grain. 

Uses. — It may be given in syphilis. A solution of 5-10 grains in 
an ounce of water, painted on with a camel's-hair brush, is a useful 
application to syphilitic sores of the tongue or mouth. 

U.S.P. Hydrargyri Sulpliidum Rubrum. Red Sulphide of 
Mercury. HgS; 231-7. 

Characters. — Brilliant dark-red crystalline masses, or a fine bright 
scarlet powder, permanent in the air, odorless and tasteless, insoluble in 
water, alcohol, nitric or hydrochloric acid, or in dilute solutions of alka- 
lies. It is dissolved by nitrohydrochloric acid, and on adding an excess 
of stannous chloride, metallic mercury is precipitated. 

Uses. — It is used for mercurial fumigation. Thirty grains may be 
used instead of calomel in the way already described (p. 404). 

Class IV. 

Tetrad Metals. 

LEAD. Titanium. TIX. 

General Actions. — Lead and tin resemble one another to a con- 
siderable extent in their physiological action. After absorption into the 
circulation lead affects the muscles, involuntary and voluntary, and the 
central nervous system. Its action on muscle appears to be first irritant 
then paralyzing. The irritant action on the muscle of the intestine leads 
to colic, and on the voluntary muscle to cramps in man. In animals, 
when the quantity administered in experiments at one time is much 
larger, paralyzing action is more marked, and in frogs and rabbits, mus- 
cular weakness and rapid loss of irritability both in the voluntary muscles 
and heart are marked symptoms. In cats the paralysis of voluntary 
muscle is less marked, and in dogs it is absent. 

The motor areas of the central nervous system appears to be much 
more affected by lead than the sensory ; and in dogs, cats, and pigeons 
choreic movements, and even convulsions occur without impairment of 
38 



594 INORGANIC MATERIA MEDICA. 

sensation or consciousness. The irritation of the motor centres is suc- 
ceeded by paralysis and death. 

Tin has an action resembling lead in increasing the contractions of 
the intestinal canal and causing paralysis of the spinal cord. In rabbits 
it produces weakness and apparent recovery, and then paresis and death. 1 

LEAD. Pb.; 207. 

General Source of Lead Salts. — Lead is obtained entirely from 
the native sulphide called galena by roasting. 

General Reactions. — The chief reactions of lead salts are shown 
in the following table: — 



Reagent. 


Reaction. 


Hydrogen sulphide 

Ammonium sulphide 

Caustic potash or soda 


} 


Black precipitate 
White 

(( u 

Yellow " 


soluble in excess. 


Ammouia ,--. 


insoluble " 


Carbonates of potash, soda, 
ammonia 


or 


u a 


Sulphuric acid or sulphates 

Potassium iodide 


" in nitric acid. 
u 









General Impurities. — Alkaline earths, zinc or copper. 

General Tests. — As alkaline earths and zinc are not precipitated 
by sulphuretted hydrogen, they can be detected by passing this gas 
through the solution of a lead salt until all the lead has been precipitated 
as sulphide. On removing the sulphide by filtration, and evaporating 
the filtrate to dryness, no residue should remain if the lead be pure, U.S. P. 

Copper may be detected by precipitating the lead from a solution by 
sulphuric acid, filtering, and super-saturating with ammonia. If copper 
be present, the solution will exhibit a blue color, U.S. P. Insoluble salts, 
as the oxide, may be dissolved in dilute nitric acid super-saturated with 
ammonia. The filtrate should show no blue color. 

Action. — Soluble lead salts unite with albumen, and form albumi- 
nate of lead. They have little or no irritating action when applied 
directly to the denuded skin or to a mucous membrane. In the mouth 
they have an astringent action, but a sweet instead of corrosive taste. In 
large doses in the stomach they may excite vomiting and may produce 
symptoms of irritant poisoning. In the intestine they act as powerful 
astringents. After absorption into the blood lead is carried by the blood 
to all parts of the body, and there becomes deposited. It appears to be 
eliminated very slowly, so that even when very minute quantities are 
taken continuously chronic lead poisoning may be produced. 

One of the most important sources of lead poisoning- of this sort 
is drinking water. Soft water attacks the leaden pipes in which it may 
be conveyed, or the cisterns in which it may be stored, and dissolves 
enough lead to cause lead poisoning, the small quantity of one grain per 

1 T. P. White, Archivf. exp. Path u. PJiarm., 1880, viii., p. 33. 



METALS. 595 

gallon appearing to be sufficient. Hard waters are not injurious, as they 
cause a coating of phosphate or sulphide of lead to form on the surface of 
the pipe or cistern, and thus protect it from further attacks. Other 
sources of lead poisoning are, beer which has stood in the pipes leading 
to the tap, and snuff, from the decomposition of the lead foil which sur- 
rounds it. There are certain trades, the workers in which are very liable 
to lead poisoning, such as color grinding, painting, plumbing, type found- 
ing, and printing (compositors). The chief source of poisoning in these 
trades is the lead which adheres to the hands and is swallowed along with 
the food, and the precautions to be adopted are cleanliness, washing the 
hands carefully before taking meals, taking the food in a different room 
from that in which the work is carried on, changing the clothes when 
the work is over, and, if necessary, drinking water acidulated with sul- 
phuric acid. 

Treatment of chronic lead poisoning consists in eliminating the 
poison, first from the tissues and then from the body. Various means 
have been employed, such as sulphur baths, the internal administration 
of sulphur, frequent doses of castor oil. As the lead is eliminated by 
the skin and mucous membrane, sulphur, applied either to the skin or 
taken internally, will convert it into an insoluble sulphide and prevent 
its reabsorption. Castor oil will remove from the intestinal canal the 
lead excreted into it. But the treatment which I employ, and which I 
find very satisfactory, is to combine the use of iodide of potassium with 
that of sulphate of magnesia, giving from five to ten grains of the iodide 
three times a day, and a drachm of the sulphate also three times 
a day, with an interval of about two hours between the medicines. 
The object of this treatment is (1) to dissolve the lead deposited 
in the tissues, and to cause its elimination by the mucus of the 
alimentary canal, and (2) to render the lead insoluble after it has passed 
into the intestine, and to remove it thence as quickly as possible. 

The symptoms of chronic lead poisoning" are a blue line on 
the gums, lead colic, lead cramps and lead paralysis. The blue line 
on the gums may appear when neither the colic, cramps nor paralysis 
are present. It appears to be produced by sulphuretted hydrogen in 
the mouth precipitating the lead as black sulphide in the gums just at 
the margin of the teeth, and this, shining through the tissue above it, 
appears of a bluish color. It is absent when the teeth have been lost, 
and slight if they are kept clean. 

The lead colic may either be preceded by symptoms of digestive 
derangement, such as loss of appetite, or may appear at once. It is 
characterized by a tearing pain referred chiefly to the region of the 
umbilicus, and generally accompanied by obstinate constipation. It is 
usually, though not always, relieved by pressure, but may sometimes 
be somewhat increased by it. 

Lead cramps are almost entirely confined to the flexor surfaces 
specially marked in the calves of the legs, and are usually worse at a 
change of weather. They may either accompany or succeed the colic. 

Lead paralyses are usually confined to the extensor surfaces, and 
more particularly affect the extensors of the wrist, so that this form of 
paralysis is sometimes known as wrist-drop. The affected muscles 



596 INORGANIC MATERIA MEDICA. 

become atrophied, and as the extensor tendons also act as ligaments of 
the wrist, the bones of the carpus may become displaced. The paralysis 
probably depends on an affection of the spinal cord rather than of the 
muscles themselves; for the muscles are affected in physiological 
groups which act together, although supplied by different nerves, and 
the degeneration of the muscle does not occur until after the paralysis 
has set in for some time. 

Lead appears to cause contraction of the muscular walls of the 
arteries, and to raise the arterial tension and to slow the heart. It has 
been supposed that this action depended on a local astringent effect 
upon muscular fibre itself, but as in cases of chronic poison the propor- 
tion of lead in the nervous system is much greater than in muscular 
fibre, it is more probable that these effects are of nervous origin. The 
contraction of the intestine which gives rise to the colic is probably due 
more to the action of the lead upon the nerves of the intestine than 
upon its muscular coats. 

Lead is eliminated, to a slight extent, in the urine, and probably 
largely by the mucus of the intestinal canal. It appears to check the 
elimination of the uric acid, and in London gout occurs very frequently 
among patients who work in lead. 

Lead salts may be administered in medicinal doses for a considerable 
time without bringing on any sign of lead poisoning ; but Garrod has 
observed, and I can confirm the statement, that the administration of 
medicinal doses of lead salts will bring on a fit of gout in persons predis- 
posed to it. Lead poisoning appears to occur readily in gouty subjects. 
Chronic lead poisoning has a tendency to induce cirrhotic changes in 
the kidneys, the tubules becoming blocked by plugs of lead carbonate 
and atrophy ensuing. 

Uses. — Lead lotions are sometimes applied externally to sprains 
and bruises. They are useful in relieving the itching of pruritus, and 
the discomfort and in lessening the discharge of eczema. As injections 
they may be applied in otorrhcea, vulvitis in children, gonorrhoea and 
leucorrhoea. They are not used in ulceration of the cornea, lest lead 
should be deposited in the ulcer and leave a permanent opacity. Inter- 
nally, lead is used for its local action on the stomach in pyrosis, and on 
the intestine in diarrhoea and dysentery, and for its astringent action on 
the vessels in hsematemesis, haemoptysis and bleeding from the kidneys 
and uterus. It has also been employed in palpitation from hypertro- 
phied heart, and in aortic aneurism. 

Plumbi Oxidum, U.S.P. and B.P. Oxide OF Lead. PbO; 
222-5. 

Preparation. — By roasting lead in a current of air. 

Characters and Tests. — In heavy scales of a pale brick-red color, 
completely soluble without effervescence in diluted nitric and acetic acids, 
either solution, when neutral, giving the reactions of lead. It should con- 
tain no copper. 

Pnrciw katioxs i.\ which Oxide of Lead is used. 

Emplastrum Ccrati Saponis. Liquor Plumbi Subacetatis. 

" Plumbi Plumbi Acetas. 



METALS. 597 

Emplastrum Plumbi, U.S. P. and B.P. Lead Plaster. 

Preparation. — By heating oxide of lead with olive oil and water. 
The oleic acid of the oil combines with the lead, forming oleate of lead 
and leaving glycerine. This plaster is a lead soap. 

Pkepakations. 
u.s.p. B.P. 

Emplastrum Ammoniaci cum Hydrargyro. Emplastrum Ferri. 

" Asafbetidse. " Galbani. 

" Ferri. " Hydrargyri. 

" • Galbani. " Resinse. 

" Hydrargyri. " Saponis. 

Opii. 
Resinae. 
" Saponis. 

Unguentum Diachylon. 

And several other plasters into which it 
enters as resin plaster. 

Uses. — Lead plaster is used to hold together the edges of wounds, to 
protect irritable surfaces, either alone or by keeping other dressings in 
contact with them by means of its adhesive power. It is also used as a 
means of applying pressure. 

Plumbi Carbonas, U.S.P. and B.P. Carbonate of Lead. 

(PbC0 3 ) 2 Pb(HO) 2 ; 773-5. 

Preparation. — By exposing lead to the fumes of vinegar and to C0 2 . 

Characters and Tests. — A soft, heavy, white powder, blackened 
by sulphuretted hydrogen, insoluble in water, soluble with effervescence 
in diluted acetic acid without leaving any residue, and forming a solution, 
which gives the reaction of lead. 

Impurity. — Lime. 

Test. — The acetic solution when treated with excess of sulphuretted 
hydrogen, boiled and filtered, gives no precipitate with oxalate of ammonia. 

Preparation, 
u.s.p. and b.p. 

Unguentum Plumbi Carbonatis 1 part in 10, U.S.P. ; 1 in 8, B.P. 

With benzoated lard, U.S.P. ; with simple ointment, B.P. 

Uses. — Carbonate of lead is used as an application to excoriated sur- 
faces, piles, boils, and ulcers. 

The ointment is used in the same way. 

Plumbi Acetas, U.S.P. and B.P. Acetate of Lead. 
Pb(C 2 H 3 2 ) 2 3H 2 ; 378-5. (Sugar of Lead.) 

Preparation. — By dissolving oxide of lead in acetic acid. 

Characters and Tests. — In white crystalline masses, slightly 
efflorescent, having an acetous odor, and a sweet astringent taste. Its 
solution in water slightly reddens litmus, and gives the reactions of lead 
and of an acetate. 

Impurity. — Slight amount of carbonate. 

Test. — Its solution in distilled water is clear, or has only a slight 
milkiness, which disappears on the addition of acetic acid. 

Dose. — 1 to 4 grains. 



598 INORGANIC MATERIA MEDICA. 

Preparations in which Acetate of Lead is used, 
u.s.p. B.P. 
Liquor Plumbi Subacetatis. Liquor Plumbi Subacetatis 5 ounces to 1 pint. 

Pilula Plumbi cum Opio 36 parts in 48. 

Suppositoria Plumbi Composita...6 parts in 30. 

Unguentum Plumbi Acetatis 1 part in 38. 

Uses. — The acetate is the preparation of lead most frequently used as 
a local application in inflammations, ulcers, ophthalmia and gonorrhoea, or 
for its general actions on the system. 

b.p. Pilula Plumbi cum Opio. Pill of Lead and Opium. — Contains 6 grains 
of lead acetate, 1 of opium, and 1 of confection of roses in every 8 grains of the pill. 
Dose. — 3 to 5 grains. 

Uses. — It is a powerful astringent, used either for the purpose of 
obtaining the local astringent action of lead upon the bowels in diarrhoea, 
or for its general effect upon the system after absorption, as in haemoptysis. 

B.P. Suppositoria Plumbi Composita. COMPOUND LEAD SUPPOSITORIES. — Each 

suppository contains 1 grain of opium and 3 grains of acetate of lead. 

Uses. — Used in piles and dysentery accompanied by much tenesmus, 
or in phthisis, where we wish to stop haemoptysis without putting lead or 
opium into the stomach and thus running the risk of interfering with 
digestion. 

B.P. Unguentum Plumbi Acetatis. OINTMENT OF ACETATE OF LEAD. — Acetate 

of lead (12 grains), benzoated lard (1 ounce). 

Uses. — It is used as a sedative and astringent application to ulcers, 
excoriations, painful piles, irritable and itching skin diseases, erysipelas, 
burns, bruises, &c. 

Liquor Plumbi Subacetatis, U.S.P. aud B.P. Solution of 

SUBACETATE OF LEAD. 

An aqueous liquid containing in solution about 25 per cent, of sub- 
acetate of lead, U.S.P. Subacetate of lead, Pb(C 2 H 3 2 ) 2 .PbO., dissolved 
in water, B.P. 

Preparation. — By boiling acetate of lead, oxide of lead, in powder, 
and distilled water together. 

Characters and Tests. — A dense, clear, colorless liquid, with alka- 
line reaction and sweet, astringent taste, becoming turbid by exposure to 
the air, and forming with mucilage of gum-arabic an opaque white jelly. 
It gives the reactions of lead and of an acetate. 

Peepakations. 
u.s.p. B.P. 

Ceratum Plumbi Subacetatis. Liquor Plumbi Subacetatis Dilutus. 

Linimentum " " Unguentum " " Compositum. 

Liquor " " Dilutus. 

USES. — It is recommended by Ringer as an application to pityriasis 
and eczema, and in combination with one or two parts of glycerine to the 
milder forms of lupus after the crusts have been removed. Diluted and 
mixed with liquor morphise acetatis, it is a useful application to 
haemorrhoids. 



METALS. 599 

laquor Plumbi Subacetatis Dilutus, U.S.P. and B.P. DILUTED SOLUTION OF 
Subacetate OF Lead. — Solution of acetate of lead 3, distilled water 97 parts, U.S.P. 
Consists of 2 fl. dr. of solution of lead and 2 fl. dr. of rectified spirit diluted with 
water up to a pint, B. P. 

Uses. — Used as a mild astringent and sedative to irritable and itching 
skin diseases and superficial inflammation ; as an eye wash, unless ulcera- 
tion of the cornea be present; as an injection in leucorrhoea and pruritus 
pudendi. 

Ceratum Plumbi Subacetatis, U.S.P. ; Unguentum Plumbi Subacetatis Composi- 

tum, b.p. Cerate of Subacetate of Lead, U.S.P. ; Compound Ointment of 
Subacetate of Lead, B.P. Solution of subacetate of lead (20 parts), camphor 
cerate (80 parts), U.S.P. Solution of subacetate of lead (6 fluid ounces), camphor 
(60 grains), white wax (8 ounces), oil of almonds (1 pint), B.P. 

Uses. — Chiefly as an application to chapped hands and ulcers. 

U.S.P. Linimentum Plumbi Subacetatis. LlNIMENT OF SUBACETATE OF LEAD. — 
Solution of subacetate of lead (40 parts), cotton seed oil (60 parts). 
Uses. — To allay itching in chilblains and skin diseases. 

Plumbi Nitras, U.S.P. and B.P. Nitrate of Lead. 
Pb(N0 3 ) 2 ; 330-5. 

Preparation. — By dissolving lead in nitric acid with the aid of heat 
and crystallizing. 

Characters and Tests. — In colorless octahedral crystals which are 
nearly opaque, permanent in the air, of a sweetish astringent taste, soluble 
in water and alcohol. The aqueous solution gives the reactions of lead. 
Added to sulphate of indigo it discharges the color. 

PEEPAEATION IN WHICH NlTEATE OF LEAD IS USED. 

Plumbi Iodidum. 

Uses. — It is sometimes applied as a disinfectant, and occasionally to 
cracked hands or lips and fissured nipples. It has been given in order to 
check haemorrhage from the lungs. 

Plumbi Iodidum, U.S.P. and B.P. Iodide of Lead. Pbl or 

Pbl 2 ; 459-7. 

Preparation. — By mixing solutions of nitrate of lead and potas- 
sium iodide. 

Characters. — A heavy, bright, citron-yellow powder, neutral, no 
taste nor smell. Sparingly soluble in water, readily soluble in chloride of 
ammonium. When strongly heated it first fuses and then is decomposed, 
emitting violet vapors of iodine, and leaving a citron-yellow residue. 

Impurities. — Chromate, zinc, alkalies, and alkaline earths. 

Tests. — On triturating 1 part of the salt with 2 parts of chloride of 
ammonium in a porcelain mortar, and adding 2 parts of water, a colorless 
liquid should result (with absence of, and different from, chromate). This 
liquid, diluted with water, affords a white precipitate with diluted sulphuric 
acid, and a black one with hydrosulphuric acid. If all the lead has been 
precipitated from a portion of the solution by the last-named reagent, the 
filtrate should leave no residue on evaporation and gentle ignition (absence 
of zinc, alkalies, or alkaline earths). 



600 INORGANIC MATERIA MEDICA. 

Pbepaeations. 

B.P. Einpl a strain Plurubi Iodidi. IODIDE OF LEAD PLASTEE. 1 part in 9 (with 
soap and resin plaster). 

Ungaientum Plunibi Iodidi, TJ.S.P. and B.P. OlXTMENT OF IODIDE OF LEAD. 
"With benzoated lard, 1 part in 10, U.S.P. ; with simple ointment, 1 part in 8, B.P. 

Uses. — It lias been used externally as an application to ringworm, 
and as a counter-irritant in scrofulous enlargement of the glands. It has 
been given internally in enlarged glands, and in chronic enlargement of 
the spleen. In the latter case the iodine may be supposed to have a 
beneficial effect upon the corpuscles of the spleen, and the lead to cause 
contraction by acting upon the involuntary muscular fibre of the organ. 

The ointment is used for enlarged glands. 

TIN. Sn. ; 118. 

B.P. Tin, granulated. 

Grain tin, reduced to small fragments by fusing and pouring into 
cold water. 

Use. — Used formerly in powder as an anthelmintic in J ounce doses. 

Solution of Chloride of Tin. SnCl 2 . 

Preparation. — By dissolving granulated tin in diluted hydro- 
chloric acid. 

Uses. — It has a powerful affinity for oxygen and for chlorine. When 
added to trichloride of gold it gives a precipitate called purple of Cassius, 
whose composition is not known. It is used as a test for mercury. When 
added to calomel it abstracts chlorine and precipitates metallic mercury. 
When added to corrosive sublimate it precipitates calomel, which it after- 
wards reduces to mercury. 

Salts of tin are not used in practice, but have been given in nervous 
diseases in somewhat the same way as zinc. 

Chloride of tin is a caustic of considerable power. In poisoning by 
it the treatment would be to give milk and alkaline carbonates. 



CHAPTER XXVII. 

Class V. 

PENTAD ELEMENTS. 

Nitrogen, Phosphorus, Vanadium, Arsenic, Niobium, Antimony , 
Tantalum, Bismuth. 

In the heading to this class I have substituted the word elements for 
metals, for nitrogen and phosphorus belong to it, although they are non- 
metallic elements. 



METALS. 601 

They form analogous compounds with oxygen and hydrogen. 

12 3 4 5 

Nitrogen N ... N 2 ... N 9 2 ...N 9 3 ... NA ... N,0 5 ... NH 3 

Phosphorus P ... ... P 2 3 P 9 5 ... PH 3 

Vanadium V ... V 2 ... V 2 2 ... V 2 3 ... V 2 4 ... V 2 5 ... 

Arsenic As... ...As 9 3 ... ...As 9 5 ... AsH 3 

Antimony Sb... ...Sb 2 3 Sb,0 5 ... SbH 3 

Bismuth Bi... ...Bi 2 3 ... ...Bi 2 5 ... 

Xitrogen. X; 14. Non-officinal. 

Nitrogen when free is chemically inactive, and does not readily 
unite with other elements. It is also physiologically inactive, but has 
been used as an anaesthetic. The anesthesia is due to asphyxia from 
absence of oxygen ; but as the carbonic acid is constantly removed by 
the inhalation of nitrogen, the symptoms of irritation produced by it in 
ordinary asphyxia are absent. 

The 1st, 3d and 5th of its compounds in the above table can take 
up the elements of water and of metallic oxides to form salts. 

Hydeogen Salt. Metallic Salt, e.g., of Potassium. 

Hyponitrous acid H 2 ON 9 or HNO. Potassium hyponitrite K 2 ON 2 or KNO. 

Nitrous acid H 9 ON 9 3 or HN0 2 . " nitrite K 2 ON 2 3 or KN0 2 . 

Nitric acid H 2 ON 2 5 or HN0 3 . " nitrate K 2 ON 2 5 or KN0 3 . 

The acid compounds of nitrogen with oxygen resemble those of phos- 
phorus and arsenic in this, that the nitrites are considerably more active 
than the nitrates, just as the phosphites and arsenites are more active 
than the phosphates and arseniates. The action of nitrites on the organ- 
ism was first investigated in the case of nitrite of amyl, but by some 
unpublished experiments made in Professor Ludwig's laboratory in 
1869-70, I satisfied myself of the correctness of Dr. B. W. Richard- 
son's observation, 1 that other nitrites such as those of ethyl and sodium 
had an action on the blood-pressure similar in kind though less in degree. 
In other experiments, Dr. Gresswell and I found that the nitrites of 
propyl and butyl had also this action, and that all nitrites were muscu- 
lar poisons. 2 Mr. Tait and I found that nitroglycerine had an action 
resembling the nitrites both in its effect on blood-pressure and the 
change it caused in the color of the blood, but the headache it produced 
deterred us from employing it in the treatment of patients. 3 

Nitrous Oxide. Nitrogen Monoxide. Laughing gas. N 2 0. 
Not officinal. 

Preparation. — By heating nitrate of ammonia. 

Action. — When a mixture of nitrous oxide and air is inhaled it 
causes excitement, generally characterized by fits of involuntary laughter, 
dancing, singing and shouting, although it sometimes appears to arouse 
pugnacity. When inhaled pure, it produces, first of all, a feeling of 
increased circulation through the body generally, accompanied by warmth 



1 B. W. Richardson, Brit, and For. Med. Chir. Rev., July, 1867. 

2 St. Bartholomew's Hospital Reports, 1876, p. 143. 

3 Ibid., p. 140. 



602 INORGANIC MATERIA MEDICA. 

and a little singing in the ears. If the inhalation be now stopped, the 
effect may pass off, but occasionally, after a few breaths of pure air have 
been taken, the same excitement may ensue which is usually produced 
by the inhalation of mixed air and gas. On one occasion, having inhaled 
pure gas for a short time, I felt a little warmth of the skin, and a hum- 
ming in the head, and, thinking it was time to desist, laid down the mask 
of the inhaler. After a few breaths of fresh air, I noticed that on 
attempting to speak, the speech was slow and hesitating. An electric 
shock then seemed to shoot through the spine, and I was seized with an 
uncontrollable desire to laugh, jump and throw the arms about, while the 
perceptive faculties appeared quite unaffected. Although unable to con- 
trol my movements, I was perfectly conscious of their ludicrous nature, 
and was astonished that two men who were sitting by, and who after- 
wards informed me that they thought the whole thing a bad joke, were 
able to preserve their gravity. After lasting for one or two minutes, 
the effect of the gas suddenly and completely passed off. 

When inhalation is continued for a longer time, the feelings of warmth 
and buzzing in the ears are succeeded by gradually increasing dimness 
of perception ; sight, sounds and tactile impressions become much dim- 
mer than usual; and then the person becomes unconscious. At this time 
the face usually assumes a livid aspect, and during the period of insensi- 
bility small operations may be performed without the patient being the 
least aware of them. When the administration of the gas is stopped, 
recovery quickly and completely occurs, often passing off without leaving 
any after effects, though occasionally more or less headache is experienced 
for some hours. No stage of exhilaration such as that which has already 
been described as occurring after the administration of a small quantity 
of nitrous oxide is noticed during recovery from complete narcosis. 

Nitrous oxide appears to act as an anaesthetic, chiefly by depriving 
the nerve-centres of oxygen. As the inhalation of pure nitrogen has a 
similar anaesthetic power, the exhilarating effect of small doses of nitrous 
oxide seems to show besides that it has a special relation to the nerve- 
centres. 

Uses. — It is useful as an anaesthetic for extraction of teeth, evulsion 
of the toe-nail, and other minor operations. The intense venosity of the 
blood which occurs during its use renders it unsuitable for continued 
administration, and therefore inadmissible in the case of a lengthy 
operation. 

Mode of Administration. — The most convenient mode of adminis- 
tering it is to have it condensed in a large iron bottle, from which the 
gas may be readily conveyed to the patient by means of a flexible tube 
attached to a mask. The mask ought to be provided with a margin of 
inflated India-rubber, so that it will fit perfectly tightly to the face and 
thus prevent the escape of gas. 

PHOSPHORUS. P; 31. U.S.P. and B.P. 

A non-metallic element obtained from bones. 

PREPARATION. — By treating bones with sulphuric acid, when sul- 
phate of calcium is precipitated and acid phosphate of calcium remains 



METALS. 603 

in solution. This is evaporated and distilled with charcoal, which 
removes the oxygen. The phosphorus distils over and is condensed 
under water. 

Characters. — A semi-transparent, yellowish, waxy-looking solid. 
When exposed to air it emits white fumes which are luminous in the dark 
and have a garlicky odor. 

Officinal Prepakations. 

U.S. p. DOSE. 

Pilulae Phosphori ( T ^ gr. in each) 1-5 pills. 

Oleum Phosphoratum (with stronger ether and almond oil, 1 per cent.) 1-5 min. 

B.P. DOSE. 

Pilula Phosphori (with balsam of tolu and yellow wax, T ^- gr. in 5 grs.) 1-5 grs. 

Oleum Phosphoratum (phosphorus in almond oil, ■£% gr. in 5 m.) 1-10 m. 

Action of Phosphorus. — Living protoplasm has the power of 
oxidizing all the members of this group, and also of reducing the pro- 
' ducts of their oxidation (Binz). It is probable that this action goes on 
more easily with phosphorus than with nitrogen. Hence if phosphorus 
replaces nitrogen in a living cell it will quicken metabolism. It is 
absorbed unchanged into the blood, and is excreted by the kidneys either 
as phosphorus or phosphoric acid. In small doses it appears to cause 
development of the fibrous tissue in the liver, and in doses too small to 
affect the liver or stomach it acts upon the osseous tissues. Its action 
upon the bones is somewhat peculiar, and has been fully investigated by 
Wegner. When phosphorus is given to growing animals, the bone, as it 
develops, is denser than usual, the cancellous tissue being like the denser 
tissue in the long bones. Cancellous tissue formed before the administra- 
tion of phosphorus remains unchanged. If the administration be still 
continued, the cancellous tissue formed previously to the use of the drug 
is absorbed, and serves to form the cavity of the bone, and after awhile 
the normal cancellated tissue at the end of the epiphysis is also replaced 
by solid bone. Afterwards even the dense bone thus formed becomes 
absorbed, and forms the cavity of the long bone. In adult animals 
phosphorus also causes the bones to become denser, and this is especially 
noticeable in chickens, in which the cavity of the bone may be completely 
filled up, so that long bones form a solid rod instead of a tube. The 
influence of phosphorus upon osseous tissues is not due to excess of phos- 
phates produced by it in the blood, but to stimulation of tissue growth 
itself by the phosphorus, for Wegner found that in animals fed with phos- 
phorus, but almost entirely deprived of phosphates, the same dense, bony 
substance was formed, except that instead of the bone being hard, it was 
like that which occurs in rickets. In men exposed to the fumes of phos- 
phorus, e.g., those employed in the manufacture of lucifer-matches, caries 
of the lower jaw is a frequent occurrence. This is not due to the 
action of the phosphorus after absorption into the circulation, but to the 
direct effect of the fumes upon the bone itself. For it has been found 
that when a bone of an animal fed by phosphorus was exposed, no 
carious change took place ; but if one were exposed to the fumes, caries 
was produced, and amongst lucifer-match makers it has been noticed that 
only those who have carious teeth suffer from necrosis of the jaw. 



604 INORGANIC MATERIA MEDICA. 

When doses larger than those which induce induration of the bones 
are given, the phosphorus appears to act upon the connective tissue 
of the stomach and liver, causing chronic inflammation of these 
organs, and atrophy of the secreting cells, so that cirrhosis of the liver 
appears. In poisonous doses the phosphorus first produces the 
symptoms of gastro-enteritis, with a garlicky taste in the mouth, the 
vomited matters having a similar odor, containing bile, and but rarely 
blood. They sometimes shine in the dark. At the end of twenty-four 
to thirty-six hours, the symptoms of gastro-intestinal irritation cease, and 
the patient is apparently well, with the exception of vague pains in the 
limbs and loins. During this period, however, fatty degeneration of the 
liver, stomach, and kidneys is going on, and the effect of the changes in 
these organs soon manifests itself. Sometimes, after two or three days, 
the patient may die suddenly, without exhibiting any fresh symptoms, 
but usually on the second or third day jaundice appears, while the urine 
contains bile, and often albumen. There is occasionally vomiting and 
purging, headache, sleeplessness, delirium, and coma, and death with or 
without convulsions. In some cases, when the poisoning runs a less 
acute course, the effect of fatty degeneration of the vessels is most 
prominent, discharges of blood occurring from the stomach, intestines, 
nose, lungs, bladder, uterus, and ears, and ecchymosis appearing on the 
surface. Increasing anaema and debility finally kill the patient. 

The treatment in cases of poisoning by phosphorus is to wash out 
the stomach freely by means of the stomach-pump, or by an emetic of 
sulphate of copper, and to give oxidized oil of turpentine in 40-minim 
doses in mucilage every fifteen minutes for an hour. Fats and oils should 
be withheld, as they dissolve any phosphorus which may be present in 
the stomach, and assist its absorption. 

The fatty degeneration produced by phosphorus appears to depend 
on a more rapid splitting up of albuminous tissues, along with deficient 
oxidation. This was shown by Voit and Bauer, who produced fatty 
degeneration of the organs by the administration of phosphorus in dogs 
absolutely deprived of food, where the fat found after death could neither 
have come from food nor from fat deposited in other parts of the body, 
as that had all been absorbed before the administration of the drug had 
been commenced. It must therefore have been formed in situ from the 
decomposition of albuminous substances, and these were shown to have 
split up more quickly than usual by the amount of urea in the urine being 
increased by the phosphorus, while oxidation in the body was shown to 
have diminished by the amount. of oxygen absorbed and carbonic acid 
given off being lessened. In man, the products of albuminous waste are 
often not converted into urea, but appear in the urine as leucin and 
tyrosin. 

The action of compounds containing phosphorus appears to depend 
considerably on the more or less complete saturation of its affinities, and 
the readiness with which the phosphorus may attach itself to the organic 
constituents of the tissues. Thus, phosphoric acid, in which the affinities 
of the phosphorus are fully saturated by oxygen, appears simply to act 
&B ;m acid without exerting any specific action, and when combined with 
soda, its effects are simply those of a neutral alkaline salt. 



METALS. 



605 



Metaphosphoric and pyrophosphoric acids appear to have a specific 
poisonous action more nearly resembling that of phosphorus. Pyrophos- 
phate of soda paralyzes the nerve-centres in the spinal cord and medulla 
oblongata, producing drowsiness, loss of reflex action, paralysis, and 
death, which is sometimes preceded by convulsions. It lowers the blood- 
pressure in mammals, slows the beats of the frog's heart, renders them 
powerful and finally arrests them in systole. When death does not occur 
rapidly, marked fatty degeneration of the heart and kidneys are found, 
and a similar change, though to a less extent, in the liver. Although it 
acts as a poison when injected subcutaneously or into the circulation, 
pyrophosphate of sodium has no poisonous action when taken into the 
intestinal canal. 

Metaphosphate of soda has a similar but less powerful action. 

Uses. — Phosphorus forms an important constituent of nervous tissue, 
and has been employed in cases of nervous debility, neuralgia, wakeful- 
ness, paralysis, locomotor ataxia, and impotence. In some cases of 
leucocythamia it is useful. It has been used in osteomalacia, and instead 
of arsenic in skin diseases (vide also p. 610). Even in small doses it may 
•cause nausea, with unpleasant eructations. It is well, therefore, to com- 
mence with a very small dose, such as y^-g- of a grain. 

General Reactions of Aesenic, Antimony, and Bismuth. 





Arsenic. 


Antimony. 


Hydrosulphuric Acid 


Yellow precipitate (solu- 
ble in ammonium 
sulphide and re- pre- 
cipitated by acids). 


Orange or brick-red 
precipitate (soluble in 
aninionium sulphide, 
and precipitated by 
acids). 

StroDg solution thrown 
into much water gives 
a white precipitate, 
which becomes 
orange on the addi- 
tion of hydrosulphu- 
ric acid. 







Bismuth. 



Black precipitate (insol- 
uble in ammonium 
sulphide). 



Strong solution thrown 
into water gives a 
white precipitate, 
which becomes black 
on the addition of 
hydrogen sulphide. 



ARSENIC. As; 75. 

Metallic arsenic is not used in medicine. It is steel-colored, crystal- 
line, and brittle, and when heated gives off garlic fumes. Very light 
(sp. gr. 5*8), very volatile. It forms two classes of salts. In one, the 
arsenious salts, it is tri-, in the other, arsenic salts, pent-atomic. Arse- 
nious oxide, As 2 3 , usually called arsenious acid, forms arsenites. Arsenic 
oxide, As 2 5 , or arsenic acid, forms arsenates, or, as they are termed in 
the U.S. P. and B.P., arseniates. 

General Sources of Arsenic. — It occurs in many ores combined 
with metals, oxygen and sulphur. Its presence as a frequent impurity 
in sulphur has already been mentioned. It is chiefly obtained by roast- 
ing the arsenides of iron, nickel and cobalt, and condensing the arsenious 
oxide in a long nearly horizontal chimney. 

General Tests for Arsenious Acid. — With hydrosulphuric acid 
it gives a yellow precipitate, which is brightest in acid solutions. Silver 



606 IXORGAXIC MATERIA MEDICA. 

nitrate gives a canary-yellow, and copper sulphate a brilliant green pre- 
cipitate (Scheele's green). These are very soluble in acid and neither 
of them is thrown down from simple aqueous solutions of arsenious acid 
(a little acid being freed in the reaction) ; a little alkali must be present. 
Both are very soluble in excess of ammonia, so that to avoid adding excess 
ammonio-nitrate of silver and ammonio-sulphate of copper are used as 
reagents, in preference to adding ammonia along with simple solutions of 
nitrate of silver or of sulphate of copper. Arseniates throw down a brick- 
red precipitate with ammonio-nitrate of silver, and are thus distinguished 
from arsenites. 

G-exeral Action of Arsexic. — Although arsenic, like antimony, has 
no great affinity for albumen, and does not produce with it a coagulum, 
yet, when applied to the skin denuded of its epidermis, it acts as a caustic 
and produces a slough. If used in a dilute form, and over a large surface, 
it may be absorbed, and may produce the general effects of the drug upon 
the system. When applied in a concentrated form it appears to produce a 
slough more rapidly, and the dead tissue forms a barrier to its farther absorp- 
tion. In the mouth it has a somewhat sweetish taste, and in small doses 
excites in the stomach a feeling of appetite. In larger doses it produces 
irritation, colicky pains, diarrhoea, and mucous evacuations, sometimes 
tinged with blood. In still larger doses it causes symptoms of gastro- 
enteritis, vomiting, and' purging, the stools being finally of a rice-watery 
appearance, closely resembling those of Asiatic cholera. These are also 
occasionally accompanied by collapse, with pale, pinched, and somewhat livid 
surface, and violent cramps of the extremities, so that cases of arsenical poi- 
soning may be readily mistaken for cholera, and vice versa. There is 
sometimes strangury, priapism, suppression of urine or bloody urine; the 
consciousness is retained to the last. In some cases there are no symptoms 
at all of gastro-intestinal irritation, the nervous system being affected, 
and the patient presents the symptoms of coma, very much resembling those 
of opium poisoning. 

The treatment in cases of arsenical poisoning is to wash out the 
stomach freely by means of the stomach-pump, and the copious adminis- 
tration of diluents, taking care to insure their evacuation by the subsequent 
speedy administration of such emetics as mustard or sulphate of zinc if 
they are not at once rejected by the vomiting caused by the arsenic itself. 
Peroxide of iron may be administered in doses of a tablespoonful every ten 
minutes, and alcohol has been given when the moist peroxide could not be 
obtained. Demulcents should afterwards be given to allay the irritation. 

Chronic poisoning- by arsenic may occur from the inhalation of 
arsenical vapor or dust, arising from wall-papers, dresses, or other sub- 
stances containing arsenic. The proportion of arsenic necessary to pro- 
duce poisoning when taken into the lungs in this way appears to be very 
small. The symptoms are at first increased appetite, then colicky pains 
and mucous or dysenteric stools, with great prostration, irritation of the 

3, running at the nose, a short cough, which is dry or accompanied by 
slight expectoration, and a white, silvery appearance of the tongue. These 
symptoms may sometimes continue for months, or even years, without the 
cause being suspected, until the recovery which ensues upon the removal 
of the offending wall-paper gives the clue to their cause. 



METALS. 607 

When taken internally for a length of time a condition of tolerance 
may be induced in the case of arsenic, as well as in antimony. This is seen 
in the arsenic-eaters of Styria, who, beginning with small quantities, are 
gradually capable of taking larger and larger doses, until they can swallow 
at once, with safety, as much as five grains. In taking such doses as these 
they are careful not to take water with the arsenic, so that it is probably 
slowly absorbed from the stomach, and is, very possibly, rapidly evacuated. 
Dr. Craig Maclagan watched a noted arsenic-eater swallow his dose, and 
obtained from the urine which he afterwards passed a considerable quantity 
of the poison. By using the arsenic in this way, these people are said to 
undergo much greater exertion than usual without exhaustion, and to be 
able to ascend the steep Styrian hills without being affected with breath- 
lessness. Some, no doubt, die in the attempt to acquire the habit, but those 
who have once become accustomed to the drug appear to continue its use 
without deriving any harm from it, and, moreover, seem sturdy and 
vigorous, and live to an old age. 

After absorption into the blood, arsenic appears to some extent to modify 
tissue change. When a solution of arsenious acid is added to blood 
outside the body, it retards coagulation, prevents putrefaction, and con- 
serves the form of the red blood corpuscles. A very dilute arsenical solution 
also conserves the irritability of the excised nerve and muscle of the frog. 

Considerable doses of arsenic given for a length of time produce 
fatty degeneration of the liver and other organs, and cause the glycogen 
to disappear from the liver, so that puncture of the fourth ventricle no 
longer produces glycosuria. 

Minute doses of arsenic appear to increase the rapidity of the pulse. 
Larger doses diminish the pulse and blood-pressure. In frogs the heart 
is slowed, and finally stands still in diastole. This stoppage of the 
heart appears to be due to paralysis of the motor ganglia, as the 
muscular substance will still continue to contract upon direct irritation. 
In warm-blooded animals it appears to prolong the irritability of the 
heart, so that it will still continue to beat for many hours after the death 
of the animal. According to Kuntzer, this is due to retardation of the vital 
processes in the mammalian heart, so that it comes to resemble that of a cold- 
blooded animal. In animals arsenic has been found to diminish the blood- 
pressure from the beginning. This appears to be due partly to 
diminished activity of the heart, but chiefly to paralysis of the splanchnics 
allowing the abdominal vessels to dilate (p. 249). In frogs it produces 
apparent paralysis, but this appears rather due to diminished sensibility 
of the gray matter in the posterior cornua of the spinal cord than to 
real paralysis, for the nerves and muscles in this state are found to be 
still quite irritable, and although the animal is insensible to pinching, 
it can and does move when laid on its back. As, according to Schiff, 
the muscular sensations are conveyed in the white substance of the pos- 
terior columns, this would appear to be unaffected, while the gray substance 
which conveys sensations of pain is completely paralyzed (p. 151). 

In some cases of poisoning by arsenic, paralysis of one or more 
limbs occurs after the acute symptoms have passed off. It usually affects 
the extensors more than the flexors, and generally is temporary, though 
it may be permanent. 



608 



INORGANIC MATERIA MEDICA. 



The action of arsenic on the skin is peculiar. Ringer and Murrell 
noticed that in frogs poisoned by it the cuticle could be stripped off the 
whole body with the greatest readiness within a few hours after its 
administration. This condition was found by Nunn to depend upon 
softening of the protoplasm of the columnar layer of cells in the epider- 
mis, so that the cuticle remained attached to the dermis only by a few 
protoplasmic threads (Figs. 131 and 132). 









£T> 









Fig. 131.— Vertical section of the healthy epi- 
dermis of a frog, a, Columnar layer of cells. 
b, Malpighian layer, c, Intermediate layer. 
e, Corneous layer. /, Sheet of connective 
tissue forming boundary between dermis and 
epidermis. After Nunn. 



Fig. 132.— Vertical section of epidermis from a 
frog poisoned by arsenic, b, vacuole in the 
softened protoplasm of the columnar layer of 
cells. At a the protoplasm is more softened 
and the vacuoles enlarged so that the cells 
are attached to the dermis only by threads of 
protoplasm. After Nunn. 



Other epithelial structures are also affected, and Cornil has found 
fatty degeneration of the epithelium lining the alveoli of the lungs in 
animals poisoned by arsenic (Fig. 133). 

Arsenic is eliminated chiefly by the urine, and to a less extent 
by the bile, and slightly by the skin. Its elimination by the urine is 
very rapid. 




Fig. 188. — Section of lung, hardened in osmic acid, from guinea-pig poisoned by arsenious acid. The 
capillaries, v, project into the cavities of the alveoli, and are lull of red blood corpuscles. The 
protoplasm, a, of the cells is filled with fatty granules. The nuclei are well preserved. After 
Cornil. 



Uses. — Arsenic has been used externally as an application to can- 
cers, and forms the basis of most of the secret "cures" for this disease. 
The old recipe for this purpose consists of the following ingredients : — 
Arsenious acid, 2 drachms; cinnabar, 2 drachms; ashes of old leather, 
8 grains; dragon's blood, 12 grains, made into a paste with water or 
saliva. 



METALS. 609 

In applying a paste of this sort it is advisable that it should consist 
of at least one-fifth of arsenic, and that it should not be applied to too 
large an extent of surface at a time. 

Internally, arsenic is used for its local action on the intestinal canal 
as a tonic and astringent, for its action on tissue change, and as a tonic 
and anti-spasmodic in cases of nervous disease. In the stomach, small 
doses stimulate the appetite, and are useful in allaying pain and checking 
vomiting. It may be given in irritative dyspepsia, in gastralgia, heart- 
burn, in the vomiting of drunkards, and in gastric ulcer or cancer. It 
is also recommended by Ringer in cases of regurgitation of food unac- 
companied by nausea. It is very useful in cases of diarrhoea where the 
tendency comes on during or immediately after the ingestion of food, 
whether in adults or children. 

Arsenic is a powerful antiperiodic, nearly rivalling quinine ; it seems 
less serviceable than quinine in well-marked cases of ague, but is sometimes 
as good, or even better than it in the irregular malarious manifes- 
tations, such as headache, neuralgia, &c, which are known under the 
head of masked malaria. It is sometimes useful in chronic rheumatism 
and rheumatic gout, and in neuralgia of various sorts its effects are 
occasionally almost magical. 

It has been used, not only in tic and hemicrania, but in spasmodic 
nervous diseases, such as angina pectoris, chorea and epilepsy, whooping- 
cough and asthma. It is often very serviceable in hay fever, and in 
cases of spasmodic sneezing coming on after exposure to dust, or even 
without any apparent cause. It has been employed in chronic bronchitis 
with copious expectoration, and in ordinary catarrh without febrile dis- 
turbance. It appears to be very useful in the commencement of phthisis. 
Under its influence the author has seen consolidation of the lung, conse- 
quent on catarrhal pneumonia, clear up completely even in a subject 
having a very bad family history. 

Probable mode of action of Arsenic in Phthisis. 

The treatment of phthisis is so important that it may be advisable to 
discuss in a few words the probable mode of action of arsenic and hypo- 
phosphites in its early stages. It is now probable that this disease 
depends on the presence of a bacillus (B. tuberculosis, p. 90). In 
order that it should grow within the body, however, it is necessary that 
a suitable nidus should be present, and the different susceptibility to the 
disease of different individuals, or of the same individual at different 
times, probably depends on their liability to present a suitable nidus. 
The Bacillus tuberculosis differs from such bacilli as the B. anthracis in 
being of very slow growth, so that when it is cultivated artificially on a 
solid medium it takes about ten days before it succeeds in establishing 
itself and begins to grow. Consequently, when applied to an open 
wound, or when inhaled into the lungs of a healthy person, it does not, 
like the Bacillus anthracis, at once begin to multiply and produce 
disease in the organism, but it is usually removed by washing in the case 
of a wound, or by expectoration in healthy persons. But if its removal 
be interfered with it will produce disease. Thus, if instead of being 
39 



610 INORGANIC MATERIA MEDICA. 

applied to an open wound it be injected under the skin so that it cannot 
be removed by washing, it will, after a time, begin to grow, and produce 
tuberculosis, first local and then general. It is probable that the case is 
similar in the lungs. In the healthy lung it finds no nidus, and is 
removed by expectoration, but if a portion of the lung be consolidated 
by catarrhal pneumonia, the consolidated part probably affords a nidus to 
the bacillus, and the longer the consolidation lasts the greater the risk of 
bacilli finding entrance. In croupous pneumonia the exudation into the 
alveoli, consisting chiefly of fibrin with a few leucocytes, quickly breaks 
up and is absorbed, so that it is comparatively rarely followed by 
phthisis. But the proliferated epithelial cells which fill the alveoli 
of the lung in catarrhal pneumonia are much more resistant; they 
break down and are absorbed much more slowly, and hence a much 
longer time is given during which bacilli may find a nidus. The marked 
hereditary nature of phthisis is a curious point in a disease which we 
suppose to depend on the presence of a bacillus, and is a character in 
which it differs from such diseases as anthrax, ague, or relapsing fever, 
which are also due to foreign organisms. But the difference probably 
depends on the slow growth of the tubercle bacillus, which renders a 
prolonged undisturbed rest at the point where it enters the body neces- 
sary for its farther growth. Tlie disease is not hereditary, "but the 
predisposition to such morbid changes in the lungs as afford a nidus 
to the bacilli is hereditary. 

The more rapidly the effused products in pneumonia can be removed 
from the lung, the less chance have the bacilli of finding a nidus. It is 
probable that arsenic, which causes fatty degeneration of the normal 
epithelial cells lining the alveoli, also causes a similar degeneration of 
such cells when filling the alveolar cavities. By thus breaking them up 
and quickening their absorption, arsenic will lessen the risk of bacilli 
finding a nidus in them and converting catarrhal consolidation into 
phthisis. Probably the hypophosphites act in a similar way. If the 
patient should be in places where there are no tubercular bacilli, the con- 
solidation may persist for a long time without phthisis occurring, and 
hence one advantage of sea voyages in cases of recent consolidation. 

Mode of Administration. — In those cases where the local action 
of arsenic on the stomach and intestine is desired, it is best to give it in 
small doses before meals, but where the action of the drug on other 
organs of the body is desired, it should be administered immediately 
after meals. 

The symptoms which show that arsenic is beginning to produce its 
physiological effect, and that it is time to diminish the dose or cease its 
administration, are irritation of the eyes, the conjunctivae being some- 
what injected, and the patient showing a tendency to rub the eyes; or 
the digestive canal may be the first to show the effect of the drug, the 
appetite may fail, and colicky pains with a tendency to diarrhoea may 
appear before the eyes are affected. Either of these symptoms indicates 
that the drug should be discontinued, or the dose diminished. 

In skin diseases arsenic is used more frequently than any other 
internal remedy. As it increases metabolism in the cells of the epidermis 
(p. 608) it is contraindicated in acute cases. Its administration should 



METALS. 611 

not be commenced while there is any active cutaneous inflammation, and 
it should be given until either the amendment begins, or the signs of 
conjunctivitis or gastric irritation appear. When these are noticed, the 
dose should be diminished until they become just perceptible, and the 
administration of the drug should be continued for some time after the 
eruption has disappeared, in order to prevent its recurrence. 

Acidum Arseniosum, U.S.P. and B.P. Arsenious Acid. 

As 2 3 ; 1 9 7'8. 

An anhydrous acid, obtained by roasting arsenical ores, and purified 
by sublimation. 

Characters and Tests. — Occurs in sublimed masses which usually 
present a stratified appearance caused by the existence of separate layers 
differing from each other in degrees of opacity, or as a heavy white 
powder. When slowly sublimed in a glass tube it forms minute brilliant 
and transparent octahedral crystals. It is sparingly soluble in water, 
and its solution gives with ammonio-nitrate of silver a canary-yellow 
precipitate insoluble in water, but readily dissolved by ammonia and 
by nitric acid. Sprinkled on a red-hot coal, it emits an alliaceous odor. 

Impurities. — Gypsum and chalk. 

Test. — It is entirely volatilized at a temperature not exceeding 400°. 
Four grains of it dissolved in boiling water with eight grains of bicarbo- 
nate of soda, discharge the color of 808 grain-measures of the volumetric 
solution of iodine. As 2 3 + 2H 2 + 41 = As 2 5 + 4HI. 

Dose. — ^ to -^ of a grain, in solution. 

Peepaeations of Aesenious Acid, 
u.s.p. 
Liquor Acidi Arseuiosi. 
Liquor Potassii Arsenitis. 

B.P. 

Liquor Arsenicalis 4 grains in 1 fluid ounce. 

" Arsenici Hydrochloricus 4 grains in 1 fluid ounce. 

Peepaeations of Arsenic Acid. 
Ferri Arsenias. 
Sodse Arsenias. 

" Arseniatis, Liquor. 

Liquor Potassii Arsenitis, U.S.P. ; Iiiquor Arsenicalis, B.P. SOLUTION OF AESE- 

nite of Potassium, U.S.P. ; Aesenical Solution, B.P. Fowlee's Solution. — 
Is a mixed solution of arsenite and carbonate of potash flavored with compound 
tincture of lavender. Contains 4 grs. arsenious acid in 1 fl. oz., B.P.; 1 in 100, U.S.P. 

Chaeactees. — A reddish liquid, alkaline to test-paper, and having the odor of 
lavender. 

Test. — After being acidulated with hydrochloric acid, it gives, with sulphu- 
retted hydrogen, a yellow precipitate, which is brightest when the arsenical solution 
has been previously diluted. 

Dose. — 2 to 8 minims. 

Use. — This is the preparation of arsenic most commonly employed. 
It may be given along with alkalies. 

Liquor Acidi Arseniosij U.S.P. ; Liquor Arsenici Hydrochloricus, B.P. SOLUTION 

of Aesenious Acid, U.S.P. ; HyDEOCHLOEic Solution of Aesenic, B.P. — A solu- 
tion of 1 part arsenious acid and 2 of hydrochloric in 100 of water, U.S.P.; 4 grs. 
with 6 min. of hydrochloric acid in 1 fl. oz. of water, B.P. 



612 INORGANIC MATERIA MEDICA. 

Chaeactees and Tests. — A colorless liquid, having an acid reaction. Sulphu- 
retted hydrogen gives at once a bright yellow precipitate. 
Dose. — 2 to 8 minims. 

Use. — Some think it milder than the ordinary liquor. Garrod thinks 
not. It can he given along with perchloride of iron in solution, or with 
acids. 

Sodii Arsenias, U.S.P.; Sodse Arsenias, B.P. Arseniate OF 
Sodium, U.S.P.; or Soda, B.P. Na 2 HAs0 4 .7H 2 0; 311-9. 

Preparation. — By fusing arsenious acid with nitrate and carbonate 
of soda. The As 2 3 is oxidized by the nitrate to As 2 5 , which combines 
with the soda to form arseniate. 

Characters and Tests. — In colorless transparent prisms, soluble in 
water; the solution is alkaline, giving white precipitates with chloride of 
barium, chloride of calcium, and sulphate of zinc, and a brick-red pre- 
cipitate with nitrate of silver (arseniate), all of which are soluble in 
nitric acid. 

Dose. — ^ to ■§■ grain; of the dried salt -^ to -^ grain. 

Peepaeations. 
b.p. 

Liquor Sodae Arseniatis j 4 ^^^^ } 1 in 100, U.S.P. ; in 1 fl. oz. of water, B.P. 

Dose. — 5 to 10 minims. 

Action. — It acts like other preparations of arsenic, but does not 
irritate the stomach so much, and may be given in larger doses. In frogs 
it produces, like arsenious acid, paralysis of the brain and spinal cord, 
but is much less powerful (Ringer and Murrell). 

Uses. — It may be used in the same diseases as arsenious acid. It is 
perhaps one of the best remedies for neuralgia which we have. 

U.S.P. Arsenii Iodidum. Iodide OF Arsenic. Asl 3 ; 454*7. 

Preparation. — By gently warming arsenious acid and iodine 
together. 

Characters. — Glossy, orange-red, crystalline masses, or shining, 
orange-red, crystalline scales, gradually losing iodine when exposed to 
the air, having an iodine-like odor and taste and a neutral reaction. The 
aqueous solution has a yellow color, and on standing gradually decom- 
poses into arsenious and hydriodic acids. On passing hydrosulphuric 
acid through the solution a lemon-yellow precipitate is thrown down. 
If the salt be heated with diluted nitric acid, vapor of iodine will be 
given off. 

Use. — In skin diseases. 

Dose.— J- grain (0-008 Gm.). 

U.S.P. Liquor Arsenii et Hydrargyri Iodidi. SOLUTION OF 
Iodide of Arsenic and Mercury. Donovan's Solution. — Iodide of 
arsenic, 1 ; red iodide of mercury, 1 ; water up to 100. 

Characters. — A pale or orange-yellow solution, with a somewhat 
styptic taste. 

INCOMPATIBLES. — Solutions of opium or morphine. 

Uses. — In skin diseases, syphilis, rheumatism, and nocturnal pains. 

Dose. — 5 to 10 minims (0-3-0-6 cc). 



METALS. 613 

ANTIMONY. Sb; 122. 

Antimony forms two classes of salts, antimonious and antimonic. In 
the former it is tri- and in the latter pent-atomic. 

General Sources. — It is chiefly found native in the form of the 
black antimonious sulphide, Sb 2 S 3 . 

General Reactions. — It is recognized by the orange-colored pre- 
cipitate which it gives with sulphuretted hydrogen in acid solutions. A 
characteristic reaction is the white precipitate which falls on throwing a 
strong solution of a salt of antimony, such as the chloride, into water and 
the change of the white into an orange color on the addition of sulphuret- 
ted hydrogen. A similar reaction occurs with salts of bismuth, but the 
white precipitate becomes black on the addition of sulphuretted hydrogen. 

A solution of chloride of antimony gives with potash or soda a white 
precipitate which only dissolves in large excess, and with ammonia a 
white precipitate insoluble in excess. But if tartaric acid be present the 
precipitate dissolves in a slight excess of potash or soda, and with ammo- 
nia only a slight precipitate is formed. 

General Actions of Antimony. — Salts of antimony probably com- 
bine with albumen, but in alkaline solutions they form no precipitate. 
They only form precipitates in acid solutions, and they consequently 
appear to exert an irritant action only on those parts of the animal body 
where they meet with a,n acid secretion, such as the orifices of the sweat- 
glands and the stomach. When applied to the skin the chloride of 
antimony destroys the cuticle, and acts as a powerful escharotic, produc- 
ing a deep slough and a slowly healing sore. 

The other preparations, however, instead of affecting the whole surface 
to which they are applied, produce inflammation in isolated spots, which, 
beginning with papules, proceeds to pustules resembling those of small- 
pox. A similar pustular irritation is sometimes noticed upon the fauces 
of persons who have been taking antimony for some time or have been 
poisoned by it. When taken internally, sniall doses produce little 
more than a feeling of warmth in the stomach and slightly increased dia- 
phoresis, but larger doses cause loss of appetite, nausea accompanied by 
enfeeblement of the circulation, and a feeling of great depression and 
weakness. Not only the secretion of sweat, but those of the mucous 
membranes, stomach, intestine, and respiratory passages, seem at the 
same time to be considerably increased. In still larger doses antimony 
produces vomiting, with great depression of the circulation, and relaxa- 
tion both of the voluntary and involuntary muscles. In large and poi- 
sonous doses it causes gastro-enteritis, with profuse diarrhoea and 
extreme collapse. The pulse is small and quick, the surface cold, and 
covered with clammy perspiration. There is great weakness and severe 
cramps of the extremities, and the symptoms somewhat resemble those 
of Asiatic cholera. Death may occur in this condition. It is some- 
times preceded by delirium and convulsions, and tonic or clonic convul- 
sive spasms. 

The treatment of antimonial poisoning consists in the administra- 
tion of tannin, and in some readily accessible form. The most easily 
obtained is a strong infusion of tea, and the tannin is more readily 



614 INORGANIC MATERIA MEDICA. 

extracted from this by the addition of a small quantity of bicarbonate of 
soda. Infusions of oak bark or of cinchona may also be used if obtain- 
able. Milk and mucilaginous drinks may also be used. A diffusible 
stimulant should be given to counteract the collapse. 

The mode in which tartar emetic causes vomiting- has given rise to 
considerable dispute. It acts as an emetic even when injected into the 
veins, as well as when given by the stomach, and it was found by 
Magendie that when the stomach of an animal was excised, and a pig's 
bladder filled with liquid attached to the lower end of the oesophagus, an 
injection of tartar emetic into the circulation caused movements of vomit- 
ing, and the contents of the bladder were expelled just as if the stomach 
had been in situ. This experiment seemed to prove not only that the 
act of vomiting was independent of the movements of the stomach itself, 
but also that tartar emetic caused vomiting by acting upon the vomiting 
centre, and not upon the stomach. The objection, however, has been 
raised that the action of the drug upon the vomiting centre is not direct, 
but reflex ; and it has been urged that, although the stomach was removed, 
the antimony might still be carried by the circulation to the oesophagus 
and intestines, and by there causing irritation might produce reflex vom- 
iting. This seems improbable, especially as the antimonial salts have 
a comparatively slight action on organs having, like the oesophagus 
and intestines, an alkaline reaction, instead of an acid one, as the 
stomach has. 

It is probable, then, that tartar emetic does produce vomiting by its 
direct action on the vomiting centre in the medulla oblongata, but prob- 
ably this direct action is not the only way in which it stimulates the 
vomiting centre — it also produces a reflex action upon it through the 
stomach. For it has been found that even when tartar emetic is injected 
into the veins, it is eliminated by the mucous membrane of the stomach 
(p. 5o), and may thus act upon that organ in the same way as when 
introduced directly into it. If its emetic action be due in any great 
measure to irritation of the stomach, one would expect that a smaller 
dose would be found sufficient to produce vomiting, when introduced 
directly into the stomach, than when injected into the veins, for in the 
former case the whole of it will come in contact with the stomach and 
will do so at once ; in the latter case only a fraction of the quantity 
injected into the veins will reach the stomach, and some time will be 
required before it accumulates in the gastric mucous membrane sufficiently 
to cause irritation. This is exactly what is found by experiment, and 
vomiting is produced more quickly, and by a smaller dose, when the drug 
is introduced into the stomach, than when injected into the veins, just 
as we should expect to be the case if its emetic action were due in con- 
siderable measure to its action upon the stomach itself. This view is also 
supported by another experiment, for after the nervous channel by which 
impressions are conducted from the stomach to the vomiting centre is 
destroyed by section of the vagi, double the dose of the drug is required 
in order to produce vomiting. It may then be concluded that antimony 
acts chiefly as an emetic by irritating the stomach, and thus exciting the 
vomiting centre reflexly, but that it also acts directly on this centre when 
conveyed to it by the blood (p. 326). 



METALS. 615 

After its absorption into the blood, antimony diminishes the blood- 
pressure, and slows the pulse. When applied directly to the heart of 
a frog, it first increases, then slows, and finally arrests its pulsations in 
diastole. This action appears to be chiefly due to paralysis of the car- 
diac muscle itself, and possibly also to the effect upon motor ganglia. 

The effect of antimony upon the circulation appears to depend 
partly upon the direct action of the drug upon the heart and vessels, and 
partly on its reflex action upon them through the nerves of the stomach. 
In warm-blooded animals the pulse becomes quicker as the feeling of 
nausea increases, and, after the vomiting, again falls nearly to the 
normal. Its volume is, at the same time, diminished. After the nausea 
has ceased, the pulse again becomes quicker, and after this secondary 
acceleration has reached a greater or less height, according to the dose, 
it again sinks to the normal. 

As the primary acceleration during the stage of nausea ceases with 
vomiting, it is probably to be attributed to reflex irritation of the accel- 
erating centres, or reflex depression of the vagus through the gastric 
nerves, whereas the cause of the secondary acceleration is more probably 
to be sought in diminished power of the vagus nerve itself. The blood- 
pressure sinks constantly, from the very beginning, and this sinking 
is probably due to diminished power of the cardiac pulsations. The 
temperature in the extremities appears to be diminished during the 
stage of nausea, owing to the smaller amount of blood going to them. As 
less blood reaches the surface in this condition, there is less opportunity 
afforded for its being cooled by contact with the atmosphere, and the 
temperature in the body gradually rises, even above the normal. When 
the spasm of the vessels in the extremities relaxes, they also become 
warmer than normal. As the effects pass off, the temperature sinks to 
the normal, or below it. 

The respiration is first increased, and then diminished. 

Large doses of antimony affect the spinal cord both in cold and 
warm-blooded animals. It appears to paralyze, after, perhaps, slightly 
exciting both the sensory and motor tracts of the spinal cord, and as 
this paralysis appears in frogs while the heart still continues to beat, it 
must be due to the direct action of the drug upon the nervous system 
itself, and not to its indirect action through the circulation. The motor 
and sensory nerves appear also to be paralyzed. The muscles are 
weakened (p. 124). 

When given for a length of time, antimony seems to produce fatty 
degeneration of various organs. 

The action of antimony upon the skin in frogs is even more rapid 
than that of arsenic, and differs from it in this respect, that the softening 
does not affect the cells of the columnar layer only, but extends to those 
of the intermediate layer (Fig. 134). In consequence of this, the cuticle 
does not merely become detached from the dermis and peel off in strips 
as in poisoning by arsenic, but, the cells of the epidermis becoming 
detached from each other, the cuticle becomes converted into a soft jelly- 
like mass which can be scraped or brushed off. 

Tartar emetic appears to be eliminated by the mucus of the stom- 
ach and alimentary canal, by the bile, and by the kidneys. Its action 



616 INORGANIC MATERIA MEDICA. 

upon the renal secretion is somewhat uncertain. It appears to increase 
urea, uric acid, and pigment, and to diminish the water and the chloride 
of sodium, probably by increasing the perspiration. 

Uses. — The local uses of antimony will be considered under the 
special preparations. 




Fig. 134.— Vertical section of epidermis from a frog poisoned by antimony, a, Columnar layer in 
which large cavities are formed. &, Columnar ceils in which the reduced protoplasm is drawn 
into processes, c, Spaces in the intermediate layer, d, Light lines between cells indicating a soften- 
ing and separation of cells. After Xunn. 

When antimony is given internally for its action on the system 
generally, tartar emetic is the preparation usually employed, but the 
other preparations of antimony have a similar action when given in appro- 
priate doses. It can be used for its emetic action, nauseant and depressant 
action, or diaphoretic action. As an emetic it has been employed in 
cases of croup, in order to cause expulsion of the false membrane ; but 
for this purpose other emetics, such as ipecacuanha, alum, or sulphate of 
zinc, are now more generally employed, as they do not cause so much 
depression. It has also been used with considerable success to cut short 
an attack of intermittent fever, either alone or combined with a purga- 
tive. Indeed in cases where malarial poisoning has been intense, quinine 
sometimes proves ineffectual unless preceded by the administration of an 
emetic and purgative. It has sometimes been injected into the veins to 
produce vomiting, in cases of obstruction of the oesophagus, as, for exam- 
ple, by a piece of meat firmly lodged in it, and to cause expulsion of a 
biliary calculus lodged in the gall-duct, by the pressure from behind 
which the movements of vomiting produce, along with the relaxation of 
the muscular fibres of the gall- duct itself. 

When large doses are administered several times, what is termed 
tolerance of the drug sets in, and it no longer produces vomiting. It 
has been used in this way in pneumonia, but the plan is now rarely fol- 
lowed. How this tolerance is produced is not at present understood. It 
is not improbable that it may be caused by the irritant action of the first 
few doses upon the stomach arresting the secretion of the acid juice and 
producing a condition similar to that which occurs in fever. In this 
condition, subsequent doses of the tartar emetic, meeting with no acid, 
will have but a feeble action upon the stomach. 

In cases of obstinate constipation it has been used along with sulphate 
of magnesia. As a nauseant it has been given to relax the cervix uteri 
in labor ; in acute inflammations, e.g., in acute orchitis, where the emetic 
is first given, and nausea is kept up by a continued administration of 
smaller doses, and also in pericarditis, pneumonia, pleurisy, peritonitis, 



METALS. 617 

meningitis, bronchitis, and hepatitis, as well as in acute rheumatism. 
As an expectorant it is used in bronchitis. The cases in which it is 
especially serviceable are those in which there is great congestion and 
much dyspnoea, with little or no secretion, as shown by loud, sibilant 
rales over the chest, the pulse being full, and the face flushed, with 
a tendency to lividity. It has also been given to check haemoptysis when 
there was much excitement of the circulation. In nervous diseases, 
attended with much excitement, such as certain cases of insanity, delirium 
tremens, and puerperal convulsions, it is of use. In the delirium of 
fever, it has been highly recommended by Dr. Graves, in combination 
with opium, as a means of producing sleep. Where the delirium is 
furious the tartar emetic must be given in full, and the opium in small 
doses ; while if the delirium is milder and the sleeplessness great, the 
opium dose must be increased and that of the tartar emetic diminished. 
The same treatment may be adopted in the delirium and sleeplessness of 
delirium tremens. 

For its diaphoretic action, antimony has been used to arrest com- 
mencing inflammations, such as catarrh, and to check febrile conditions. 
For this purpose it is not unfrequently given as tartar emetic in doses of 
3^ grain frequently repeated, or as James's powder. In acute dropsy it 
appears to be occasionally useful, especially as a diaphoretic, in combina- 
tion with bitartrate of potash and squills. 

Peepaeations containing Antimony, 
u.s.p. B.P. 

Antimonii et Potassii Tartras. Antimonii Oxidum. 

Oxidum. Antimonmni Nigrum. 
" Sulphidum. " Sulphuratum. 

" " Puriflcatum. " Tartaratum. 

Sulphuratum. Liquor Antimonii Chloridi. 

Pilulae Antimonii Compositse. Pilula Hydrargyri Subchloridi Composita. 

Pulvis Antimonialis. Pulvis Antimonialis. 

Syrupus Scillse Compositus. Unguentum Antimonii Tartarati. 

Vinum Antimonii. Vinum Antimoniale. 

Antinionii Sulphidum, U.S.P. ; Antimouium Nigrum, B.P. 

Sulphide of Antimony, U.S.P. ; Black Antimony, B.P. — Native 
sulphide of antimony, Sb 2 S 3 ; 336 ; purified from siliceous matter by 
fusion, and afterwards reduced to fine powder. 

Characters and Tests. — A grayish-black crystalline powder. It 
dissolves almost entirely in boiling hydrochloric acid, evolving sul- 
phuretted hydrogen. H 2 added to the solution precipitates a white 
oxychloride. 

Peepaeations in which Black Antimony is used. 

u.s.p. • B.P. 

Antimonii Sulphidum Puriflcatum. Antimonium Sulphuratum. 

Liquor Antimonii Chloridi. 

This is the ore from which the other compounds are prepared. 
It seems to be inert, and is not used internally. 

U.S.P. Antimonii Sulphiduni Puriflcatum. Purified Sul- 
phide of Antimony. Sb 2 S 3 ; 336. 



618 INORGANIC MATERIA MEDICA. 

Preparation. — The crude sulphide is obtained in very fine powder 
by elutriation, then digested with ammonia to remove arsenic, washed 
and dried. 

Characters. — A dark gray powder, odorless and tasteless, and 
insoluble in water or alcohol. It fuses at a temperature below red-heat. 
When boiled with ten parts of hydrochloric acid it is nearly all dis- 
solved, hydrosulphuric acid being evolved. The solution when added 
to water yields a white precipitate which is soluble in a solution of 
tartaric acid. After separation of the precipitate by filtration, the 
filtrate gives an orange-red precipitate with hydrosulphuric acid. 

Impurities. — Other sulphides and arsenic. 

Tests. — If 2 Gm. of the salt be mixed and cautiously ignited in a 
porcelain crucible with 8 Gm. of pure nitrate of sodium, and the fused 
mass boiled with 25 Gm. of water, there will remain a residue which 
should be white or nearly so, and not yellowish or brownish (absence 
of other metallic sulphides). On boiling the filtrate with an excess 
of nitric acid until no more nitrous vapors are evolved, then dissolving in 
it 0*1 Gm. of nitrate of silver, filtering again if necessary, and cautiously 
pouring a few drops of water of ammonia on top, not more than a 
white cloud, but no red nor reddish precipitate should appear at the 
line of contact of the two liquids (absence of more than traces of 
arsenic). 

Preparation. 
Antimonium Sulphuratum. 

Antimonium Sulphuratum, U.S. P. and B.P. SULPHURATED 
Antimony. 

U.S. P. Chiefly antimonious sulphide, Sb 2 S 3 ; 336; with a very small 
amount of antimonious oxide. 

B.P. Sulphide of antimony, Sb 2 S 3 ; 336 ; with a small and variable 
amount of oxide of antimony, Sb 2 3 . 

Preparation. — By boiling black sulphide with caustic soda the sul- 
phide is partly converted into oxide and partly unites with sodium, 
forming sulphantimonite and antimonite of sodium. 

Sulphide of Sulphantimonite Oxide of 

Antimony. Soda. of Sodium. Antimony. 

2Sb 2 S 3 + 6NaHO = 2Na 3 SbS 3 + Sb 2 3 + 3H 2 0, 

and 
Oxide of Antimonite 

Antimony. Soda. of Sodium. 

Sb 2 3 + 6NaIIO = 2Na 3 Sb0 3 + 3H 2 0. 

These antimony compounds are soluble in caustic soda, but when this 
is neutralized they are precipitated, the greater part of them being 
decomposed and the Sb 2 3 reconverted into Sb 2 S 3 . 

Sulphantimonite Sulphuric Sodium Sulphate of 

of Sodium. Acid. Sulphate. Antimony. 

2Na*SbS 8 + 3II 2 S( ) 4 = 3Na 2 S0 4 + Sb 2 S 3 + 3II 2 S. 

Antimonite 
Of Sodium. 

2Na 3 Sb0 3 + 3H 2 S0 4 = 3Na,S0 4 + Sb 2 3 + 3H 2 0. 



METALS. 619 

Characters and Tests. — U.S. P. A reddish-brown, amorphous 
powder, odorless and tasteless, and insoluble in water and in alcohol. 
When heated with 12 parts of hydrochloric acid, it is nearly all dissolved 
with evolution of hydrosulphuric acid. The residue, after having been 
washed and dried, burns, on the application of a flame, with the charac- 
teristic odor of sulphur, and should leave not more than a scanty ash. 
On dropping a solution of sulphurated antimony in hydrochloric acid 
into water, a white precipitate is produced, which, after washing and 
drying, should weigh not less than 85 per cent, of the sulphide. The 
liquid filtered from this precipitate yields an orange-red precipitate with 
hydrosulphuric acid. 

B.P. An orange-red powder, readily dissolved by caustic soda, also 
by hydrochloric acid with the evolution of sulphuretted hydrogen and 
the separation of a little sulphur. Boiled in water with acid tartrate of 
potash it dissolves, and the resulting solution is precipitated orange-red 
with sulphuretted hydrogen. 

Distilled water boiled with sulphurated antimony, filtered and acidu- 
lated with hydrochloric acid, should be rendered not more than slightly 
opalescent by test solution of chloride of barium (limit of sulphate). 

Dose. — 1 to 5 grains. 

Peepaeations. 

u.s.p. 

Pilulae Antimonii Composita (Plummer's pill) (p. 588) 1 part in 4. 

B.P. 

Pilula Hydrargyri Subchloridi Composita (Plummer's pill) (p. 588) 1 part in 5. 

The oxide it contains is probably the active part, and as this is 
variable the action is rather uncertain. 

Liquor Antimonii Chloridi, B.P. SOLUTION OF CHLORIDE OF 
Antimony. 

Preparation. — By boiling black antimony with hydrochloric acid, 
Sb 2 S 3 + 6 HC1 = 2 Sb01 3 + 3 H 2 S. 

Characters and Tests. — A heavy liquid usually of a yellowish- 
red color. A little of it dropped into water gives a white precipitate, 
and the filtered solution lets fall a copious deposit on the addition of 
nitrate of silver. If the white precipitate formed by water be treated 
with sulphuretted hydrogen it becomes orange-colored. The specific 
gravity of the solution is 1*47. One fluid drachm of it mixed with a 
solution of a quarter of an ounce of tartaric acid in four fluid ounces of 
water, forms a clear solution, which, if treated with sulphuretted hydro- 
gen, gives an orange precipitate, weighing, when washed and dried at 
212°, at least 22 grains. 

Peepaeation in which Solution of Chloeide op Antimony is used. 
Antimonii Oxidum. 

Uses. — Is a powerful caustic — sometimes applied to cancers and to 
poisoned wounds. 

Antimonii Oxidum, U.S.P. and B.P. Oxide of Antimony. 

Sb 2 3 ; 288. 



620 INORGANIC MATERIA MEDICA. 

Preparation. — By pouring solution of chloride of antimony into 
water and treating the precipitate of oxychloride with sodium carbonate. 

Chloride of Oxychloride of Hydrochloric 

Antimony. Antimony. Acid. 

12SbCl 3 + 15H 2 =2SbCl 3 5Sb 2 3 + 30HC1. 

Oxychloride of Carbonate Oxide of Sodium 

Antimony. of Sodium. Antimony. Chloride. 

2SbCl 3 ,5Sb 2 3 + 3Na 2 C0 3 = 6Sb 2 3 + 6NaCl + 3C0 2 . 

Characters and Tests. — A grayish-white powder, fusible at a low 
red-heat, insoluble in water, but readily dissolved by hydrochloric acid. 
The solution, dropped into distilled water, gives a white deposit, at 
once changed to orange by sulphuretted hydrogen. It dissolves entirely 
when boiled with an excess of the acid tartrate of potash. 
Dose. — 1 to 4 grains. 

Preparations, 
u.s.p. and b.p. dose. 

Puivis AntimoniaUs. Antimonial powder or James's powder 

(one part of oxide of antimony with two of phosphate of lime)... 3-10 grs. 

Uses. — Oxide of antimony may be used for the same purposes as 
tartar emetic, but it is not soluble in water, and it depends very much on 
the state of the stomach how much of it will be dissolved. It is there- 
fore less certain in its action than tartar emetic, and the latter is conse- 
quently to be preferred. In consequence of its insolubility it is said to 
be slower and milder than tartar emetic, but this advantage is more than 
counterbalanced by its uncertainty. 

James's powder is given as an antipyretic in fever and rheumatism. 
It is also given in chronic skin diseases along with mercury. 

Antimonii et Potassii Tartras, U.S. P.; Antimoiiium Tar- 
taratum, B.P. Tartrate of Antimony and Potassium, U.S.P.; 
Tartarated Antimony, B.P. 

2KSbOC 4 H 4 6 .H 2 0; 664, U.S.P.; KSbC 4 H 4 7 .H 2 0, B. P.— A tar- 
trate of potash and antimony. 

Preparation. — By boiling acid tartrate of potash and oxide of anti- 
mony together, 2KHC 4 H 4 6 + Sb 2 3 = 2K(SbO)C 4 H 4 6 + HO. 

Characters and Tests. — In colorless transparent crystals exhibit- 
ing triangular facets, soluble in water, and less so in proof spirit. It 
decrepitates and blackens upon the application of heat (tartrate). Its 
solution in water gives with hydrochloric acid a white precipitate, soluble 
in excess, and which is not formed if tartaric acid be previously added. 

Dose. — As a diaphoretic, -^ to -jt of a grain; as an emetic, 1 to 2 
grains. Of the wine, as a diaphoretic, 10 to 40 min.; as an emetic for 
children, \ to 1 fl. dr., repeated frequently. 

Preparations, 
u.s.p. DOSE. 

Syrupus Scilhe Compositus 5 min.-l fl. dr. 

vimim Antimonii. Wine of Antimony 4 parts in 60 of water and 

stronger white wine up to 1000. 

B. P. STRENGTH. 

Unguentam Antimonii Tartarati 1 part in 5. 

| With simple ointment.) 
\ inum Antimoniaie. Antimonial Wine 2 gr. in 1 fl. oz. of sherry. 



METALS. 



621 



Use. — This preparation of antimony is readily soluble, and as the 
proportion of the dose administered which actually takes effect is more 
constant than that of the other preparations of antimony, it has gradually 
displaced them. For its uses vide p. 616. 

Tartar emetic ointment has been used as a counter-irritant in cases 
of neuralgia, paralysis of children, enlarged joints, acute meningitis, 
laryngitis, acute bronchitis, whooping-cough, phthisis, asthma, angina 
pectoris, and subacute ovaritis. For many of these purposes the appli- 
cation of iodine preparations is now preferred. 

BISMUTH. Bi; 210. 

Bismuth forms three classes of compounds in which it is bitri- and 
quinqui-valent respectively. 

General Action. — The soluble salts of bismuth, such as the citrate 
of bismuth and ammonia, when given in large doses have an action like 
that of antimony or arsenic and cause gastro-enteritis with fatty degen- 
eration of the liver. Small doses of soluble preparations, or larger doses 
of sparingly soluble preparations, have a sedative effect on the stomach 
like that of minute doses of arsenic. The subnitrate is so sparingly solu- 
ble that its utility in gastric catarrh is probably due to its mechanical 
action, like charcoal (p. 459) or binoxide of manganese. 

General Sources. — It is found native in the metallic state. 

General Reactions. — It is distinguished by the white precipitate 
which falls on throwing a solution of the nitrate or chloride into water, 
and the blackening of this by sulphuretted hydrogen. 



Geneeal Peepaeation of Salts of Bismuth. 


Salt. 


Prepared from 


By 


Subnitrate, U.S.P. and 
B.P. 


Bismuth. 


Dissolving in nitric acid, throwing 
the solution into a large quantity 
of water, collecting and drying the 
precipitate. 


Subcarbonate, U.S.P. \ 
Carbonate, B.P. / 


Do. 


Dissolving in nitric acid, evaporat- 
ing to a small bulk and adding to 
solution of ammonium carbonate. 


Oxide, B.P. 


Subnitrate. 


Boiling with solution of soda. 


Citrate, U.S.P. 


Do. 


Boiling with citric acid and washing 
with a large quantity of water, 
when insoluble citrate is formed. 


Solution of citrate of 
bismuth and ammo- 
nia, B.P. 


Bismuth. 


Dissolving in nitric acid as for sub- 
nitrate, evaporating to a small 
bulk, adding citric acid, and add- 
ing ammonia until the precipitate 
of citrate is redissolved and the 
liquid is neutral or slightly alka- 
line. 


Citrate of bismuth and 
ammonia, U.S.P. 


Citrate of bismuth. 


Mixing the citrate to a smooth paste 
with water and adding ammonia 
until it is dissolved and the liquid 
is neutral or faintly alkaline. 



622 IXOKGANIC MATERIA MEDICA. 

Uses. — Subnitrate of bismuth is used under the name of Spanish or 
pearl white to whiten the complexion, and as a dusting powder, lotion, 
or ointment to chapped nipples and hands, abraded ' surfaces and chronic 
oozing from the skin, as eczema, in order to take up moisture and allay 
smarting and itching. 

It has also been employed externally as an application in scaly dis- 
eases, and in intertrigo. From its power of diminishing the irritability 
of mucous membranes it was applied by Ferrier, along with morphia in 
the form of a snuff, to arrest nasal catarrh, and has been used as an injec- 
tion in ozoena, leucorrhcea, and gonorrhoea to diminish the irritability. 
It is applied as a local sedative to diminish the pain, nausea or vomiting 
in irritable dyspepsia, and to lessen the irritability of the intestine in 
diarrhoea and dysentery. It is very serviceable, either alone or com- 
bined with lime or alkalis in the gastro-intestinal catarrh caused by cold, 
which is commonly known as cold in the stomach, as well as in the same 
affection occurring in children at the period of dentition. 

It is useful in pyrosis, gastralgia and vomiting, whether the vomiting 
be from ulcer of the stomach or other causes. It acts remarkably well 
in the indigestion and pain in the stomach caused by the use of alcohol. 
In such cases it is best given with a little magnesia, about ten grains of 
the subnitrate with an equal quantity of magnesia or its carbonate. 

The carbonate of bismuth is more soluble in the gastric juice than 
the subnitrate, and is supposed to be more powerful, and the same advan- 
tage, if advantage it be, is possessed by the citrate of ammonia and bis- 
muth. My own experience leads me to prefer the less soluble subnitrate 
to either of the other preparations. 

B.P. Bismutlmm. Bismuth. — A crystalline metal. As met with 
in commerce it is generally impure. 

Preparation. — Bismuthum Purificatum. 

B.B. Bismuthum Purificatum. Purified Bismuth. 

Preparation. — By fusing with nitrate of potash. 

Characters. — A crystalline metal of a grayish-white color, with a 
distinct roseate tinge. Specific gravity 9-83. Dissolved in a mixture of 
equal volumes of nitric acid and distilled water, it forms a solution which 
by evaporation yields colorless crystals, that are decomposed on the addi- 
tion of water, giving a white precipitate. 

Impurities. — Iron and copper. 

Test. — If the mother liquor from which the crystals have been sepa- 
rated be added to solution of carbonate of ammonia, the precipitate formed 
and the solution are free or nearly free from color. 

Preparations containing Bismuth. 

r.s.p. b.p. 

Bismuthi Carbonas. Bismuthi Carbonas. 

Citras. " Subnitras. 

et Ammonii Citras. Liquor Bismuthi et Amnionic Citratis. 

" Citratis Liquor. Trochisci Bismuthi. 
" Subnitras. 

Bismuth! Subnitras, U.S. P. and B.P. Subnitrate of Bis- 
muth. BiON0 3 .II 2 0; 306, U.S.P.; BiN0 4 .H 2 0, B.P. 



METALS. 623 

Characters and Tests. — A heavy white powder in minute crys- 
talline scales, blackened by sulphuretted hydrogen ; insoluble in water, 
but soluble in nitric acid mixed with half its volume of distilled water, 
forming a solution which poured into water gives a white precipitate. 
It forms with sulphuric acid diluted with an equal bulk of water a solution 
which is blackened by sulphate of iron (nitrate). The nitric acid solution 
gives no precipitate with diluted sulphuric acid (no lead) nor with solu- 
tion of nitrate of silver (no chloride). 

Impurities. — Lead, nitrates, chlorides. 

Dose. — 5 to 20 grains. 

Peepaeation. 
b.p. dose. 

Trochisci Bismuthi, 2 grains in each lozenge 1 to 6 lozenges. 

Bismuthi Subcarbonas, U.S. P.; Bismuthi Carbonas, B.P. 

SUBCARBONATE OF BlSMUTH, U.S. P. ; CARBONATE OF BlSMUTH, B.P. 

(BiO) 2 C0 3 .H 2 ; 530, U.S.P.; 2(Bi 2 C0 5 ).H 2 0, B.P. 

Characters and Tests. — A white powder, blackened by sulphu- 
retted hydrogen ; insoluble in water, but soluble with effervescence in 
nitric acid. The solution gives the reactions of bismuth. 

Impurities. — Nitrate. 

Test. — When added to sulphuric acid colored with sulphate of indigo 
the color of the latter is not discharged. 

Dose. — 5 to 20 grains. 

B.P. Liquor Bismuthi et Animonige Citratis. SOLUTION OF 
Citrate of Bismuth and Ammonia. 

Characters. — A colorless solution with a saline and slightly 
metallic taste. Neutral or slightly alkaline to test paper ; mixes with 
water without change. It gives the reactions of ammonia and bismuth. 
One fluid drachm contains 3 grains of oxide of bismuth. 

Dose. — J to 1 fluid drachm. 

U.S.P. Bismuthi Citras. Citrate of Bismuth. BiC 6 H 5 7 ; 399. 

Characters. — A white amorphous powder, permanent in the air, 
odorless and tasteless, insoluble in water or alcohol, but soluble in water 
of ammonia. 

Uses. — Not given internally, but used to prepare the solution with 
ammonia. 

Preparation. — Bismuthi et Ammonii Citras. 

U.S.P. Bismuthi et Ammonii Citras. ClTRATE OF BlSMUTH 
and Ammonium. 

Characters. — Small, shining, pearly or translucent scales, becoming 
opaque on exposure to air, odorless, having a slightly acidulous and 
metallic taste, and a neutral or faintly alkaline reaction. The aqueous solu- 
tion of the salt gives the reaction of bismuth, of ammonia and of a citrate. 

Dose. — 2 to 4 grains. 

Uses. — The solution of bismuth and ammonia, B.P., and the soluble 
salt, U.S.P., are more astringent and irritant in their action than the 
insoluble subnitrate, oxide or carbonate. They may be used as astrin- 
gents, but are inferior to the insoluble preparations as a means of allay- 
ing irritation. 



624 INORGANIC MATEEIA MEDICA. 

CHAPTER XXVIII. 
Class VIII. 

Group I. 
Iron, Nickel, Cobalt, Manganese. 

FESBTJM; IKOX ; Fe ; 55-9. 

Metallic iron in the form of fine, bright, and non-elastic wire. 

Iron forms ferrous salts in which it is bivalent, e.g., FeCl 2 or FeS0 4 , 
and ferric, in which it is either trivalent or quadrivalent. Ferric chlo- 
ride may be regarded as FeCl 3 or as Fe 2 Cl 6 , in which each of two atoms 
of quadrivalent iron have one affinity saturated by union with each other, 
and the other three by chlorine, Cl 3 — Fe — Fe — Cl 3 . 

General Sources. — It is found native in the metallic state, and also 
as oxide, sulphide, chloride, carbonate, phosphate, sulphate, and arseniate. 
It is obtained from its ores by smelting with coke and clay or limestone. 

General Reactions. — These are shown in the accompanying table. 
The reactions most generally mentioned in the pharmacopoeias are those 
with ferrocyanide and ferricyanide of potassium. It is to be remembered 
that a preparation of iron containing it in both the ferrous and ferric 
condition, or which, by its decomposition, yields iron in these two states, 
gives a precipitate with both of these reagents. The arseniate of iron, 
B.P., magnetic oxide, and the citrate of iron and quinine are exam- 
ples of this. 

Gexeeal Reactions of Ieon Salts. 



Reagent. 


Ferrous Salts. 


Ferric Salts. 


Hydrogen sulphide. 


No precipitate. 


White precipitate of sulphur 
(the ferric are reduced to 
ferrous). 


Ammonium sulphide. 


Black precipitate. 


Black precipitate 


Caustic alkalis and 
ammonia. 


Nearly white precipitates of 
ferrous hydrate, rapidly 
becoming green, and then 
brown. 


Foxy-red precipitates of ferric 
hydrate. 


Carbonates of ditto. 


Whitish precipitate of fer- 
rous carbonate which 
changes like the hydrate. 


Fox3 T -red precipitates. Car- 
bonic acid escapes. 


Potassium ferrocy- 
anide 


Nearly white precipitate, be- 
coming blue on exposure. 


Deep blue precipitate (Prus- 
sian blue) * 


Potassium ferricy- 
anide. 


Deep blue precipitate. 


No precipitate. Dark colora- 
tion. 


Tincture of galls. 




Intense black. 



* With the tartrate of iron and ammonia (U.S.P.) no color nor precipitate is pro- 
duced unless the solution is acidulated with hydrochloric acid. 



METALS. 



625 



General Impurities. — Zinc, copper, and fixed alkalis may be 
present in its salts. Ferrous salts may be present as impurities in ferric 
and vice versa. 

Tests. — The test used for the chloride in the U.S. P. is as follows: — 
If the iron be completely precipitated from a solution of the salt by an 
excess of water of ammonia the filtrate should not yield either a white 
precipitate (absence of zinc) or a dark-colored precipitate with hydro- 
sulphuric acid (absence of copper), nor should it leave a fixed residue on 
evaporation and gentle ignition. The absence of ferrous salts as impu- 
rities in ferric is ascertained by their giving no precipitate with ferricya- 
nide of potassium. The absence of ferric salts as an impurity in ferrous 
is ascertained by the precipitate not being blue at first, but nearly white, 
and only becoming blue on exposure. 



General Preparation of Salts of Iron. 



Ferrous Sulphate 
(p. 629). 

Dried Sulphate (p. 630) 



Precipitated, U.S.P., 
or Granulated, B.P., 
(p. 630). 

Carbonate (Saccha- 
rated) (p. 630). 



Do. (Mistura Ferri 
Composita) (p. 630). 

Ferric Tersulphate, 
U.S.P. (p. 631). 
" Sulphate, B.P. 
(p. 631). 

" Subsulphate 
(p. 631). 

" Oxide (p. 631). 



Do. (Hydrated, 
U.S.P., Humid, 
B.P.) (p. 631). 

Do. Hydrated, 
B.P. (p. 632). 



" Do. Magnetic 
(p. 632). 

Reduced iron (p. 632). 



40 



Prepared from 



Iron. 



Ferrous sulphate. 



Ferrous sulphate. 



Do. 



Do. 



Do. 



Ferric sulphate. 



Do. 



Do. 



Do. and ferrous sul- 
phate. 

Ferric oxide. 



By 



Dissolving in sulphuric acid. 



Heating to drive off water of crys- 
tallization. 

Pouring an aqueous solution into 
spirit. 



Decomposing (by sodium bi-carbonate, 
U.S.P.) , (by ammonium carbonate, 
B.P.), and mixing with sugar. 

Decomposing by potassium carbonate 
and mixing with myrrh, &c. 

Adding sulphuric acid and oxidizing 
by heating with nitric acid. (6Fe 
S0 4 + 3H 2 S0 4 + 2HN0 3 = 3Fe 2 (So 4 ) 3 
+ 4H 2 + N 2 2 ). 

Do. using too little sulphuric acid to 
form tersulphate. 

Mixing with magnesia and water, 
U.S.P. 

Pouring the diluted solution into solu- 
tion of soda, B.P. 



Pouring the diluted solution into solu- 
tion of soda, B.P. ; and drying below 
212°. 

Pouring the diluted solution into solu- 
tion of soda, B.P. 

Passing hydrogen over it while heated 

(Fe 2 3 + 6H = F 2 + 3H 2 0). 



626 INORGANIC MATERIA MEDICA. 

General Preparation of Salts of Iron — {continued). 



Ferric chloride (p. 
633). 



" Nitrate (p. 634). 



" Acetate (Tinc- 
ture of, B.P.) (p. 
633). 



" Do. (Solution of, 
U.S.P.) (p. 633). 



" Citrate (p. 636). 



Tartrate of iron and 
potassium, U.S. P. 
(Ferrum Tartratum, 
B.P.) (p. 635). 

Tartrate of iron and 
ammonia (p. 635). 



Citrate of iron and 
ammonia (p. 635). 

Citrate of iron and 
quinine (p. 636). 



Citrate of iron and 
strychnine (p. 636). 



Sulphate of iron and 
ammonia (p. 637). 

Ferrous Lactate (p. 
637). 

Ferrous Oxalate (p. 
637). 



Prepared from 



Iron. 

Iron. 

Ferric sulphate. 

Do. Tersulphate. 

Do. (Tersulphate). 



Persulphate. 



Do. 



Do. 

Do. and sulphate of 
quinine. 



Ferric sulphate and 
strychnine. 



Ferric sulphate and 
ammonium sulphate. 

Iron. 

Ferrous sulphate. 



Ferrous Iodide (p. Iron. 
637). 



By 



Dissolving in hydrochloric acid and 
oxidizing by nitric acid. (3Fe 2 + 
12HC1 = 6FeCl 2 + 12H — 6FeCl 2 + 
6HC1- 

N 2 2 ). 

Dissolving in nitric acid (Fe 2 -f 8HN0 3 



Fe 2 (N0 3 )6 



N 2 2 ). 



Decomposing an alcoholic solution of 
acetate of potash, by a solution of 
ferric sulphate and separating the 
potassium sulphate by filtration. 

Precipitating ferric oxide by ammonia, 
washing and dissolving in glacial 
acetic acid, and diluting to the neces- 
sary strength. 

Precipitating oxide by ammonia, wash- 
ing and dissolving in citric acid. 
This forms the Liquor Ferri Citratis, 
U.S.P. Ferri Citras is prepared by 
evaporation of the Liquor under 
60° C. 

Precipitating ferric oxide by ammonia, 
washing and mining with acid tar- 
trate of potash. 

Do. using tartaric acid and tartrate of 
ammonium in place of acid tartrate 
of potash. 

Do. using citric acid and ammonia. 



Precipitating ferric oxide and quinine 
by ammonia and dissolving it in 
citric acid. 

Precipitating ferric oxide by ammonia 
and dissolving it along with strych- 
nine in citric acid. 

Heating them together. 



Dissolving in lactic acid. 

Precipitating a solution with oxalic 
acid (ferrous oxalate is very slightly 
soluble). 

Heating with iodine and water. (The 
completion of the process is recog- 
nized by the brown color of the iodine 
disappearing and the froth becoming 
white). 



METALS. 627 

General Preparation op Salts of Iron — (continued). 





Prepared from 


By 


Ferrous Iodide, Syrup 


Iron. 


Same as ferrous iodide, and then adding 


of (p. 638). 




sugar. 


" Bromide (Syrup 


Do. 


Same as syrup of iodide, using bromine 


of) (p. 638). 




instead of iodine. 


Arseniate of iron (p. 


Ferrous sulphate, ar- 


Mixing a solution of arseniate and ace- 


638). 


seniate of soda, and 


tate of soda with one of ferrous sul- 




acetate of soda. 


phate. If arseniate of soda alone 
were used, free sulphuric acid would 
be formed, which would react on the 
arseniate 3FeSo 4 + 2Na 2 HAs0 4 ■= 
Fe 3 As 2 8 + 2Na 2 S0 4 + H 2 S0 4 . To 
avoid this acetate of soda is added. 
The sulphuric acid combines with 
the soda and sets free acetic acid 
which has no action on the arseniate 
of iron. 3FeS0 4 + 2Na 2 HAs0 4 + 
2NaC 2 H 3 2 = Fe 3 As0 8 + 3Na 2 S0 4 + 
2HC 2 H 3 2 . 


Phosphate of iron 


Ferrous sulphate, 


The same process as in the prepara- 


(p. 638). 


phosphate of soda, 


tion of arseniate. The reactions are 




and acetate of soda. 


similar. 3FeS0 4 + 2Na 2 HP0 4 + 2Na 
C 2 H 3 2 = Fe 3 P 2 8 + 3NaS0 4 + 2H 
C 2 H 3 2 . 


Pyrophosphate of 


Citrate of iron. 


Decomposing solution by solution of 


iron (p. 639). 




sodium pyrophosphate. 


Hypophosphite of 


Ferrous sulphate. 


Decomposing by hypophosphite of cal- 


iron (p. 639). 




cium when ferrous hypophosphite is 
precipitated, but on evaporation 
becomes ferric. 


Valerianate of iron 


Ferric sulphate. 


Decomposing by valerianate of soda. 


(p. 639). 










General Action op Iron Salts. — Iron differs from most of the 
other heavy metals in forming a normal constituent of the animal body, 
so that it may be regarded as a food as well as a medicine. It forms an 
important constituent of the haemoglobin in the blood. This acts as the 
oxygen carrier to the tissues, and therefore, the tissue-oxidation and the 
functional activity of the organs depend more or less upon the amount 
of iron present in the body. Both per- and proto-salts of iron form 
compounds with albumen, but they differ in their properties. The fer- 
rous salts give a yellow color with albuminous solutions, but do not pre- 
cipitate them, the albuminous compound being, apparently, usually soluble. 
Diluted ferric salts, on the contrary, precipitate albumen slowly, and 
concentrated solutions precipitate it rapidly. The precipitate is soluble 
in dilute acids and in gastric juice. 

When applied to the skin neither ferrous nor ferric salts have 
any action, as they do not dissolve the epidermis nor pass through it in 



628 INORGANIC MATERIA MEDICA. 

any appreciable quantity. When applied to a denuded surface, or to a 
mucous membrane they combine with albumen. The ferrous salts have 
but a slight astringent action, whereas the ferric salts coagulate the 
albumen on the surface and also blood. They are thus powerful astrin- 
gents and styptics. In the niouth they all have an inky taste, and as 
they are liable to form black sulphides with sulphurated hydrogen, which 
is not unfrequently present in the breath, they are apt to discolor the 
teeth or tongue. In the stoniacli they have an astringent and irritant 
action, that of the ferric being more powerful than that of the ferrous 
salts. In the intestine they have a somewhat similar action ; meeting 
here, as they often do, with sulphurated hydrogen, they become converted, 
in great part, into sulphides, and, passing out into the stools, give to 
them an inky, black color which sometimes alarms patients. In small 
doses they usually have an astringent action, and tend to cause constipa- 
tion. Larger doses, on the other hand, seem to stimulate peristalsis, and 
increase the number of stools, and sometimes even small doses will cause 
diarrhoea in some individuals. After absorption into the blood they are 
found to increase, not only the number, but the percentage of haemoglo- 
bin contained in the blood corpuscles, and they may also cause a little 
free iron to be present in the serum. By thus increasing oxidation in 
the tissues they increase the functional activity of the various organs. 
The effect of ferrous and ferric salts added to the blood is very different, 
ferric salts producing a firm coagulum, whereas the ferrous salts tend 
rather to diminish the coagulability of the blood. 

Iron has an action on the nervous system which varies according 
to the dose and mode of administration. When injected subcutaneously 
in frogs, iron salts cause slight excitement and then paralysis of the 
central nervous system. In the later stages of poisoning the irritability 
of the voluntary muscles is diminished, but the heart is not affected. In 
mammals they cause congestion of the stomach and intestine, and diar- 
rhoea. They produce paralysis both of sensation and motion. The 
blood-pressure falls. This is due to paralysis of the vaso -motor 
nerves, especially of the intestine, resembling that produced by arsenic, 
antimony, emetine, and colchicine. 

Iron is eliminated to a considerable extent by the bile, by the 
mucous membrane of the intestine, and by the kidneys. 

Uses of Iron. — The ferrous salts are rarely employed for their local 
action. The ferric salts are used as styptics. The strong solution of 
perchloride may be employed to arrest bleeding from the cavity of a 
tootli after extraction, or to stop the oozing from a wound where it is 
impossible to ligature all the bleeding points. When diluted it may be 
used as an injection to arrest haemorrhage from the nose, or may be 
injected into the cavity of the uterus to arrest bleeding from that organ. 
Mixed witli laudanum it has been used as an injection in gonorrhoea and 
gleet. Both ferrous and ferric salts are administered internally in order 
to produce the general action of iron in increasing the blood corpuscles. 
They differ to some extent, however, the ferrous salts having a less 
astringent action on the intestines than the ferric. In cases where the 
mucous membrane of t lie alimentary canal is irritable this is advantageous, 
as in such instances the ferric salts might cause digestive disturbances 



METALS. 629 

and headache. In other instances, however, especially those where 
the tongue is pale and flabby, the more astringent preparations are 
to be preferred. The chief condition in which iron is useful is where we 
have anaemia and chlorosis, whether these be due to loss of blood, imper- 
fect nutrition, chronic discharges, scrofula, syphilis, malarial poisoning, 
amenorrhea or albuminuria, or be consequent upon acute febrile disease, 
but it is also serviceable in a number of disturbances of the nutritive and 
nervous systems. It has been recommended in large doses in cases of blood- 
poisoning, such as diphtheria and erysipelas, and in nervous diseases like 
chorea, epilepsy, giddiness, formication, twitching of the fingers and sub- 
jective sensations of light and heat or cold to which some patients are liable, 
especially about the climacteric period. It is also used internally in order 
to diminish discharges from the mucous membranes of the intestines, as 
in chronic diarrhoea and dysentery, and from the vagina in leucorrhcea. It 
acts as an astringent on the kidney, lessening the amount of blood in 
hgematuria, and sometimes the amount of albumen in albuminuria. It is 
also a useful adjunct to diuretics in cardiac and renal dropsy (p. 299). 

B.P. Vinum Ferri. — This is prepared by macerating iron wire 
in sherry for a month. Some of it is converted into tartrate and dis- 
solved by the bitartrate of potash in the wine. 

Use. — It is useful in anaemia both in children and adults. 

Dose. — 1 to 2 fl. dr. or more. 

B.P. Mistura Ferri Aromatica. — This is a curious preparation 
containing tannate of iron in very small quantities. It is sometimes 
called Heberden's ink. It is usually said that iron and tannin are incom- 
patible, and so they are in so far that they produce ink, but this prepa- 
ration is said to be a very useful one. 

Iron cannot be taken up in very large quantities, and its absorption is 
often prevented by the condition of the patient's stomach. This prepa- 
ration has been put together evidently with the view of combining all the 
drugs, which were likely to do good by themselves, and in total disregard 
of the chemical action which would take place among themselves. 

Preparation. — By macerating pale cinchona bark (1 oz.), calumba 
root (J oz.), cloves (J oz.), and fine iron wire (J oz.), in peppermint water 
(12 oz.) for three days, agitating occasionally ; then filtering and adding 
as much peppermint water to the filter as will make the product measure 
121 fl. 0Zt • to this add compound tincture of cardamoms (3 fl. oz.) and 
tincture of orange peel (J fl. oz.), and preserve the mixture in a well- 
stopped bottle. The pale cinchona bark contains tannin, which combines 
with the iron. Both it and calumba are gastric tonics, and the carmina- 
tives relieve flatulence. 

Dose. — 1 to 2 fl. oz. 

Ferri Sulphas, U.S.P. and B.P. Sulphate of Iron. FeS0 4 . 
7H 2 0; 277-9. 

Characters and Tests. — In oblique rhombic prisms, of a pale 
greenish-blue color and styptic taste ; insoluble in rectified spirit, soluble 
in water. The aqueous solution gives the reaction of a sulphate and of 
a ferrous salt. 

Dose. — 1 to 5 grains. 



630 INORGANIC MATERIA MEDICA. 

Peepabations. 

U.S.P. B.P. 

Ferri Sulphas Exsiccata. Ferri Sulphas Exsiccata 

Pilula Aloes et Ferri 1 part in 7. 

Ferri Sulphas Exsiccatus, U.S.P. ; Ferri Sulphas Exsiccata, 

B.P. Dried Sulphate of Iron. FeS0 4 .H 2 ; 169-9. 

Prepared by heating sulphate. It is less apt to oxidize, and is well 
fitted for pills. 

Dose. — J grain to 3 grains. 

Peepaeation. 

U.S.P. 

Pilulse Aloes et Ferri. 

Ferri Sulphas Precipitatus, U.S.P. ; Ferri Sulphas Grauu- 
lata, B.P. Precipitated Sulphate of Iron, U.S.P.; Granulated 
Sulphate of Iron, B.P. FeS0 4 .7H 2 ; 277-9. 

Characters and Tests. — In small granular crystals of a pale 
greenish-blue color. In other respects corresponds to the characters and 
tests for sulphate of iron. 

Dose. — 1 to 5 grains. 

Uses. — It is very astringent. It has been used externally as oint- 
ment or lotion to the skin in erysipelas, as a lotion in ophthalmia, and as 
a lotion or injection in prolapsus ani, and bleeding piles. It has also been 
used as an injection in gonorrhoea and leucorrhoea. 

Internally it is used in cases of anaemia, especially where this is 
accompanied by a tendency to profuse sweating, passive haemorrhages, or 
mucous discharges, such as chronic catarrh or leucorrhoea. Its astringent 
action on the stomach has been said to render it serviceable in gastrodynia 
and gastric ulcer. 

Ferri Carbonas Saccharatus, U.S.P. ; Saccharata, B.P. 

Saccharated Ferrous Carbonate, U.S.P. ; Saccharated Car- 
bonate of Iron, B.P. 

Carbonate of iron, FeO,C0 2 or FeC0 3 , mixed with peroxide of iron 
and sugar, the carbonate forming at least 15 per cent, of the mixture, 
U.S.P., 37 per cent., B.P. 

Characters and Tests. — Small coherent lumps, or powder, of a 
gray color, with a sweet, very feeble chalybeate taste. It dissolves with 
effervescence (carbonate) in warm hydrochloric acid diluted with half its 
volume of water, and the solution gives only traces of sulphate (p. 498) 
and exhibits the reactions of a ferrous salt. 
Dose. — 5 to 20 grains. 

Peepaeation. 
B.P. (With confection of roses.) DOSE. 

Pilula Ferri Carbonatis 1 part in 1J 5-20 grs. 

Mistura Ferri Composita, U.S.P. and B.P. COMPOUND 

Mixture of Iron. Griffith's Mixture. 

COMPOSITION. — Sulphate of iron, 6; myrrh, 18; sugar, 18; car- 
bonate of potassium. 8; spirit of lavender, 50; rose water, 900, 
(J.S.P. Sulphate of iron, 25 grs. ; carbonate of potash, 30 grs. ; myrrh 



METALS. 631 

and refined sugar, of each 60 grs. ; spirit of nutmeg, 4 fl. drs. ; rose water, 
9J fl. oz., B.P. 

Dose. — 1 to 2 fluid ounces. 

Uses. — Carbonate of iron in its various preparations is one of the 
most useful forms of iron for administration as a hematinic and emmen- 
agogue. 

Liquor Ferri Tersulphatis, U.S. P. ; Persulphatis, B.P. 

Solution of Tersulphate of Iron, U.S.P.; of Persulphate of 
Iron, B.P. Fe 2 (S0 4 ) 3 ; 399-8. 

Characters and Tests. — A dense solution of a dark-red color, 
inodorous and very astringent, miscible in all proportions with alcohol 
and water. Diluted with ten volumes of water, it gives the reactions of 
a sulphate and of a ferric salt only. 

Pbepaeations in which Solution of Peesulphate of Ieon is used. 
Ferri et Ammonise Citras. Ferri Peroxidum humidum. 

" et Quinise Citras. Ferrum Tartaratum. 

" Oxidum magneticum. Tinctura Ferri Acetatis. 

Uses. — Not used as a remedy, but to prepare peroxide, &c. 

U.S.P. Liquor Ferri Subsulphatis. SOLUTION OF SuBSUL- 
phate of Iron. Solution of Basic Ferric Sulphate. (Monsel's 
Solution.) 

Characters. — Like the tersulphate; but on mixing two volumes of 
the solution with one of concentrated sulphuric acid a solid white mass 
separates on standing. 

Dose. — 3 to 10 minims (-18-64 c.c). 

Actions. — Astringent, styptic, haematinic. Less irritating than the 
tersulphate. 

Uses. — Like the chloride. It is a useful astringent in relaxed sore 
throat and tonsillitis. 

Ferri Peroxidum Humidum, B.P. Moist Peroxide of Iron. 
Hydrated peroxide of iron with about 86 per cent, of uncombined water. 
It should be recently made, B.P. 

Ferri Oxidum Hydratum, U.S.P. Hydrated Oxide of Iron. 
Fe 2 (HO) 6 ; 213-8. 

Characters and Tests. — A soft, moist, pasty mass, of a reddish- 
brown color. Dissolves readily in diluted hydrochloric acid, and gives 
the reaction of a ferric salt only. 
Dose. — J to J ounce. 

Use. — As an antidote for arsenic, it should be given in doses of a 
tablespoonful every five or ten minutes. It may be used in anaemia and 
amenorrhoea. 

Peepaeations. 
U.S.P. Empiastrum Ferri (Hydrated oxide dried, with Canada turpentine, Bur- 
gundy pitch and lead plaster). 

U.S.P. Trochisci Ferri (Troches of iron). Iron lozenges, 5 grs. in each lozenge. 

U.S.P. Ferri Oxidum Hydratum cum Magnesia. Hyd RATED 
Oxide of Iron with Magnesia. — Antidote to arsenious acid. 



632 ItfOKGANIC MATERIA MEDICA. 

Preparation. — Mix solution of tersulphate of iron, 1000 grs. (65-00 
gm.) with twice its weight of water. Rub the magnesia, 150 grains 
(10-00 gm.) with water to a smooth and thin mixture; transfer this to a 
bottle capable of holding 32 fl. oz., or about 1 litre, and fill it up with 
water. When the preparation is wanted for use, mix the two liquids 
by adding the magnesia mixture gradually to the iron solution, and 
shake them together until a homogeneous mass results. 

Note. — The diluted solution of tersulphate of iron and the mixture 
of magnesia with water should always be kept on hand, ready for imme- 
diate use. 

Use. — As an antidote in poisoning by arsenic. 

B.P. Ferri Peroxidum Hydratum. Hydratbd Peroxide 
of Iron. 

Characters. — A reddish-brown powder, destitute of taste and not 
magnetic. It dissolves completely, though slowly, with the aid of heat, 
in hydrochloric acid, diluted with half its volume of water, and the solu- 
tion gives the reactions of a ferric salt only. 

Dose. — 5 to 30 grains. 

B.P. Peepaeation. 

Ernpiastrum Ferri. Iron Plastee. — Hydrated peroxide of iron in fine powder, 
Burgundy pitch and lead plaster. 

Uses. — Not astringent. Given in powder or electuary chiefly in 
cases of tic and neuralgia. 

Iron plaster is often called "strengthening plaster." It forms a 
mechanical support to weak parts and keeps them warm. Used in pains 
or weakness across the loins in females, in rheumatic pains, as lumbago, 
weak joints, &c. 

B.P. Ferri Oxidum Magiieticum. Magnetic Oxide of Iron. 
Magnetic oxide of iron, Fe 3 4 , combined with about 20 per cent, of 
water of hydration, and containing some peroxide of iron. 

Characters and Tests. — Brownish-black, destitute of taste, 
strongly attracted by the magnet. It dissolves without effervescence in 
hydrochloric acid diluted with half its volume of water, and the solution 
thus obtained gives the reactions both of ferrous and ferric salts. 

Dose. — 5 to 10 grains. 

Uses. — It is but sparingly soluble, and so not so good as reduced iron. 

Ferrum Reclactum, U.S. P. and B.P. Reduced Iron. — 
Metallic iron, with a variable amount of magnetic oxide of iron. 

Characters and Tests. — A fine grayish-black powder, strongly 
attracted by the magnet, and exhibiting metallic streaks when rubbed 
with firm pressure in a mortar. It dissolves in hydrochloric acid with 
the evolution of hydrogen, and the solution gives a light blue precipitate 
with the yellow prussiate of potash. Fe -f- 2ITC1 = Fe Cl 2 + H 2 . 

IMPURITY. — Magnetic oxide. 

Test. — When ten grains are added to an aqueous solution of fifty 
grains of iodine and fifty grains of iodide of potassium (Fe -|- I 2 = Fe 
\., which dissolves in Klj, and digested in a small flask at a gentle heat, 



METALS. 633 

the reduced iron is converted into iodide and dissolved, and not more 
than five grains should be left undissolved, which should be entirely sol- 
uble in hydrochloric acid (oxide). 
Dose. — 1 to 5 grains. 

Trochisci Ferri Kedacti, B.P. REDUCED lEON LOZENGES, B.P. — Each lozenge 
contains one grain of reduced iron. 
Dose. — 1 to 6 lozenges. 

Uses. — This preparation is generally well borne even if the stomach 
be somewhat irritable. It has no astringent action. When dissolved by 
the gastric juice it evolves hydrogen, and if sulphur be present as an 
impurity eructations of sulphuretted hydrogen are produced. 

Tinctura Ferri Acetatis, U.S. P. and B.P. Tincture op 
Acetate of Iron. 

Dose. — 5 to 30 minims. 

Use. — May be given along with acetate of potash in dropsy. 

U.S. P. Mistura Ferri et Ammonii Acetatis. Mixture op 
Acetate op Iron and Ammonium (Basham's Mixture) comprises 
tincture of chloride of iron (2 parts), diluted acetic acid (3), solution 
of acetate of ammonium (20), elixir of orange (10), syrup (15), water (50). 

Dose. — J-l fluid ounce. 

Use. — As hgematinic generally, and in cases of renal disease 
especially. 

U.S.P. Ferri Chloridum. Chloride of Iron. — Fe 2 Cl 6 12H 2 ; 
540-2. 

Characters. — Orange-yellow crystalline pieces, very deliquescent, 
odorless or having a faint odor of hydrochloric acid, a styptic taste, and 
an acid reaction. Freely and wholly soluble in water, alcohol, or ether. 
The dilute aqueous solution gives a brown-red precipitate with water of 
ammonia, a blue one with test solution of ferrocyanide of potassium, 
and a white one, insoluble in nitric acid, with test solution of nitrate 
of silver. 

Use. — In the solid state it keeps indefinitely, whereas in solution it 
is apt to deposit ferric oxide leaving excess of acid in the solution which 
renders it irritating. When required it may be dissolved in water in the 
proportion of 1J-6 drachms to the ounce of water. When semi- deli- 
quesced it is an efficient styptic. 

Liquor Ferri Cliloridi, U.S.P. ; Liquor Ferri Perchloridi 
Fortior, B.P. Solution of Chloride of Iron, U.S.P. ; Strong 
Solution op Perchloride of Iron, B.P. 

Characters and Tests. — An orange-brown solution with a strong 
styptic taste, miscible with water and rectified spirit in all propor- 
tions. Diluted with water it gives the reactions of a chloride and of a 
ferric salt only. 

Applied externally as a styptic and caustic. 

Peepaeation. 

U.S.P. 
Tinctura Ferri Cliloridi. TlNCTUEE OF CHLOEIDE OF lEON. DOSE. — 10 to 30 

minims. 



634 IXORGAXIC MATERIA MEDICA. 

Peepaeations. 
Mistura Ferri et Ammonii Acetatis, U.S. P. 

B.P. DOSE. 

Liquor Ferri Percliloridi (with water) 1 volume in 4. 10-30 niin. 

Tinctura Ferri Percliloridi (with spirit) 1 volume in 4. 10-30 min. 

Uses. — The strong solution is one of the most powerful styptics 
we possess. It forms, almost immediately, a hard black coagulum with 
blood, and by blocking up the mouths of the vessels arrests further 
haemorrhage. Cotton wool steeped in this may be used to arrest the 
haemorrhage from the cavity of a tooth after its extraction, and to stop 
the bleeding from leech bites. It has been applied as a caustic in 
hospital gangrene, in bleeding from the uterus, and, diluted with three 
volumes of water, it may be injected into the uterine cavity, but is better 
applied hy swabbing it over the interior of the uterus with a sponge. It 
has been injected into aneurisms, in order to produce coagulation within 
them. There is, however, great danger that part of the clot may 
become detached and carried onwards, producing embolism, or that 
inflammation and ulceration may take place within the aneurismal sac 
itself. 

It has also been injected into varicose veins and nsevi for a simi- 
lar purpose, but in naevi on the face it may cause sloughing, and 
leave scars. It has been used as a spray for the purpose of arresting 
haemorrhage from the lungs. 

The liquor and tincture are perhaps more often employed than 
any other preparation of iron. They are astringent, generally causing 
constipation, but sometimes they irritate the intestine, increasing the 
number of stools. They are amongst the most efficient preparations of 
iron as haematinics. They are contraindicated by a red irritable 
tongue, and succeed best when the tongue is pale, flabby and marked 
with the teeth at the edges. 

I have found that when patients bear iron badly and complain 
of headache even after small doses, they can take with benefit a single 
drop of the tincture or solution of the perchloride in a full tumbler of 
water. In its great dilution the mixture somewhat resembles chalybeate 
waters, which often succeed much better than pharmaceutical prepara- 
tions. The tincture has been given in erysipelas in very large doses, 
20-30 min., repeated every hour or two. 

Liquor Ferri Nitratis, U.S. P.; Liquor Ferri Pernitratis, 

B.P. Nitrate of Iron, U.S. P. ; Solution of Pernitrate of Iron, 
B.P. Fe 2 (N0 3 )6; 483-8. 

Characters and Tests. — A clear solution of a reddish-brown 
color, slightly acid and astringent to the taste. When to a little of it 
placed in a test-tube half its volume of pure sulphuric acid is added, and 
then a solution of sulphate of iron is poured on, the whole assumes a 
dark brown color (nitrate). It gives the reactions of a ferrous salt only. 

DOSE. — 10 to 40 minims. 

USES. — It has been used as an astringent in the diarrhoea of chil- 
dren, and, also as an astringent, to diminish discharges from mucous 
surfaces, also to arrest haemorrhage from internal organs. It can be 



METALS. 635 

given along with spirit of nitrous ether or nitrate of potash in cases of 
anaemia with albuminuria and dropsy. 

Ferri et Potassii Tartras, U.S. P. ; Ferrum Tartaratuin, 

B.P. Tartrate of Iron and Potassium, U.S. P.; Tartarated 
Iron, B.P. 

Characters and Tests. — Thin, transparent scales of a deep garnet 
color, slightly sweetish and astringent in taste, soluble in water and 
sparingly soluble in spirit. The aqueous solution, when acidulated with 
hydrochloric acid, gives the reactions of a ferric salt only. When the 
salt is boiled with solution of soda, peroxide of iron separates, but no 
ammonia is evolved (not the ammonio-citrate), and the filtered solution 
when slightly acidulated by acetic acid gives, as it cools, a crystalline 
deposit (potassium). 

Dose. — 5 to 10 grains. 

The double salts of iron with potassium, ammonium, quinine, &c, 
are usually called the scale preparations of iron from their appear- 
ance. These are less astringent than, and do not confine the bowels so 
much as, either the proto-sulphate or the per-salts. Another advantage 
is that they may be given along with alkaline carbonates without being 
precipitated. They are employed in cases where the other preparations 
cause headache, or where other preparations derange the digestion, on 
account of the stomach being irritable. 

U.S. P. Ferri et Ammonii Tartras. TARTRATE OF Iron AND 
Ammonium. 

Characters. — Transparent scales, varying in color from garnet-red 
to yellowish-brown, only slightly deliquescent, without odor, having a 
sweetish and slightly ferruginous taste and a neutral reaction. It is not 
precipitated by ammonia but gives a brown precipitate of ferric oxide 
with potash and evolves the vapor of ammonia. On adding test solution 
of ferrocyanide of potassium to the salt, no blue color or precipitate is 
produced unless the solution is acidulated with hydrochloric acid. 

Ferri et Ammonii Citras, U.S. P. ; Ferri et Ammoniae Citras, 
B.P. Citrate of Iron and Ammonium, U.S. P. ; Citrate of Iron 
and Ammonia, B.P. 

Characters. — In thin, transparent scales of a deep red color, slightly 
sweetish and astringent in taste. It feebly reddens litmus paper, is sol- 
uble in water, but almost insoluble in rectified spirit. Heated with 
solution of potash it evolves ammonia and deposits peroxide of iron. The 
alkaline solution from which the iron has separated does not, when 
slightly supersaturated with acetic acid, give any crystalline deposit 
(distinction from and absence of tartrate). 

Dose. — 5 to 10 grains. 

Preparations. 

U.S. p. DOSE. 

Ferri et Strychnine Citras 

Liquor Ferri et Quinine Citratis 

Vinum Ferri Citratis 1-2 fl. drs. 

B.P. 

Vinum Ferri Citratis. 8 grains in 1 fl. oz. of orange wine 1-4 fl. drs. 

U.S.P. Vinum Ferri Citratis. (Citrate of iron and ammonia, 4 ; tincture of 
sweet orange peel, 12 ; syrup, 36 ; stronger white wine, 44.) 



636 INORGANIC MATERIA MEDICA. 

U.S.P. Liquor Ferri Citratis. An Aqueous Solution of 
Ferric Citrate, Fe 2 (C 6 H 5 7 ) 2 ; 489*8, containing about 35 per cent. 
of the anhydrous salt. 

Characters. — A dark brown liquid, odorless, having a slightly fer- 
ruginous taste and acid reaction. It gives the reactions of a citrate and 
a bluish-green precipitate with ferrocyanide of potassium, which is 
increased and rendered dark blue by the subsequent addition of hydro- 
chloric acid. 

Dose. — Ten minims (0*6 c.c), equal to 5 grains of the salt. 

U.S.P. Ferri Citras. Citrate of Iron. Fe 9 (C 6 H 5 7 ) 2 .6H 9 ; 

597-8. 

Characters. — Transparent garnet-red scales, permanent in the air, 
odorless, having a very faint, ferruginous taste and an acid reaction. 
Slowly but completely soluble in cold water and readily so in boiling 
water ; insoluble in alcohol. 

Peepaeatiox. 
Ferri et Quininse Citras. 

Use. — Is pleasant. A solution of 240 grains in 1 fl. oz. of water 
keeps perfectly, and may be given in doses of 10 minims, equal to 5 
grains, as a tonic. 

Ferri et Quininae Citras, U.S.P. ; Ferri et Quinise Citras, 

B.P. Citrate of Iron and Quinine, U.S.P. ; Citrate of Iron and 
Quinia, B.P. 

Characters and Tests. — Thin scales of a greenish, golden-yellow 
color, somewhat deliquescent, and entirely soluble in cold water. The 
solution is very slightly acid, and is precipitated reddish-brown (iron) by 
solution of soda, white (quinine) by solution of ammonia, blue by the 
yellow ferric and red prussiates (ferrous) of potash, and grayish-black by 
tannic acid. The taste is bitter (quinine) as well as chalybeate. 

Dose. — 5 to 10 grains. 

U.S.P. Liquor Ferri et Quininse Citratis. SOLUTION OF 
Citrate of Iron and Quinine. (Citrate of iron and ammonium, 65 ; 
quinine, 12 ; citric acid, 28 ; alcohol, 30 ; distilled water up to 200.) 

Dose. — 8 to 15 minims (J— 1 c.c). 

Peepabation. 

U.S.P. 

vinum Ferri Amamm. Bittee WlNE of Ieon. (Solution of citrate of iron and 
quinine, 8; tincture of sweet orange peel, 12 ; syrup, 36; stronger white wine, 34.) 
Dose.— 1-2 fl. drs. (4-16 c.c). 

U.S.P. Ferri et Strychnine Citras. ClTRATE OF Iron AND 

Strychnine. 

Characters. — Transparent garnet-red scales, deliquescent on 
exposure to air ; odorless, having a bitter and slightly ferruginous taste 
and a slightly acid reaction. If one Gm. of the salt be dissolved in 4 
c.c. of water in a small test-tube, then 1 c.c. of solution of potassa added 
and the mixture shaken with 2 c.c. of chloroform, the residue left on 



METALS. 637 

evaporating the chloroform will answer to the reaction of strychnine. 
(See " Strychnina.") 

Dose.— 3 to 5 grains (0-20-0-33 Gm.). 

Uses. — As tonic and chalybeate to combine the uses of strychnine 
and iron. 

U.S. P. Ferri et Ammonii Sulphas. Sulphate of Iron and 
Ammonium. Ammonio-Ferric Sulphate or Ammonic-Ferric Alum. 
Fe 2 (NH 4 ) 2 (S0 4 ) 4 .24H 2 0; 963-8. 

This is an ammonia iron-alum in which the place of the aluminium 
oxide is occupied by the ferric oxide. 

Characters. — Pale violet octahedral crystals, efflorescent on exposure 
to air, odorless, having an acid styptic taste and a slightly acid reaction. 

Dose. — 5 to 10 grains. 

Uses. — It is more astringent than common alum, and has not the 
stimulating properties of other iron salts. It is useful in leucorrhoea. 
Internally it is sometimes very useful in lessening albumen in cases of 
intermittent albuminuria. 

TJ.S.P. Ferri Lactas. Lactate of Iron. Fe(C 3 H 5 0) 2 .3H 2 0; 
287-9. 

Characters. — Pale greenish-white, crystalline crusts or grains, per- 
manent in the air ; odorless, having a mild sweetish ferruginous taste and 
a slightly acid reaction. When heated on platinum foil the salt froths 
up, gives out thick white acrid fumes and chars, a brown-red residue 
being finally left. If the salt be boiled for fifteen minutes with nitric 
acid of the sp. gr. 1*200, white granular mucic acid will be deposited on 
cooling the liquid. 

Peepaeation. 
U.S.P. Syrupus Hypophospiiituin cum Ferro. (Lactate of iron, 1 ; syrup of hypo- 
phosphites, 99.) 

Dose. — 12-20 grains per diem ; of syrup, J to 1 fl. dr. 
Use. — In chlorosis and anaemia. 

U.S.P. Ferri Oxalas. Oxalate of Iron. FeC 2 4 .H 2 0; 161-9. 

Characters. — A pale yellow, or lemon-yellow crystalline powder, 
permanent in the air, odorless and nearly tasteless, very slightly soluble 
in cold or hot water, but soluble in cold concentrated hydrochloric acid 
and in hot diluted sulphuric acid. 

Dose.— 2 to 3 grains (0-13 to 0-20 Gm.). 

Ferri Iodidum, B.P. Iodide of Iron. Fel 2 ; 309-1 — Iodide of 
iron, Fel or Fel 2 , with about 18 per cent, of water of crystallization and 
a little oxide of iron. 

Characters and Tests. — Crystalline, green, with a tinge of brown, 
inodorous, deliquescent, almost entirely soluble in water, forming a 
slightly green solution which gradually deposits a rust-colored sediment, 
and acquires a red color. Its solution gives the reaction of an iodide and 
of a ferrous salt. 

Dose. — 1 to 5 grains. 



638 LXORGAXIC MATERIA MEDICA. 

Peepaeations. 
u.s.p. axd b.p. dose. 

Piliila Ferri Iodidi. 1 part in 3 3-8 grs. 

(With sugar and liquorice ) 
Syrupus Ferri Iodidi. 43 grains in 1 fluid drachm |-1 fl. dr. 

U.S.P. Ferri Iodidum Saccharatum. Saccharated Iodide 
of Iron. 

Characters. — A yellowish-white or grayish, powder, very hygro- 
scopic, odorless, having a sweetish ferruginous taste, and a slightly acid 
reaction. 

Dose.— 2 to 5 grains (0*13 to 0-33 Gm.). 

Uses. — Iodide of iron is given when a combination of the effect of 
iodine on the lymphatic system is desired along with the haematic action 
of iron. It is thus very useful in the form of the syrup in dispensary 
practice in large towns, where pale, anaemic, flabby, and scrofulous children 
abound, and come in large numbers to be treated. It is generally advan- 
tageous to combine it with cod-liver oil, a few drops of the syrup being 
dropped into the oil and taken along with it. It has been given in 
phthisis in the same way, and has been useful in rheumatic arthritis and 
syphilis. 

U.S.P. Syrupus Ferri Bromidi. Syrup of Bromide of Iron. 
— A syrupy liquid containing 10 per cent, of ferrous bromide. FeBr 2 ; 
215-5. 

Dose. — J to 1 fluid drachm (1-9 to 3*75 c.c). 

Use. — In nervous diseases accompanied by anaemia. It is doubtful, 
however, whether it is not better to give the iron and bromine separately, 
as sufficient bromine cannot be given in this form. It may, however, be 
advantageously combined with other bromides. 

B.P. Ferri Arsenias. Arseniate of Iron. — Arseniate of iron, 
Fe 3 As 2 8 , partially oxidized. 

Characters and Tests. — A tasteless amorphous powder of a green 
color, insoluble in water, but readily dissolved by hydrochloric acid. 
This solution gives a copious light-blue precipitate with the yellow prus- 
siate of potash (ferric), and a still more abundant one of a deeper color 
with the red prussiate of potash (ferrous). A small quantity boiled with 
an excess of caustic soda and filtered, gives, when exactly neutralized by 
nitric acid, a brick-red precipitate on the addition of solution of nitrate 
of silver (arseniate). 

Dose. — ^ to J grain. 

Uses. — Used when we wish to employ arsenic and iron together, as 
in skin diseases in anaemic subjects. 

Ferri Phosphas, U.S.P. and B.P. PHOSPHATE OF Iron. — 
Phosphate of iron, Fe 3 P 2 8 , partially oxidated. 

Characters and Tests. — A slate-blue amorphous powder, insolu- 
ble in water, soluble in hydrochloric acid. The solution yields a precipi- 
tate with both the yellow (ferric) and red prussiate of potash, that 
afforded by the latter being the more abundant (ferrous) ; and when 
treated with tartaric acid and an excess of ammonia, and subsequently 
with the solution of ammonio-sulphate of magnesia, lets fall a crystalline 



METALS. 639 

precipitate (phosphate). When the salt is digested in hydrochloric acid 
with a lamina of pure copper, a dark deposit does not form on the metal 
(distinction from and absence of arseniate). 
Dose. — 5 to 10 grains. 

Peeparations containing Phosphate of Iron. 

U.S.P. 
Syrupus Ferri Quininse et Strychninae Phosphatum. (Phosphate of iron, 133; 
quinine, 133 ; strychnine, 4 ; phosphoric acid, 800 ; sugar, 6000 ; distilled water up 
to 10,000). This preparation resembles Easton's Syrup. 

b.p. dose. 

Syrupus Ferri Phosphatis (freshly precipitated phosphate (p. 627) is 

dissolved in dilute phosphoric acid and sugar added) 1 gr. in 1 rl. dr.... 1 fl. dr. 

Uses. — It is used in diabetes, in rickets, and in nervous depression. 
It is frequently given along with the phosphates of lime, potash, and 
soda, as the preparation usually called Parrish's Chemical Food, or with 
the phosphates of quinine and strychnine as in Easton's Syrup. 

U.S.P. Ferri Pyropliosplias. Pyrophosphate of Iron. 

Characters. — Thin, apple-green, transparent scales, permanent in 
dry air when excluded from light, but turning dark on exposure to light. 
Odorless, having an acidulous slightly saline taste, aud a slightly acid 
reaction. When heated with solution of potassa in excess a brown-red 
precipitate is thrown down, and the filtrate, after being supersaturated 
with acetic acid, yields a white precipitate with test solution of nitrate of 
silver (difference from phosphates). 

Dose.— 2 to 5 gr. (0-13 to 0-33 Gm.). 

Uses. — Has no disagreeable taste, and is very soluble, so that it can 
be given in any form. 

U.S.P. Ferri Hypophospliis. Hypophosphite of Iron. Fe 2 
(H 2 P0 2 ) 6 ; 501-8. 

Characters. — A white or grayish-white powder, permanent in the 
air, odorless and nearly tasteless, only slightly soluble in water, more 
readily so in presence of hypophosphorous acid, freely soluble in hydro- 
chloric acid, or in solution of citrate of sodium, forming with the latter 
a green solution. When strongly heated in a dry test-tube, the salt 
evolves a spontaneously inflammable gas (phosphorated hydrogen), and 
on ignition leaves behind ferric pyrophosphate. The salt is readily 
oxidized by nitric acid or other oxidizing agents. It should be com- 
pletely soluble in acetic acid (absence of. ferric phosphate). This solu- 
tion, when mixed with test solution of oxalate of ammonium, should 
not afford a white precipitate soluble in hydrochloric acid (absence of 
calcium). 

Dose. — 5 to 10 grains in pill, more generally given in syrup. 

Uses. — In nervous debility with anaemia, and also in phthisis. 

U.S.P. Ferri Valerianas. Valerianate of Iron. Fe 2 (C 5 H 9 
2 ) 6 ; 717-8. 

Characters. — A dark tile-red amorphous powder, permanent in 
dry air, having a faint odor of valerianic acid, and a mildly styptic taste. 
Insoluble in cold water, but readily soluble in alcohol. Boiling water 



640 INORGANIC MATERIA MEDICA. 

decomposes it, setting free the valerianic acid and leaving ferric hydrate. 
When slowly heated the salt parts with its acid without fusing, but when 
rapidly heated it fuses and gives off inflammable vapors having the odor 
of butyric acid. 

Dose. — 1 grain or more. 

Uses. — In hysteria with anaemia. 

MAXGAXESE. Mn ; 55-54. 

Mangani Oxidum Nigrum, U.S. P. ; Manganesii Oxidum 

Nigrum, B.P. Black Oxide of Manganese. — Native crude per- 
oxide of Manganese containing at least 66 of the pure oxide. Mn0 2 : 
86. U.S.P. 

Characters and Tests. — A heavy black powder, which dissolves 
almost entirely in hydrochloric acid with evolution of chlorine, and gives 
off oxygen when heated to redness. 

Uses. — Used for producing chlorine, and for making oxygen. It has 
been used instead of bismuth in pyrosis and irritable conditions of the 
stomach, with pain after eating; and instead of iron in debilitating 
diseases, anasmia, syphilis, scurvy, and in skin diseases. 

U.S.P. Mangani Sulphas. Sulphate of Manganese. — 
MnS0 4 ,4H 2 0; 222. 

Characters. — Colorless or pale rose-colored, transparent right 
rhombic prisms, odorless, having a slightly bitter and astringent taste, 
and a faintly acid reaction. The aqueous solution of the salt yields 
with sulphide of ammonium a flesh-colored precipitate completely soluble 
in moderately-diluted acetic acid (absence of zinc) ; with test solution of 
ferrocyanide of potassium it affords a reddish-white precipitate, and a 
brown one with test solution of ferri cyanide of potassium. 

Action of Manganese Salts. — When injected into the blood, or 
subcutaneously, manganese salts paralyze voluntary movement and 
reflex action, and stop the heart in diastole. The paralysis of reflex 
action is due to destruction of the transverse conduction of the spinal 
cord (p. 149), longitudinal conduction remaining intact until death 
(Robert). Proto-sulphate produces purging in doses of 1 to 2 drms., 
and in consequence of Gmelin's experiments has been thought to increase 
the secretion of bile. 

Uses. — Has been used in place of iron in anosmia, but without good 
results. Possibly it may be serviceable in amenorrhcea. 

Class VIII. 

Group II. — Gold, Platinum. 

AUKUM; GOLD, An. 
B.P. Gold, Fine. GOLD, FREE FROM METALLIC IMPURITIES. 

Gold foil is used for stopping teeth and to make the test solution. 

B.P. Solution of Chloride of Gold. 

PREPARATION. — By dissolving gold foil in a mixture of nitric and 
hydrochloric acids and diluting. 



METALS. 641 

U.S. P. Auri et Sodii Cliloridum. CHLORIDE OF Gold AND 
Sodium. 

A mixture composed of equal parts of dry chloride of gold, AuCl 3 ; 
302-4 ; and chloride of sodium, NaCl ; 58*4. 

Preparation. — By dissolving gold in nitro-hydrochloric acid and 
evaporating to dryness chloride of gold is obtained. This is dissolved 
in water, and mixed with its own weight of pure decrepitated common 
salt, also dissolved in water. The mixed solution is then evaporated to 
dryness. 

Characters. — An orange-yellow powder, slightly deliquescent, in 
damp air odorless, having a saline and metallic taste and a slightly acid 
reaction. The compound is very soluble in water ; at least one-half of 
it should be soluble in cold alcohol. When exposed to a red heat it is 
decomposed and metallic gold is separated. A fragment of the com- 
pound imparts an intense persistent color to a non-luminous flame. 

Dose. — ^ to ^ grain (-006--012 Gm.) once or twice a day. 

Action. — Salts of gold cause rapid paralysis of the central nervous 
system in frogs, which appears to affect first the optic lobes and cere- 
bellum, then the cord, and lastly the cerebral lobes (vide p. 168). In 
mammals small doses appear to increase the appetite ; larger ones cause 
symptoms of irritation in the stomach and intestines, viz., loss of 
appetite, diarrhoea and emaciation, followed by paralysis of the limbs, a 
catarrhal condition of the respiratory passages, and death by asphyxia. 
Large doses injected into the veins cause oedema of the lung's, and rapid 
death, with convulsions from asphyxia. In man they are said to increase 
the secretions, and to produce salivation like mercury, but without 
stomatitis. They are eliminated in the urine. 

Uses. — Salts of gold have been supposed to act like those of mer- 
cury and silver. They have been given like mercurial salts in syphilis, 
scrofula and cancer ; and, like silver salts, have been used in myelitis. 
Gold has been supposed to act specifically on the genital organs, and has 
been used in chronic uterine inflammation and irritation, and inflamma- 
tion and neuralgia of the ovaries. 

PLATINUM. Pt. 197. 

B.P. Platinum Foil. 

A heavy whitish metal, 8*921. Withstands considerable heat. The 
foil is convenient for holding .salts of organic acids which it is wished to 
char. 

B.P. Solution of Perchloride of Platinum. PtCl 4 ; 339. 

Preparation. — By dissolving thin platinum foil in a mixture of 
nitric acid and hydrochloric acid and diluting. 

Uses. — Used to distinguish potassium from sodium and to precipitate 
salts of ammonium, and of compound ammoniums, e.g., organic alkaloids. 

Action. — Soluble salts of platinum are as poisonous as arsenic. In 
frogs they appear to paralyze the centres for voluntary motion in the 
cerebral lobes, and irritate the motor centres between them and the 
cord, so that voluntary motion is diminished, but reflex convulsions 
occur. The excitability of voluntary muscle is much lessened, that of 



642 INORGANIC MATERIA MEDICA. 

the heart is not apparently altered. In mammals the most prominent 
symptom is paralysis of the peripheral ends of the vaso-inotor nerves. 
In consequence of this, diarrhoea, blood in the motions, hyperemia of 
the abdominal viscera, and ecchymoses of the mucous membrane of the 
stomach and intestine and bladder occur. 

B.P. Platinum Black. 

Platinum in a state of minute division, obtained by adding excess of 
carbonate of soda and some sugar to solution of perchloride of platinum, 
and boiling until a black precipitate is formed, which is washed and dried. 

Action. — Platinum black appears to have a greater power than even 
charcoal to condense gases, and especially oxygen in its pores. By giv- 
ing the oxygen off again it acts as an oxidizing agent. 

Use. — To test amylic alcohol by oxidizing it into valerianic acid. 



SECTION IV. 



ORGANIC MATERIA MEDICA. 



This Section contains Organic Compounds artificially prepared, and 
not merely extracted from Vegetable Substances containing them. 
Although it is small, it contains some of the most important remedies 
we possess, and by and by will probably replace to a great extent, 
and perhaps entirely, the vegetable materia medica. 



CHAPTER XXIX. 

CARBON COMPOUNDS— FATTY SERIES. 

Carbon is a tetrad element. It is sometimes represented graphically 
thus : 

I 

-C- 

I 

It combines with four atoms of a monad, or two of a dyad ele- 
ment, e.g. : 

H-C-H or )C\ 

i ^ 

It combines with itself, and thus the number of its compounds is 
almost endless. 

These compounds are divided into two great classes, according to the 
mode in which the atoms are linked. 

(643) 



644 ORGANIC MATERIA MEDICA. 

In the first class, or fatty series, the carbon atoms are supposed to 
be linked so as to form an open chain, e.g. : 

III II /0= 

-C-C-C- or -C-C-C &c. 

Ill II \c= 

I 

In the second class, or aromatic series, the carbon atoms are supposed 
to be linked so as to form a closed chain. 



■c c- 

ii i 
c c- 



Some of the simpler compounds of carbon have already been con- 
sidered — carbonic acid, C0 2 (p. 487), hydrocyanic acid, HCN (p. 489), 
acetic acid, C 2 H 4 2 (p. 481). 

General Action. — It will be noticed that compounds of carbon 
with hydrogen alone, as in the hydrocarbons of the marsh-gas series; 
with oxygen alone, as in carbonic acid, C0 2 ; with sulphur alone, as in 
bisulphide of carbon, CS 2 ; or with chlorine alone, as in tetrachloride of 
carbon, CC1 4 , all tend to paralyze the nervous system, and to destroy 
the functional activity of its various parts in a definite order. Thought 
fails first, next sensation, and next reflex action (p. 188). 

The compounds with hydrogen have a comparatively slight action on 
muscle, but those containing chlorine are more powerful muscular poi- 
sons, and destroy the contractility of muscular fibre, both voluntary and 
involuntary. 

Many compounds containing oxygen in addition to carbon and hydro- 
gen have an anaesthetic action, e.g., alcohol and ether; others, like 
acetic acid, have a strongly irritant action. Compounds of carbon with 
nitrogen, hydrogen, and oxygen may have a very complicated chemical 
constitution, and, as in the organic alkaloids, have physiological actions 
which are too varied and specialized to allow of their being classed at 
present under a general law. 

U.S.P. Carbonei Bisulphidum. Bisulphide of Carbon. 
CS 2 ; 76. — Bisulphide of carbon should be kept in well-stopped bottles, 
in a cool place, remote from lights or fire. 

Characters. — A clear, colorless, highly refractive liquid, very 
diffusive, having a strong, characteristic odor, a sharp, aromatic taste, 
and a neutral reaction. It is insoluble in water; soluble in alcohol, 
ether, chloroform, and fixed or volatile oils. Specific gravity 1*272. 
It vaporizes abundantly at ordinary temperatures, is highly inflammable, 
boils at 46° C. (114°. 8 F.), and, when ignited, burns with a blue flame, 
producing carbonic and sulphurous acids. 



CARBON COMPOUNDS FATTY SERIES. 645 

It should not affect the color of blue litmus paper moistened with 
water (absence of sulphurous acid). A portion evaporated spontaneously 
in a glass vessel should leave no residue (sulphur). Test solution of 
acetate of lead agitated with it should not be blackened (absence of 
hydrosulphuric acid). 

Action. — When inhaled it is a rapid, powerful, but transient anaes- 
thetic. 

Uses. — It is not used as an internal remedy. It can be used to pro- 
duce local anaesthesia by atomization. It has been employed as a local 
irritant in enlarged lymphatic glands, neuralgia, and deafness accom- 
panied by insufficiency of wax. 

FATTY SERIES. 
HYDROCARBONS. 

The chemical nature of a carbon compound depends on the arrange- 
ment of its constituent atoms, but its physical characters on the number 
of the atoms. 

The physical character of a compound greatly influences its 
physiological action, a gaseous body being more easily absorbed and 
excreted than a liquid, and a liquid more easily than a solid. There 
will also be differences amongst the gaseous, liquid, and solid bodies 
themselves ; for if a liquid, for example, has a low boiling-point so as to 
volatilize readily at ordinary temperatures, it will more resemble a gas 
in its action, while a liquid which has a high boiling-point will act more 
like a solid. 

Thus in the group of hydrocarbons belonging to the paraffin series 
the lowest members are gaseous at ordinary temperatures, the highest 
members form solid wax-like bodies, while those which are intermediate 
are liquid. Obviously we cannot expect a gas which can be inhaled in 
large quantities, and which will be quickly excreted when pure air is 
inhaled instead, to have the same action as a solid wax-like substance 
which can only be slowly absorbed, and slowly excreted or broken up in 
the organism. 

The boiling- -point of substances belonging to a series differs some- 
what according to the chemical nature of the substance, but amongst the 
members of the series having the same chemical nature it rises with the 
number of atoms. It will be seen from the accompanying table that the 
boiling-point differs according to the series, e.g., that of chlorides is 
lower than that of bromides ; this, again, is lower than that of iodides. 
In each series also of chlorides, bromides, or iodides, the boiling-point 
rises with the number of carbon atoms which the member of the series 
contains. 

As the action of substances depends so much on their volatility, it 
may be convenient to give here the boiling-points of the various members 
of the paraffin series : — 



646 



ORGANIC MATERIA MEDICA. 



Radical. 


•It 


c 

it 


r$ + 


§ + 


^ hi ""do 


1 


Methyl, CH 3 

Ethyl, C,H* 


12 V 5° ' 39° 
46-4° 1 71° 
77-6° 100-4° 
105-6° 128*7° 


40° 

72° 
102° 
129-6° 
153-4° 
179-4° 

221° 


Gas. 

Gas. 

Gas. 

1° 

38° 

70° 

99° 

124° 

202° 

278° 


66-0° 

78-4° 
97.40 

116-9° 
138° 

158° 
176° 
192° 


20-8° 

48-8° 

58° 

92-5° 
127-9° 
150° 


Gas. 
35° 


Propyl, C 3 H 7 

Butyl, aH q 


85° 
140° 


Amyl, CvHn 


163° 


Hexyl, C 6 H 13 

Heptyl, C 7 H U 

Octyl, C S H 17 

Dodecyl, C 12 H 23 .... 
Hexdecyl, or 
Cetyl,C 16 H 33 


180° 


199° 


205° 

281° 

300° 

Melting 
Point. 

55° 



Physiological Action of Hydrocarbons Belonging to the 
Marsh-Gas Series. — These hydrocarbons may be regarded as hydrides 
of the radicals, methyl, &c. Those low in the series — methane, ethane, 
propane, and butane — are permanent gases at ordinary temperatures, 
and when inhaled pure produce anaesthesia much like that of nitrous 
oxide. The intermediate fluid members of the series, e.g., pentane, and 
substances containing them, as benzin, petroleum oil, &c, give off vapor 
having an anaesthetic action somewhat like that of chloroform. 

The higher members of the series are solid at ordinary temperatures, 
and are used as a basis for ointments under the names of petrolatum, 
vaseline, cosmoline, &c. 

U.S. P. Benzinum. Benzin. Petroleum Benzin. Petro- 
leum Ether. — A purified distillate from American petroleum, consist- 
ing of hydrocarbons, chiefly of the marsh-gas series [C 5 H 12 ; C 6 H 14 , and 
homologous compounds], having a specific gravity from 0-670 to 0-675, 
and boiling at 50° to 60° C. (122° to 140° F.). 

Benzin should be carefully kept in well-stopped bottles or cans, in a 
cool place, remote from lights or fire. 

Characters. — A transparent, colorless, diffusive liquid, of a strong, 
characteristic odor, slightly resembling that of petroleum, but much less 
disagreeable ; neutral in reaction ; insoluble in water, soluble in about 6 
parts of alcohol, and readily so in ether, chloroform, benzol, and fixed 
and volatile oils. It is highly inflammable, and its vapor, when mixed 
with air and ignited, explodes violently. 

Benzin, when evaporated upon the hand, should leave no odor, and, 
when evaporated in a warmed dish, should leave no residue (absence of 
heavy hydrocarbons). When boiled a few minutes with one-fourth its 
volume of spirit of ammonia and a few drops of test solution of nitrate of 
silver, the ammoniacal liquid should not turn brown (absence of pyrogenous 
products, and sulphur compounds); and it should require six parts of 
officinal alcohol to dissolve it (difference from benzol). If 5 drops are 



CARBON COMPOUNDS FATTY SERIES. 647 

added to a mixture of 40 drops of sulphuric acid with 10 drops of nitric 
acid, in a test-tube, the liquid warmed and set aside for half an hour, 
and then diluted, in a shallow dish, with twice its volume of water, it 
should not have the bitter-almond-like odor of nitro-benzol (absence of 
benzol). 

Dose. — As a vermifuge, 30 min. 

Uses. — It is a good solvent for fats, resins, caoutchouc, and some of 
the alkaloids. It has been used externally as a sedative in prurigo and 
other cutaneous diseases, and internally as a vermifuge for tape-worm. 

XJ.S.P. Petrolatum. Petrolatum. [Petroleum Ointment. 
Vaseline.] — A semi-solid substance, consisting of hydrocarbons, chiefly 
of the marsh-gas series, C 16 H 34 , &c, obtained by distilling off the lighter 
and more volatile portions from American petroleum, and purifying the 
residue. Melting-point about 40° C. to 51° C. (104° F. to 125° F.), 
the first constituting the softer, and the second the firmer variety. 

When petrolatum is prescribed or ordered, without specifying its 
melting point, the low-melting variety, which liquefies at about 40° C. 
(104° F.), is to be dispensed. 

Characters. — A yellowish or yellow, fat-like mass, transparent in 
thin layers, more or less fluorescent, especially when melted, completely 
amorphous, tasteless and odorless, or giving off, at most, only a faint 
petroleum odor when heated, and having a neutral reaction. When 
gently heated, until the mass is almost entirely melted, the liquid portion 
has a specific gravity varying from 0*835 to 0*860. It is insoluble in 
water, scarcely soluble in alcohol, or in cold absolute alcohol, but soluble 
in 64 parts of boiling absolute alcohol, and readily soluble in ether, 
chloroform, bisulphide of carbon, oil of turpentine, benzin, benzol, and in 
fixed or volatile oils. When heated on platinum foil, it is completely 
volatilized without emitting the acrid vapors of burning fat or resin. 

If 5 Gm. of petroleum ointment be digested, for half an hour, with 5 
Grm. of soda and 25 Grm. of water, the aqueous layer separated, and super- 
saturated with dilute sulphuric acid, no oily substance should separate 
(absence of fixed oils or fats of vegetable or animal origin, or of resin). 
Liquefied petroleum ointment agitated with sulphuric acid of specific 
gravity 1*540 should not acquire a dark color within two hours (absence 
of readily carbonized organic impurities). 

Uses. — These hydrocarbons, which are not liable to become rancid, 
have been found very useful as a bland protection, and as a substitute 
for animal and vegetable fats in the preparation of ointments. 

ALCOHOLS. 

Alcohols of the Series C 2 H 2n + 1#OH# — These may be regarded 
as hydrates of the radicals. They differ from the hydrides by the 
radical being united in them to hydroxyl, HO, instead of to hydrogen. 
The most important of them are : — 

Methyl alcohol, CH 4 0. Wood spirit. 

Ethyl alcohol, C 2 H 6 0. Spirit of wine. 

Propyl alcohol. C 3 H 8 0. 

Amyl alcohol, C 5 H 12 0. Fusel oil or potato spirit. 



648 



ORGANIC MATERIA MEDICA. 



These alcohols have all a toxic action when given in sufficiently large 
doses. The general effect they produce on the organism appears to be 
much the same in all, viz., paralysis affecting the nerve-centres in 
the inverse order of their development, Their lethal power and the 
symptoms they produce are modified by their physical characters, such 
as their solubility in water, and their volatility ; for if they are not 
readily soluble in water they cannot be readily absorbed, and probably 
will not be readily excreted. Their toxic power increases with their 
atomic weight, so that a less quantity of the higher alcohols will produce 
death. This is shown in the following table by Dujardin-Beaumetz. It 
will be noticed, however, that the lowest term and also the higher 
terms of the series form exceptions. This may possibly be due to rapid 
absorption as compared with excretion (p. 56) in the case of methylic 
alcohol, and to slow absorption in the case of cenanthic and caprylic 
alcohols : — 



Kind of Alcohol. 



Xon-fermented 



Fermented. 



Methylic Alcohol, CH 4 



Non-fermented. 



Ethylic 

Propylic 

(Isopropylic) 

Butylic 

Amylic 

CEnanthylic 
Caprylic 



C 2 H 6 
C 3 H 5 

(C 3 H s O) 
C 4 H 10 O 



C;H 16 

C S H 1S 



Mean toxic dose in grammes 

per kilogramme weight of 

the animal. 



Diluted. 
7-0 

7-75 
375 
(3'7 to 3-8) 
1-85 
1-50 




All the alcohols produce symptoms which are divided by Dujardin- 
Beaumetz into three stages, the first of which corresponds to the first and 
second stages of action I have given at p. 188, and his second and third 
corresponding to the third and fourth of mine respectively. These stages 
are modified "by (a) the kind of alcohol used, (b) its quantity, and (<?) 
the resistance of the subjects. 

Etliylic alcohol has the most typical action, and in poisoning by it 
all the stages succeed one another in regular order. In the case of the 
other alcohols obtained by fermentation the stages are also regular, but 
the farther the alcohol is from ethylic, the less regular do the stages 
become. They succeed one another more rapidly, their character is less 
marked, and convulsive phenomena appear. 

In the case of methylic alcohol the excitement is greater, the 
subsequent stages succeed one another more quickly, and reach their 
acme sooner ; but if the dose be insufficient to cause death, the effects 
pass off more quickly. 

In the case of oenanthic and caprylic alcohol, the stages do not 
present the same regularity, and convulsions occur. 

All the alcohols now mentioned lower the temperature. 

On post-mortem examination after acute poisoning by alcohols, the 
blood, stomach, intestines, liver, lungs, and kidneys are found to be 



CARBON COMPOUNDS — FATTY SERIES. 649 

affected. It is possible, however, that some of these lesions are not to 
be regarded as specific consequences of the action of alcohol, but rather 
as due to the death by asphyxia which ensued from the respiratory 
paralysis. The blood is of a dark color, and forms clots in the 
heart. When the alcohol is given "by the mouth, the stomach 
and intestine are much congested and softened, the congestion 
being greater when the alcohol is undiluted. When the alcohol is 
injected subcutaneously, the stomach is little altered, but the intes- 
tine is congested, the congestion being probably due, according to 
Dujardin-Beaumetz, to elimination of the alcohol by the intestinal 
mucous membrane. The liver is the gland most affected. It is con- 
gested, soft, and friable. The spleen is also gorged with blood, and 
soft. The lungs are congested with small extravasations, which are most 
abundant when the alcohol has been given by the mouth. Haemorrhages 
are observed in the kidneys, especially in the case of the non-fermented 
alcohols. 

Methyl Alcohol, CH 3 .OH; Wood Spirit. Synonyms — Carbi- 
nol, Hydroxymethane, Methol. Not officinal. 

Preparation. — By destructive distillation of wood, and neutraliza- 
tion and repeated distillation of the product. 

Characters. — A colorless, mobile liquid. When pure it has a taste 
and smell somewhat like ethyl alcohol ; but ordinary wood spirit contains 
many impurities which give it a disagreeable odor and burning taste. 

Uses. — The admixture of wood spirit with alcohol renders the latter 
so disagreeable as to unfit it for drinking, so that it can be sold under 
the name of methylated spirit as a solvent, and for other uses in 
the arts, without interfering with the duties on potable alcoholic drinks. 

Alcohol. Ethyl Alcohol. C 2 H 5 .OH. 

General Source and Preparation. — Alcohol is prepared from 
solutions of grape sugar by adding to them a ferment, which causes the 
glucose to split up into alcohol and carbonic acid. 

The solutions of grape sugar which yield alcohol are generally pre- 
pared from malt. This is made by steeping barley for a while in water 
till it begins to germinate. The barley when fresh contains starch and 
a ferment termed diastase, which converts the starch into sugar during 
the process of germination. 

When this has gone far enough, as is ascertained by the radicle 
attaining a certain length, the process is stopped by roasting the malt, as 
the sugar would all be used up again by the plant if it were allowed to 
continue its growth. The malt is then infused in warm water, and the 
solution of grape sugar which it yields is fermented by yeast, a small 
fungus which causes the grape sugar to split up and yield alcohol. The 
alcohol thus obtained is very much diluted with water, and in order to 
separate them the liquor is distilled, when the alcohol passes over first 
and the greater part of the water is left behind. 

General Impurities. — Water, fusel oil, and aldehyde. The water 
may have come to be present either as an accidental impurity or as an 
intentional adulteration. One of the most important impurities of alco- 
hol is the presence of organic alkaloids. A good deal of spirit is made 



650 ORGANIC MATERIA MEDICA. 

from spoiled grain, maize, &c, which, cannot be used for food. In diseased 
grain alkaloids are formed, and these appear to pass over with the alco- 
hol during distillation. 

Tests. — Water is detected by the use of the hydrometer, as any 
admixture of water with alcohol raises the specific gravity of the latter. 

The presence of oily, fatty, or resinous substances in alcohol is rec- 
ognized by diluting it with water, when these substances, being insoluble 
in weak spirit, are precipitated and render the solution turbid. 

Traces of fusel oil and aldehyde are almost always present, and they 
are reckoned as impurities by the B.P. only when they rise above a cer- 
tain amount. The quantity of them present in alcohol is determined by 
adding to 4 oz. of it 30 grain-measures of standard solution of nitrate 
of silver and exposing it to the sunlight for 24 hours. The nitrate of 
silver is deoxidized by these substances and a black precipitate consisting 
of oxide or of some organic compound is deposited. 

General Action of Alcohol. — When alcohol is added in sufficient 
quantity to albuminous solutions it precipitates them, apparently 
simply by withdrawing the water from them, because when water is 
added to the freshly precipitated albumen it redissolves easily. When, 
however, the precipitate is kept for some time in alcohol, it loses its solu- 
bility, and is no longer redissolved by water. When applied to the skin, 
alcohol evaporates readily, and gives rise to a sensation of cold. It 
renders the epidermis drier and harder, and if kept in contact with the 
skin, evaporation being prevented, it passes through the epidermis, and, 
acting upon the tissue below, stimulates it, causing an increased supply 
of blood to the part, and producing a feeling of warmth or burning. A 
similar action takes place when it is applied to a mucous membrane, e.g., 
when taken into the mouth. It here produces a slight precipitate 
of albumen on the surface and acts as an astringent, drawing the parts 
slightly together, and forming on the surface a whitish pellicle, which, 
however, rapidly disappears. It causes considerable reflex secretion 
of saliva. When taken into the stomach in small quantities, it has a 
similar action on that organ, causing increased vascularity and increased 
secretion, accompanied by a feeling of warmth, and it excites a feeling of 
appetite, for which purpose it is taken by some persons befqre meals. It 
aids the expulsion of flatulence from the stomach and intestines. In 
cases of diarrhoea it has a somewhat astringent action in the intestine, 
but in persons accustomed to take alcohol to excess the bowels are always 
rather loose, constipation occurring very rarely, if at all. 

After absorption into the "blood, it appears to form a compound 
with hemoglobin, which takes up and gives off oxygen less readily than 
haemoglobin itself (Schmiedeberg). It thus lessens the oxidizing power 
of the blood, and will, consequently, diminish oxidation in the tissues. 

Considerable dispute has arisen as to whether alcohol is a food or 
not. The chief argument in favor of its not being a food is that it is 
eliminated in the urine unchanged, but this seems to occur only when it 
is given in considerable quantities. In small doses it is partly elimi- 
nated by the breath, but most of it appears to undergo combustion in 
the body, and very little of it passes out in the urine. In this respect 
it agrees with other foods, such as cane sugar. Hammond found that 



CARBON COMPOUNDS FATTY SERIES. 651 

when on insufficient diet he was losing weight, the addition of a little 
alcohol not only enabled him to reach his former weight, but to add to it. 

The argument in favor of alcohol being a food is that it is retained 
in the body, and supplies the place of other foods, so that the quantity 
of food which would without it be insufficient, with its aid becomes 
sufficient. 

The conclusion to which all the evidence points is that alcohol is a 
food, and in certain circumstances, such as febrile conditions, it may be 
a very useful food, but in health, when other kinds of food are abun- 
dant, it is unnecessary, and, as it interferes with oxidation, it is an 
inconvenient kind of food. 

After its absorption into the circulation it causes dilatation of the 
vessels on the surface of the body, and increases the rapidity of the 
pulse. From the freer circulation which thus takes place in the capil- 
laries of the surface, the skin of the face and hands become more flushed. 
The blood flows so freely from the arteries into the veins that there is no 
longer time for it to become completely venous in its passage. In con- 
sequence of the capillaries being dilated, the skin is no longer mottled, 
but of a uniformly pink color. The veins are distended ; they fill more 
rapidly when emptied, and are of a lighter blue than usual, owing to the 
blood they contain being more arterial. 

The action of alcohol upon the temperature seems to depend upon 
two factors. One of these is its power of lessening oxidation, but this 
only comes into consideration with large doses, when this factor may aid 
considerably in reducing the temperature. The other factor is the dila- 
tation of the vessels on the surface, which occurs even after moderate 
doses. This dilatation allows the warm blood from the interior of the 
body to circulate more readily near the surface, and thus subjects it to 
the cooling influence of the surrounding air, and also to the cooling 
effect of evaporation from the skin. By increasing the sweat it may 
lessen the temperature of the body, even when that of the surrounding 
air is as high or higher than it, and it will also cool the blood by freer 
radiation when the temperature of the atmosphere is below that of the 
body. It is evident that the cooling effects of alcohol will thus depend 
to a great extent on the atmospheric conditions of temperature and 
moisture to which the person taking it is subjected, as well as on the 
quantity of alcohol. Normally, when a person is subjected to cold, the 
vessels of the skin contract and prevent the warm blood in the interior 
of the body from approaching the surface and thus becoming cooled ; but 
when large quantities of alcohol are taken, this mechanism becomes par- 
alyzed, the blood from the interior circulates over the surface, and is 
cooled down more and more until its temperature becomes so much 
reduced as to be incompatible with life, and the patient is frozen to death. 
The dangerous effects of alcohol under such circumstances are well 
known to the lumberers in Canada, and to Arctic voyagers, who dread 
alcohol, and generally avoid it altogether. The utility of this self-same 
action of alcohol is very evident when a person comes from the cold 
atmosphere into a warm room ; for here the individual may still remain 
cold, although in front of a fire, as the contraction of the surface vessels 
now continues, and the blood is no longer able to convey warmth to the 



652 ORGANIC MATERIA MEDICA. 

interior, just as it was formerly unable to convey the cold. If alcohol 
be now taken, and the vessels dilated, the blood is allowed to circulate in 
the surface, soon becomes warm, and thus diffuses the warmth equally 
through the body. 

In considering the action of alcohol upon the nervous system, one 
must distinguish between the effect it produces upon the various nerve 
centres by increasing the circulation through them, and the effect of the 
alcohol on the nervous structures themselves. By increasing the circu- 
lation it may stimulate the functions of all the nerve centres, and render 
them, for the time being, capable of greater activity. It may thus 
enable its consumer to think more clearly, to express himself more 
fluently, or to perform feats of greater bodily activity than usual, but its 
action on the nerve centres themselves is a paralyzing one. 

The mode of action of alcohol on the circulation has not been well 
ascertained; but it seems probable that in considering it we must take 
into account both its direct action upon the circulatory apparatus itself 
and its reflex action upon that through other organs. Thus it is not 
improbable that even from the mouth it exercises an influence over the 
cranial circulation (p. 177). Although we have no experiments on 
the effect of irritation of the branches of the fifth nerve on the cranial 
circulation, yet individuals of all nations, when desiring to think more 
accurately, are accustomed to irritate some branch of this nerve, either 
by scratching the head, rubbing the forehead or chin, striking the nose, 
or taking snuff. Chewing sweet or pungent substances has a similar 
effect in enabling some persons to think more clearly, while, under simi- 
lar circumstances, alcohol is sipped by others. From the stomach it 
probably stimulates the heart and vascular system reflexly, and thus 
increases both the cranial and general circulation. When given in very 
large doses, as when a bottle of whisky has been drunk at a draught, the 
reflex action on the heart has been so great that death has occurred 
immediately from shock. 

Its action upon the nervous tissues themselves seems to be one of 
progressive paralysis, affecting them in the inverse order of their devel- 
opment, the highest centres being affected first, and the lowest last. 
Thus the power of judgment usually goes first, while the imagination 
may be lively, and the emotions even more than usually active, so 
that, after a man becomes incapable of discussion, he is combative, affec- 
tionate, or lachrymose ! The motor centres may be next affected, 
either after or before the perceptive centres, so that the speech may be 
uncertain and thick, while the power of judgment is little affected, or the 
speech may remain tolerably distinct after the power of clear conception 
is entirely gone. The cerebellum appears to be affected sometimes 
before and sometimes after the cerebrum. This depends partly upon the 
constitution of the individual, and partly on the quality of the alcoholic 
liquor. The affection of the cerebellum gives rise to double vision, and 
inability to walk, from the relations of surrounding objects being no 
longer correctly perceived. After both cerebrum and cerebellum are 
paralyzed, the cord may still retain its functional activity, so that the 
man who cannot walk may be able to ride, owing to the reflex contrac- 
tion of the adductors produced by the impression of the saddle. The 



CARBON COMPOUNDS — FATTY SERIES. 



653 



respiratory centre is next paralyzed, if the quantity taken be suffi- 
ciently large. The heart continues to beat although the respiration 
may be paralyzed ; but if a sufficient dose of alcohol be administered, 
and respiration be kept up artificially in an animal, so as to allow it to 
act upon the heart, the cardiac ganglia may also become paralyzed. 

The sensibility of the vaso-motor centre to reflex impressions 
appears to be early destroyed, and the consequence of this is that injuries 
which in a sober man would produce death by shock, have comparatively 
little effect on a man who is drunk. 

The diagnosis of drunkenness from opium-poisoning and from 
apoplexy is of great practical importance, for it occasionally happens 
that cases brought into hospital by the police have been dismissed as cases 
of drunkenness, and have proved afterwards to be apoplectic cases. The 
difficulty of diagnosis is increased by the fact that the patient may have 
had alcoholic drinks poured down his throat by sympathetic bystanders, 
so that the first indication of drunkenness, viz., the smell of alcohol in 
the breath, may occur equally in apoplexy. The other chief points of 
diagnosis are given under " Opium." 

Effect of Impurities on the Action of Alcohol. — It will be 
seen by the following table from Dujardin-Beaumetz that the toxic action 
of alcohol is greatly increased by impurities, so that inferior brandy 
from a public house has a lethal action nearly one-half greater (as 5'30 
to 7*75) than pure ethylic alcohol. 



Kind of Spirit. 



Mean toxic doses per kilogramme 

weight of body of dog, to cause 

death in 24-36 hours. 



Spirits and 
brandies. 



Crude. 



Rectified. 



Ethylic alcohol 

Spirit of wine of Montpellier 

" from pears 

" from cider and from the marc of grapes... 

Spirit from grain 

" from molasses and beetroot 

Brandy from a public house (ordinary quality) 

" " " (inferior quality) 

Spirit from potatoes 

" (said to have been ten times rectified) 



grammes. 


grammes. 


7-75 




750 




735 


... 


7-30 






6-96 




6-90 


7-6 




5 30 






6'85 



grammes. 



7 25 
715 



710 
7 35 



Chronic Alcoholic Poisoning. — In persons who are accustomed 
to take an excessive quantity of alcoholic stimulants for a length of time, 
although perhaps never sufficient to produce the symptoms of acute 
intoxication, alterations are produced in the digestive and nervous sys- 
tems. One of the commonest evidences of this condition is vomiting- 
of watery fluid in the morning immediately after rising. The bowels 
are rarely, if ever, constipated, being generally open three or four times 
daily. There is a tendency to fatty degeneration of various organs, the 
skin acquires a satiny feeling, and the capillaries on the surface of the 



654 ORGANIC MATERIA MEDICA. 

face often become prominently dilated, giving a characteristic hue to the 
complexion, which is often especially marked upon the nose. The liver 
is apt to undergo fatty degeneration, and, at first, to be congested. After- 
wards, the connective tissue becomes increased, the organ contracts, 
interfering with the circulation in the abdominal viscera, and producing 
ascites. This may be complicated by cirrhosis of the kidney also. The 
nervous system may also be affected, the mental powers becoming 
impaired, the temper, at the same time, frequently being irritable, while 
a tremulousness appears in the tongue, lips, and hands. 

When those accustomed to indulge freely in stimulants are attacked 
by acute disease, or when they receive injuries, or when, in consequence 
of a drinking bout, their stomachs are so deranged as to bring on loss 
of appetite and vomiting, and to lower their nutrition, they are liable to 
delirium tremens. So long as the drunkard is able to eat and digest 
his food, he is little liable to this disease. As a rule, delirium comes on 
in from two to four days after he has lost his appetite and begun to 
vomit. This delirium is marked by a peculiar tremor of the tongue, as 
well as of the limbs, and by delusions which are especially connected 
with the sense of sight, the unfortunate patient imagining that he sees 
noxious animals crawling around him, or that he is plagued by demons, 
which are sometimes of a blue color, from which the disease is popularly 
known as " blue devils." The tongue is moist, and covered with a thick 
white fur. There is loss of appetite and vomiting, which is often obsti- 
nate. The delirium is constant and active. It may become violent, and 
there is great restlessness and sleeplessness. It may gradually subside, 
and the patient recover his health, or a condition of mania may ensue. 
Patients sometimes die suddenly, without any warning symptoms. 

The treatment of delirium tremens consists in keeping up the 
strength of the patient by a nutritive diet, and preserving him from 
exhaustion by combating the sleeplessness which would cause it. The 
vomiting, which is the chief obstacle to nutrition, is often well combated 
by a combination of bismuth, magnesia, and hydrocyanic acid, to which 
small quantities of morphine may be added. Until the patient is able 
to retain food, he ought to be fed by nutritive enemata, while chloral 
may be administered for the sleeplessness. A combination of chloral 
with bromide of potassium is often very useful. Large doses of digitalis 
have been given in order to quiet the delirium, and sometimes with 
benefit ; but this is a very dangerous treatment, and it seems not 
improbable that the reason why the enormous doses of such a powerful 
drug have produced so little effect has simply been that they have not 
been absorbed from the stomach, for I have seen a case in which food lay 
undigested and unabsorbed in the stomach for a period of four days, 
after which it was vomited. 

Causes of Chronic Alcoholism. — The craving for stimulants 
which leads to chronic alcoholic poisoning may be acquired by the habit 
of drinking in society ; but it is not seldom due to the practice of taking 
alcohol in order to relieve depression of spirits, bodily or mental weak- 
ness, or inability to work as long or as well as might be desired. In 
men, the depression of spirits and feeling of weakness may be due 
to unfavorable physical surroundings, close atmosphere, over-work, 



CARBON COMPOUNDS — FATTY SERIES. 655 

exhausting discharges, or mental worry. In women it may not only be 
connected with any of these, but also with uterine derangement. The 
craving appears to be partly gastric and partly systemic, and it is to 
be combated by the substitution for alcohol of other stimulants which 
will not have the same deleterious action. As a stimulant to the 
stomach, producing a sensation of warmth, tincture of capsicum is very 
useful, and aromatic spirit of ammonia stimulates both the stomach itself 
and the circulation and nervous system generally. A useful formula 
consists of 20 or 30 minims of aromatic spirit of ammonia, with 5 to 
10 minims of tincture of capsicum, in two ounces of infusion of gentian 
or cascarilla. This draught, which amounts to an ordinary wineglass-full, 
should be taken when the craving is felt. In place of this draught a 
lemon may be sucked, or a glass of iced or cold water, or effervescing 
water may be slowly sipped so as to get its stimulating action on the 
cerebral circulation (p. 176) and heart (p. 177). At the same time, 
chalybeate tonics and strychnine may be given in order to increase the 
nutrition of the tissues generally. The liquid extract of red cinchona 
bark has been recommended in such cases, and no doubt this medicine, 
along with easily digested food, beef-tea, and warm nutritious drinks, 
such as hot cocoa, may prove a useful adjunct in the treatment of chronic 
alcoholism. 

In some patients the tendency to drink appears to be epileptic in 
character. The person affected by it will remain sober for weeks or even 
months, and then be suddenly seized with the fit, begin to drink, and 
remain drunk for several days together, and, after the conclusion of the 
bout, will again remain sober for a long time. I have seen a case 
in which this species of intermittent drunkenness was brought on by a 
fall from a horse, and was associated with epilepsy. TRe fit began with 
an intense craving for drink, and after one or two days' drunkenness 
epilepsy came on. If the desire for drink was not gratified, the fit came 
on sooner after the craving began than it would otherwise have done, but 
it was not so violent. The treatment in these cases is bromide of potas- 
sium combined with tonics. 

Uses. — The cold produced by the evaporation of alcohol when it is 
applied to the skin and rapidly dissipated by fanning or blowing upon it 
is useful in preventing syncope, in relieving headache, or in rousing from 
fainting or coma. For these purposes one of the most convenient forms 
of application is eau-de-cologne, and in cases of headache this may be 
used, diluted with equal parts of water, and applied by means of a thin 
handkerchief. The power of alcohol to harden the epidermis renders it 
a useful application in cases where we desire to hinder the formation of 
bed-sores or prevent the nipples from cracking. Brandy is the form 
most frequently employed for this purpose, as it stimulates the circulation 
when its evaporation is prevented, and especially when aided by friction. 
It has been used as a liniment in the form of brandy or spirit to sprained 
joints. A little brandy held in the mouth increases the secretion of 
saliva, and often relieves toothache. Alcohol is also a useful gargle in 
relaxed sore-throat, port wine being a form in which it is frequently 
applied for this purpose. It is also a useful astringent wash to the mouth 
in cases of profuse salivation. As in small doses it increases the secretion 



656 ORGANIC MATERIA MEDICA. 

of gastric juice, it forms a useful addition to the meals of persons 
whose digestive powers are weak either in consequence of temporary 
exhaustion or from permanent debility, occurring in convalescence from 
acute disease, general malnutrition, or from old age. Some men, after 
being busily engaged all day, go home exhausted, and dine immediately on 
their arrival. The consequence of this is that their food remains undi- 
gested, and they suffer from weight of the stomach and drowsiness. 
This condition may generally be prevented in persons below middle age, 
by simply making them rest for awhile, so that the stomach, as well as 
the body generally, may recover from fatigue before the meal is taken, 
but in elderly individuals the addition of a little alcoholic stimulant may 
be necessary to insure digestion. This use of alcohol was noticed in the 
Ashantee campaign, in which the effect of alcohol as a stimulant, com- 
pared with beef-tea, was carefully tested. It was found that when 
a ration of rum was served out the soldier at first marched more briskly, 
but after about three miles had been traversed the effect of it seemed to 
be worn off, and he then lagged more than before. If a second ration 
were then given its effect was less marked, and wore off sooner than that 
of the first. A ration of beef-tea, however, seemed to have as great a 
stimulating power as one of rum, and not to be followed by any secondary 
depression. At the end of the march a short rest during the cooking 
of the evening meal seemed sufficient to enable the younger men to eat 
and digest it without the aid of rum, which they did not desire ; but the 
men who had passed middle age not only wanted their own share of the 
alcohol, but were glad to get that of their younger comrades also. 

In the intestine alcohol is used as a carminative to relieve flatulent 
distention, as an antispasmodic in colic, and as an astringent in diarrhoea. 

Alcoliol as a Stimulant. — As a stimulant alcohol seems serviceable 
in acute diseases running a limited course, where we wish to sustain the 
patient's strength until the crisis is past, as well as to prevent it sinking 
from debility afterwards. The various rules which have been given for 
the administration of alcohol (in fever) may be condensed into one. If 
the alcohol tends to bring the patient nearer to his normal condition it is 
doing good ; if it takes him further away from a healthy condition it 
does harm. The points which are usually specially attended to are the 
condition of the tongue, pulse, respiration, skin, and nervous system. 

If it is found that the alcohol (a) renders the dry tongue moist, (b) 
slows and strengthens the pulse when it is too quick, or quickens it when 
it has been abnormally slow, (<?) slows the hurried respiration, (d) renders 
the skin cooler or moister when too hot and dry, and (e) lessens delirium 
and brings on sleep, — then its action is beneficial. If it have an oppo- 
site effect it is harmful. Useful indications regarding the advantage of 
alcohol, and the amount to be given in any particular case may be 
obtained by the practitioner remaining beside the patient, counting the 
pulse, and watching the tongue, respiration, skin, and general condition 
for a quarter of an hour after the dose has been given. He will thus be 
able to give more definite directions than he otherwise could as to its 
continuance when he is absent. Particular care should be taken in the 
administration of alcoholic stimulants to patients in the small hours of the 
morning. It is about this time that attendants are most apt to become 






CARBON COMPOUNDS — FATTY SERIES. 657 

sleepy, and therefore careless, and just at this time, also, the external 
temperature is lowest, the fire is apt to get low, and the vital powers of 
the patient are most likely to sink. In giving alcoholic stimulants to 
support the strength in disease, care must be taken that they are not 
given so frequently, and in such large quantities, as to disorder the stom- 
ach and to produce subacute gastritis. Sometimes when given very freely 
to support the failing circulation, they have this effect ; the result of 
which is that both food and stimulants are vomited, and the patient may 
be brought to death's door. The treatment here consists in the free admin- 
istration of ice, along with two or three minims of solution of morphine 
and hydrocyanic acid, frequently repeated until the vomiting is arrested. 
During its elimination by the urine, alcohol may act as an irritant 
to the urinary passages when these are already inflamed. It is, conse- 
quently, injurious in gonorrhoea; and some sorts of beer, especially 
Bavarian beer, will even bring on gonorrhoea on persons who have pre- 
viously had it, but who have been free from it at the time of taking the beer. 

U.S. P. Alcohol. Alcohol. — A liquid composed of 91 per cent, 
by weight (94 per cent, by volume) of ethyl alcohol (C 2 H 5 HO ; 46), and 
9 per cent, by weight (6 per cent, by volume) of water. 

Characters. — A transparent, colorless, mobile and volatile liquid, 
of a characteristic, pungent and agreeable odor, and a burning taste. It 
should not change the color of blue or red litmus paper previously mois- 
tened with water. It boils at 78° C. (172°-4 F.), and is readily inflam- 
mable, giving a blue flame without smoke. Specific gravity 0-820 at 
15°-6 C. (60° F.), and 0-812 at 25° C. (77° F.). 

Impurities. — Fusel oil, amyl alcohol, methyl alcohol, aldehyde, oak 
tannin, foreign organic matters. 

Tests. — If a portion of at least 50 cc. be evaporated to dryness in a 
glass vessel, no residue or color should appear. If mixed with its own 
volume of water and one-fifth its volume of glycerine, a piece of blotting- 
paper on being wet with the mixture, after the vapor of alcohol has 
wholly disappeared, should give no irritating or foreign odor (no fusel 
oil). And if a portion be evaporated to one-fifth its volume, the residue 
should not turn reddish upon the addition of an equal volume of sul- 
phuric acid (no amyl alcohol). When treated in a test-tube with an equal 
volume of solution of potassa, there should not be an immediate darken- 
ing of the liquid (no methyl alcohol, aldehyde and oak tannin). If a 
portion of about 150 cc. be digested for an hour with 20 grs. of carbon- 
ate of lead and filtered, the filtrate then distilled from a water-bath, and 
the first 20 cc. of the distillate treated with 1 cc. of test solution of per- 
manganate of potassium, the color should not disappear within one or two 
minutes (absence of methyl alcohol). If 20 cc. are shaken in a glass- 
stoppered vial, previously well rinsed with the same alcohol, with 2 cc. 
of test solution of nitrate of silver, the mixture should not be rendered 
more than faintly opalescent during one day's exposure to direct sunlight 
(absence of more than traces of foreign organic matters, fusel oil, &c). 

B.P. Alcohol. Absolute Alcohol. C 2 H 5 HO ; 46. 
Preparation. — By mixing rectified spirit with potassium carbonate 
and lime, both of which have a strong affinity for water, and then distilling. 
42 



658 OKGANIC MATERIA MEDICA. 

Characters and Tests. — Colorless and free from empyreumatic 
odor. Specific gravity 0*795. It is entirely volatilized by heat; is not 
rendered turbid when mixed with water (no oils) ; and does not cause 
anhydrous sulphate of copper to assume a blue color when left in contact 
with it (no water). 

B.P. Spiritus Rectificatus. Rectified Spirit. — Alcohol, 
C 2 H 6 0, with 16 per cent, of water; obtained by the distillation of fer- 
mented saccharine fluids. 

Characters and Tests. — Colorless, transparent, very mobile and 
inflammable, of a peculiar pleasant odor, and a strong spirituous burning 
taste. Burns with a blue flame without smoke. Specific gravity 
0*838. Remains clear when diluted with distilled water. Odor and taste 
purely alcoholic. Four fluid ounces with thirty grain-measures of the 
volumetric solution of nitrate of silver exposed for twenty-four hours to 
bright light, and then decanted from the black powder which has formed, 
undergoes no further change when again exposed to light with more of 
the tests (no fusel oil). 

Impurities. — Water, fusel oil. 

Alcoliol Dilutum, U.S.P. ; Spiritus Tenuior, B.P. Diluted 
Alcohol, U.S.P. ; Proof Spirit, B.P. 

Alcohol and distilled water equal parts; specific gravity 0*928 at 
15*6° C. (60° F.), and 0*920 at 25° C. (77° F.), U.S.P. Rectified 
spirit, 5 pints, mixed with distilled water 3 pints ; specific gravity 0*920, 
B.P. 

Spiritus Vini Gallici, U.S.P. and B.P. Spirit of French 
Wine. Brandy. 

An alcoholic liquid obtained by the distillation of fermented grapes, 
and at least four years old, U.S.P. Spirit distilled from French wine. 
It has a peculiar flavor, and a light sherry color derived from the cask 
in which it has been kept, B.P. It should contain from 39 to 47 per 
cent, by weight, or 46 to 55 per cent, by volume, of alcohol. 

Preparation. 

B.P. 

Mistura Spiritus Vini Gallici. 

B.P. Mistura Spiritus Villi Gallici. MIXTURE OF SPIRIT OF FRENCH WlNE. 

Egg Flip (vide also Eggs). Beat up together brandy and cinnamon- water, of each 
4 fl. oz., the yolks of two eggs, and sugar \ ounce. Dose. — 1-2 fl. oz. 

B.P. Vinum Xericum. Sherry. — A Spanish wine. 

Characters. — Pale yellowish-brown, containing about 17 or 18 per 
cent, of alcohol. 

Us i;s. — As a stimulant, and in preparing all the wines of the B.P. 
except Vinum Ferri Citratis and Vinum Quiniae. 

U.S.P. Vinum Album. WHITE WlNE. 

Characters. — A pale, amber-colored or straw-colored alcoholic 
liquid, made by fermenting the unmodified juice of the grape, freed from 
seeds, stems and skins. White wine should have a full, fruity agreeable 
taste, without excessive sweetness or acidity ; and it should have a 



CARBON COMPOUNDS FATTY SERIES. 659 

pleasant odor, free from yeastiness. Its sp. gr. at 15°'6 C. (60° F.) 
should not be less than 0*990 nor more than 1*010. 

Impurity. — Tannic acid. 

Tests. — If 10 cc. of white wine be diluted with an equal volume 
of distilled water, and treated with 5 drops of test solution of ferric 
chloride, only a faint greenish-brown color should make its appearance 
(absence of tannic acid.) Upon evaporation and twelve hours' drying on 
the water-bath, it should leave a residue of not less than 1*5 per cent., nor 
more than 3*0 per cent. Using litmus paper as an indicator 250 cc. of white 
wine should require for complete neutralization not less than 15 nor more 
than 26 cc. of the volumetric solution of soda. 

U.S.P. Vinum Album Fortius. Stronger White Wine. 

Composition. — White wine 7 parts, alcohol 1 part. When tested for 
alcohol it should not contain less than 20 nor more than 25 per cent, of 
absolute alcohol by weight. 

Use. — In preparing all the medicated wines in the U.S.P. 

U.S.P. Vinum Rubrum. Red Wine. 

A deep red alcoholic liquid, made by fermenting the juice of colored 
grapes in presence of their skins. 

Characters. — Red wine should have a full, fruity, moderately 
astringent, pleasant taste, without decided sweetness or excessive acidity. 
It should have a pleasant odor, free from yeastiness. Its sp. gr. at 15° *6 
C. (60° F.) should not be less than 0*989 nor more than 1*010. 

Tests. — If 10 cc. of red wine be diluted with an equal volume of 
distilled water, and treated with 5 drops of test solution of ferric chloride 
the liquid should acquire a brownish-green color, due to tannic acid. 
Upon evaporation and twelve hours' drying on the water-bath, it should 
leave a residue of not less than 1*6 per cent., nor more than 3*5 per cent. 

Using litmus paper as an indicator, 250 cc. of red wine should require 
for complete neutralization not less than 15 nor more than 26 cc. of the 
volumetric solution of soda. If 50 cc. of red wine be treated with a 
slight excess of water of ammonia, the liquid should acquire a green or 
brownish-green color ; if it be then well shaken with 25 cc. of ether, the 
greater portion of the ethereal layer removed, and evaporated in a porce- 
lain capsule with excess of acetic acid and a few fibres of uncolored silk, 
the latter should not acquire a crimson or violet color (absence of aniline 
colors). With test solution of acetate of lead, red wine should form a 
heavy precipitate, which may vary in color from bluish-green to green. 

B.P. Alcohol Amylicum. Amylic ALCOHOL. 

Amylic alcohol, C 10 H 12 O 2 or C 5 H 12 0, with a small proportion of other 
spirituous substances. An oily liquid, contained in the crude spirit pro- 
duced by the fermentation of saccharine solutions with yeast, and 
separated in the rectification or distillation of such crude spirit. 

Characters and Tests. — A colorless liquid with a penetrating and 
oppressive odor, and a burning taste. When pure its specific gravity is 
•818, and its boiling point 270°. Sparingly soluble in water, but soluble 
in all proportions in alcohol, ether, and essential oils. Exposed to the 
air in contact with platinum black it is ' slowly oxidized, yielding valeri- 
anic acid. 



660 ORGANIC MATERIA MEDICA. 

Peepaeations in which Amylic Alcohol is used. 
Sodse Valerianas. Amyl Nitris. 

Uses. — It is oxidized into valerianic acid. 

ALDEHYDES. 

These substances in their chemical constitution lie between alcohols 
and acids. They are obtained from alcohols by the removal of two 
atoms of hydrogen, hence the name aldehyde (alcohol deht/drogemtum). 

Ethyl Aldehyde. — Synonyms — aldehyde, acetic aldehyde, or ethyl- 
idene oxide. C 2 H 4 0. Not officinal. 

Preparation. — It may be prepared in several ways, as the hydrogen 
can be removed from alcohol either by oxidizing agents or chlorine. 
C 2 H 6 + — C 2 H 4 + H 2 0, or C 2 H 6 + Cl 2 = C 2 H 4 + 2HC1. 

Characters. — A colorless, mobile liquid, with an ethereal, acrid, and 
suffocating odor. Specific gravity 0*79. Boiling-point, 22° C. 
(71° -6 F.). 

Action. — It is antiseptic. It has a strong local irritant action. 
"When inhaled it causes excitement followed by anaesthesia. It has a 
powerfully depressant action on respiration, and rapidly produces asphyxia, 
so that it is not used as an anaesthetic. 

Paraldehyde. C 6 H 12 3 . — It appears to be a polymeric modifica- 
tion of aldehyde. Not officinal. 

Characters. — A colorless fluid. 

Action. — It is a pure narcotic, causing sleep like chloral. It is 
about half the strength of chloral, and is said to be without any depress- 
ing action on the heart and respiration. It may thus be used instead of 
chloral in cases of weak heart. Its local action renders its use unadvis- 
able in severe gastric disorders and laryngeal phthisis. 

Dose. — 3 to 6 Gm., or more. 

Administration. — It is soluble in about 8 parts of water, and may 
be given with glycerine, syrup of tolu, or syrup of oranges. 

SIMPLE ETHERS. 

These correspond in structure to oxides in which the place of a metal 
is taken by an alcohol radical, thus potash, ^ > or K 2 0, corresponds to 

C H ) 

Q 2 TT fi [Oor (C 2 H 5 ) 2 0, ethylic ether. 

2 ■> J 

iEther, U.S.P. and B.P. (C 2 H 5 ) 2 ; 74. Ether. 

A liquid composed of about 74 per cent, of ethyl oxide, C 2 H 5 ; and 
about 2G per cent, of alcohol containing a little water. Specific gravity 
about 0-750 at 15° C. (59° F.), U.S.P. A volatile liquid prepared 
from alcohol, and containing not less than 92 per cent, by volume of pure 
ether, C 4 II 10 O, B.P. 

Preparation. — By distilling rectified spirit with sulphuric acid, and 
freeing the ether thus obtained from water by redistillation with calcium 
chloride and lime. 



CARBON COMPOUNDS FATTY SERIES. 661 

In this process ethylsulphuric or sulphovinic acid and water are 
first formed, ethyl replacing one atom of hydrogen in the sulphuric acid. 

Sulphuric Acid. Alcohol. Ethylsulphuric Acid. Water. 

2}so 4 + °A|o = °A}so 4 + g}o. 

By the action of fresh alcohol on the ethylsulphuric acid it is decom- 
posed, ether being formed and sulphuric acid being reproduced. 

Ethylsulphuric Sulphuric 

Acid. Alcohol. Acid. Ether. 



C 2 H 5 

H 



} so * + ajt} = 5} SOj + ck}°- 



Theoretically this process might go on ad infinitum if fresh alcohol 
were continually supplied, but practically the acid volatilizes partly in 
the form of oil of wine, so that the process cannot go on indefinitely. 

Characters and Tests. — A colorless, very volatile and inflamma- 
ble liquid, emitting a strong and characteristic odor, and boiling below 
105°. Specific gravity 0-735. Fifty measures agitated with an equal 
volume of water are reduced to 45, by an absorption of 10 per cent. It 
evaporates without residue. 

Impurities. — Water, alcohol, and fixed impurities. 

Tests. — Water is detected by the greater sp. gr., and so is alcohol ; 
the fixed impurities by their remaining on evaporation. 

Dose.— 20 to 60 min. 

B.P. Peepaeattons. 

iEther Purus 

Collodium 6 volumes in 8 nearly. 

" Flexile 6 volumes in 8 " 

Liquor Epispasticus 4 volumes in 5 " 

Spiritus ^theris 1 volume in 3 " 

U.S. P. ^Etlier Fortior. Stronger Ether, (C 2 H 5 ) 2 ; 75. 

Peepabations. 
Spiritus JEtheris. Spiritus iEtheris Compositus. 

Characters. — A liquid composed of about 94 per cent, of ethyl 
oxide and about 6 per cent, of alcohol, containing a little water. Specific 
gravity not higher than 0-725 at 15° C. (59° F.) or 0-716 at 25° C. 
(77° F.). 

Ether is highly inflammable, and its vapor when mixed with air and 
ignited explodes violently. 

It should boil actively in a test-tube half filled with it and held a short 
time in the hand on the addition of small pieces of broken glass. 

Uses. — Used for inhalation as an anaesthetic. 

B.P. JEther Purus. Pure Ether. — Ether, C 4 H 10 O, free from 
alcohol and water. 

Preparation. — By washing ether with distilled water, and then dis- 
tilling from calcium chloride and recently calcined lime. 



062 ORGANIC MATERIA MEDICA. 

Uses. — Used as an anaesthetic ; to prepare some alkaloids, as 
aconitine ; to test the amount of quinine in bark. 
Test. — Specific gravity not exceeding 0*720. 

Spiritus iEtheris, TJ.S.P. and B.P. Spirit OF Ether. — It 
is a mixture of ether (1), rectified spirit (2). 
Test. — Specific gravity, 0*809. 
Dose. — 30 to 90 min. 

Peepaeation. 

B.P. 

Tinctura Lobeliae iEtherea. 

Uses. — Spirit of ether is used as carminative and stimulant. It is 
useful in lessening the pain in passage of biliary or urinary calculi. 

Action of Ether. — When applied to the skin ether evaporates very 
readily, and causes intense cold. The application of ether to the surface 
will freeze it completely, and render it perfectly insensitive to pain. If the 
freezing be continued for too long a time, the frozen part may be killed, 
and separate as a slough. In the niouth, ether acts as a powerful 
stimulant to the salivary secretion. In the stomach it increases the 
secretion of gastric juice, stimulates the movements of the organ, expels 
flatulence, and probably tends to increase the co-ordination of the move- 
ments of the stomach and intestine, so that it diminishes spasm and 
relieves pain. When absorbed into the circulation from the intestine, or, 
still more markedly, when absorbed from the lungs after an inhalation, it 
first stimulates the circulation, and, after a very brief, and perhaps 
hardly perceptible period of stimulation of the nerve-centres, it depresses 
their powers in succession. First of all it affects the cerebral hemis- 
pheres, causing delirium and unconsciousness ; next, the gray matter 
of the spinal cord ; next the white matter of the spinal cord, and 
lastly the cardiac and vaso-motor centres in the medulla oblongata. 
It does not appear to destroy the irritability of the muscles in animals 
poisoned by it, but muscles exposed to its vapor soon lose their contrac- 
tility, and fall into a condition of rigor mortis. Nerves, also, which are 
exposed to its vapor, lose their irritability, so that when attempted to be 
irritated, they no longer respond, the irritability of the sensory fibres 
apparently disappearing before that of the motor fibres. When the vapor 
is applied only for a short time, they may regain their irritability, but if 
its application be continued too long, the irritability is permanently 
destroyed. There is no marked alteration in the blood of animals 
poisoned by ether, but when mixed in small quantity with blood outside 
the body, it appears to form a compound with the lncmoglobin, and to 
lessen its oxidizing power. If mixed with the blood in large quantity, 
it destroys the blood corpuscles, probably by dissolving the protogon 
which forms an essential constituent of them. 

The heart is very much less easily paralyzed by ether than by chloro- 
form. If two rabbits are thoroughly narcotized by ether and chloroform 
vapor respectively, and the thorax opened, and artificial respiration kept 
up with air containing these vapors, the heart of one can be readily 
stepped by increasing the proportion of chloroform vapor in the air blown 
in, whereas the heart of the other is only arrested when the proportion 



CARBON COMPOUNDS FATTY SERIES. 663 

of ether vapor becomes exceedingly large. It is this peculiarity of ether 
which gives it the advantage over chloroform, and renders death from 
syncope during operations less probable when ether is employed as an 
anaesthetic. 

Another difference between ether and chloroform, which 
renders the former much safer as an anaesthetic, is that the vaso-motor 
centre appears, like the heart, to be very much less readily affected by 
ether than by chloroform, so that irritation of a sensory nerve continues 
for a longer time to raise the blood-pressure when ether is employed as 
an anaesthetic. The disadvantages of ether are that it is less agreeable 
to take, and that its odor hangs unpleasantly about the patient for a 
much longer time than is the case with chloroform. It causes greater 
irritation of the air passages, and may produce a catarrhal condition. It 
has to be administered in a more concentrated form than chloroform, 
and thus is not so convenient as the latter when operations on the face 
and mouth are necessary. It is frequently administered along with nitrous 
oxide, the nitrous oxide being first given alone until the patient is sufficiently 
under its influence not to notice the taste or smell of the ether. Nitrous 
oxide loaded with ether vapor is then given, and as soon as complete 
insensibility is induced air is mixed with ether vapor, the anaesthesia 
being maintained by regulating the proportion of vapor according to the 
condition of the patient. 

SALINE ETHERS. 

These correspond to metallic salts, in which the metal is replaced by 
an organic radical, e.g. : 

Potassium Sulphate. Ethyl Sulphate. 

1 1 S0 4 or K 2 S0 4 . £g | S0 4 or (C 2 H 5 ) 2 S0 4 . 

U.S. P. Oleum ^thereuin. Ethereal Oil. — A volatile 
liquid, consisting of equal volumes of heavy oil of wine and of stronger 
ether. 

The heavy oil of wine is either a mixture of ethyl sulphate (C 2 H 5 ) 2 
S0 4 , ethyl sulphite (C 2 H 5 ) 2 S0 3 , and a polymeric form of ethylene 
(C 2 H 4 ), or else a sulphovinate of a hydrocarbon radical. 

Preparation. — By mixing alcohol with sulphuric acid, allowing it 
to stand for twelve hours, and then distilling. The distillate consists of 
three layers — ether, water and yellow ethereal oil of wine. The yellow 
oil of wine is separated and exposed to the air for twenty-four hours in a 
shallow capsule, so that any ether evaporates. It is then put in a wet 
filter, washed with distilled water, and mixed with an equal volume 
of stronger ether. 

Characters. — A transparent, nearly colorless, volatile liquid, of a 
peculiar aromatic ethereal odor, a pungent, refreshing, bitterish taste, 
and a neutral reaction to dry litmus paper. Specific gravity, 0*910. 

Peepaeation. 
Spiritus iEtheris Compositus. 



664 ORGANIC MATERIA MEDICA. 

Spiritus ^Etheris Coinpositus, U.S. P. and B.P. COMPOUND 
Spirit of Ether. — Hoffmann's anodyne. 

Composition. — Stronger ether 30, alcohol 67, ethereal oil 3 parts. 

Use. — Like that of spirit of ether, but more powerful. It is given 
in similar doses. 

iEther Aceticus, U.S.P. and B.P. Acetic ^Ether. C 2 H 5 C 2 

H 3 2 ; 88. Acetate of Ethyl. 

Preparation. — By distilling rectified spirit with acetate of soda and 
sulphuric acid, NaC 2 H 3 2 + H 2 S0 4 + C 2 H ? = C 2 H 5 ,C 2 H 3 2 + NaH 
S0 4 -j- H 2 0. The acetic ether and water distil over together, and they 
are separated by means of calcium chloride. 

Characters. — A transparent and colorless liquid, of a strong fra- 
grant ethereal and somewhat acetous odor, a refreshing taste and a 
neutral reaction. 

Dose.— 20 to 60 min. 

Uses. — It has an action much like ether, but is inconvenient as an 
anaesthetic. It has a pleasanter taste than ether, and is used as a stimu- 
lant, carminative, and antispasmodic. It may be given along with the 
acetates of iron and potash in albuminuria. 

Spiritus JEtheris Xitrosi, U.S.P. and B.P. SPIRIT OF NlTROUS 
Ether. 

An alcoholic solution of ethyl nitrite (C 2 H 5 N0 2 ; 75), containing 5 
per cent, of the crude ether, U.S.P. A spirituous solution containing 
nitrous ether (C 2 H 5 N0 2 ; 75), B.P. 

Preparation. — By distilling rectified spirit with nitric and sulphuric 
acids and copper wire, and diluting the distillate with spirit. In this 
process the copper reduces the nitric to the nitrous radical. 

C 2 H 5 HO + HN0 3 + H 2 S0 4 + Cu = C 2 H 5 N0 2 + 2H 2 + CuS0 4 . 

Impurities. — Water, free acid. 

Characters and Tests. : — Transparent and nearly colorless, with a 
very slight tinge of yellow, mobile, inflammable, of a peculiar penetrat- 
ing apple-like odor, and sweetish cooling sharp taste. Specific gravity, 
0-845. It effervesces feebly or not at all when shaken with a little 
bicarbonate of soda (no acid). When agitated with solution of sulphate 
of iron and a few drops of sulphuric acid it becomes deep olive-brown or 
black. If it be agitated with twice its volume of saturated solution 
of chloride of calcium in a closed tube, 2 per cent, of its original volume 
will separate in the form of nitrous ether and rise to the surface of the 
mixture (proper strength). 

Dose. — 3 to 2 fluid drachms. 

Use. — Is used as a diaphoretic and diuretic. 

Preparation. 

U.S.P. 

Mistura Glycyrrhizie Composita. 

Amy] Nitris, U.S.P. and B.P. Nitrite of Amyl. C 5 H n N 2 2 ; 
117. 

Preparation. — By distilling dilute amyl alcohol with nitric acid, 
sulphuric acid and copper wire. The distillate is washed with caustic 



CAKBON COMPOUNDS FATTY SERIES. 665 

soda to remove hydrocyanic and other acids ; the moisture removed 
by potassium carbonate, and the nitrite purified by fractional distillation. 

Characters. — A yellowish liquid with a strong ethereal, fruity 
smell. When freely exposed to air it decomposes, leaving a large residue 
of amyl alcohol. Insoluble in water, but soluble in all proportions in 
alcohol, ether and chloroform. 

Impurities. — It is apt to contain free acid, nitrate of amyl, nitro- 
pentone. 

Tests. — The physiological test is the most certain. One or two 
sniffs from a bottle containing the nitrite are usually sufficient to produce 
flushing of the face and fulness in the head. If the preparation is impure 
or has lost its strength, this effect does not occur. Some specimens are 
entirely inert. 

Physiological Action. — When mixed with blood it forms methte- 
moglobin ; which is not so readily deoxidized as haemoglobin itself. The 
blood, under the influence of the nitrite, becomes of a dark chocolate 
color, both in the arteries and veins, and oxidation in the body is inter- 
fered with; so much so, that in rabbits convulsions almost exactly 
resembling those of ordinary asphyxia are very rapidly produced by the 
inhalation of the drug. The methaemoglobin may be broken up by 
reducing agents, and the blood will then take up oxygen again. It is 
therefore probable that when the venosity of the blood becomes great, the 
unoxidized products of tissue-waste will act as reducing agents, and again 
restore the internal respiration. When inhaled, nitrite of amyl causes 
at first a short, dry, tickling cough, followed in about half a minute by 
flushing of the face, throbbing of the carotids and their branches, a 
quicker and fuller pulse, a feeling of tension in the head, sometimes 
lachrymation, quickened respiration and giddiness. The giddiness is 
more especially felt if the patient is sitting up. If the dose of nitrite be 
large the respiration becomes very quick, labored and dyspnceic. The 
blood-pressure is very greatly lessened by nitrite of amyl, the dimi- 
nution being chiefly due to dilatation of the arterioles. The pulse in 
man and in dogs is very much quickened by it. In rabbits the accelera- 
tion is not so great. This appears to show that the quickening is in a 
great measure due to diminution in the tone of the vagus roots in the 
medulla, caused by the fall of blood-pressure. The dilatation of the 
arterioles appears to be due to weakening or paralysis, either of the mus- 
cular walls of the arterioles themselves, or of the vaso-motor ganglia in 
or near them. This is shown by the fact that the nitrite of amyl lowers 
the blood-pressure in animals, even after the cord has been divided just 
below the medulla. It has been objected to this that Bernheim has found 
that when the capillaries are dilated by nitrite of amyl they may still be 
made to contract, by irritation of the vaso-motor nerves ; and he concludes 
from this that the dilatation is due rather to paralysis of vaso-motor centres 
than to vaso-motor nerves, or to the arterioles. It is possible that the 
dilatation may be partly due to weakening of the vaso-motor centres also ; 
but Bernheim' s objection is altogether without force, because in animals 
killed by curare, the muscles will still contract on the application of an 
electric current to the motor nerves. In this case the nerves are so far 
paralyzed that they will no longer respond to the stimuli sent down from 



666 ORGANIC MATERIA MEDICA. 

the nerve-centres, although they will do so to strong currents, and proba- 
bly the same thing occurs with the muscular walls of the arterioles when 
paralyzed by nitrite of amyl. 

Action on Muscles. — The voluntary muscles are not paralyzed in 
animals poisoned by nitrite of amyl, but when the muscles of a frog are 
exposed to the vapor they soon lose their contractility. It was stated by 
Dr. Richardson that nitrite of amyl, like curare, paralyzed the ends of 
the motor nerves, and that it acted in consequence as an antidote to 
strychnia. On repeating his experiments other obseiwers have failed to 
detect any paralysis of motor nerves ; I have found that nitrite of amyl 
alone does not paralyze them, nor does strychnine alone, but if a frog be 
poisoned with strychnia after one leg has been protected by a ligature 
from the influence of poison, and is then exposed to the vapor of nitrite 
of amyl, the joint action of the strychnine and nitrite paralyzes the ends 
of the motor nerves, while the nerves of the limb protected from the 
strychnine retain their irritability, although both were equally exposed to 
the nitrite of amyl. 1 

Action on the Nervous System. — It lessens reflex action, appa- 
rently by its action on the spinal cord. 

On the Urine. — When nitrite of amyl is given to animals either by 
inhalation or hypoclermically, sugar appears in the urine. 

Uses. — The action of nitrite of amyl in causing flushing was first 
observed by Guthrie, and Dr. B. W. Richardson recommended it as a 
remedy in spasmodic conditions, from the power he thought it to possess 
of paralyzing motor nerves. In the spring of 1867, I had opportunities 
of constantly observing a patient who suffered from angina pectoris, and 
of obtaining from him numerous sphygmographic tracings, both during the 
attack and during the interval. These showed that during the attack the 
pulse became quick, the blood-pressure rose, and the arterioles contracted ; 
for the form of the pulse curve was such as could only be caused by con- 
traction of the arterioles (Fig. 135). The pain, which came on every 




FlO. 135.— Normal pulse-tracing of a patient suffering from aortic regurgitation and angina pectoris. 

night, lusted for one and a half or two hours. All other remedies were 
Dearly useless, though bleeding always removed the pain for one night. 
It seemed probable that the great rise in tension was the cause of the 
pain, and it occurred to me that if it was possible to diminish the tension 
by drugs instead of* by bleeding, the pain would be removed. 

I knew from unpublished experiments by Dr. A. Gramgee, that nitrite 
of amy] had this power, and therefore tried it on the patient. My expec- 
tations \u-rc perfectly answered. The pain usually disappeared in three- 

1 These experiments were made with Rana temporaries 



CARBON COMPOUNDS FATTY SERIES. 667 

quarters of a minute after the inhalation began, and at the same time the 
pulse became slower and much fuller, and the tension diminished. Occa- 
sionally the pain would disappear, though the pulse regained its normal 
fulness, and on these occasions the pain always reappeared after the lapse 
of a few minutes (Fig. 136). Whenever the pulse again regained its 




Fig. 136. — Tracing of the same pulse during severe anginal pain. 

normal character completely (Fig. 137), I knew that the pain would not 
again return. 




Fig. 137. — Tracing of the same pulse during temporary relief of pain by nitrite of amyl. The pain 

returned after a few minutes. 

In some cases of angina pectoris nitrite of amyl has failed. One 
reason of this may be either that the drug has not been pure, or that it 
has undergone changes from age. In one case mentioned to me by Dr. 
Balfour, the patient was only relieved by nitrite of amyl newly made, 
the drug appearing to lose its power in a few days. From its power of 
relaxing vascular spasm, I used it in headache and found it occasionally 
serviceable. As migraine is generally connected with vascular spasm, I 
employed the nitrite of amyl in headache, and found that frequently, 
though not invariably, it relieved the pain. It was also useful in neu- 
ralgia of the scalp. As epilepsy has been supposed to depend upon 
spasmodic contraction of the cerebral vessels, I employed it in this 
disease, during the fit, without success, but Dr. Crichton Browne found 
that when administered immediately after the appearance of the aura it 
prevented the fit which would otherwise have come on. In sea-sickness, 
a disease probably of cerebral, rather than gastric origin, nitrite of amyl 
appears to give relief. It has been employed to aid circulation in cases 
of syncope, and in chloroform poisoning, its administration in the latter 
case being combined with the depression of the patient's head below the 
level of his body, and the use of artificial respiration. In spasmodic 
asthma it sometimes affords some relief, but this is not very marked. It 
is useful in the case of persons who are subject to sudden flushes of heat 
and profuse perspiration. 

The administration of nitrite of amyl is not attended with much 
danger. I have pushed it in many cases, and have seen no bad effects 
from its use. In cases of chronic bronchitis and emphysema, however, 
it is advisable not to give it even for the relief of asthmatic attacks 
which come on in this disease, as the difficulty of breathing already 
present may be seriously increased by the action of the drug upon the 
blood. It has been thought that its administration would be especially 



668 ORGANIC MATERIA MEDICA. 

dangerous in aortic disease ; and no doubt it is well both in this disease 
and in other cases to give the drug in the recumbent posture and thus 
avoid the faintness which might otherwise occur. Although it causes a 
feeling of fulness in the head, little danger of apoplexy is to be 
apprehended from it, because the blood-pressure, instead of being higher, 
is much lower than usual, and therefore the tendency of the vessel 
to burst must be reduced to its minimum. 

Xitro-glycerinuin. NiTRO-GLYCERlNE, Glonoine. C 3 H 5 (N0 3 ) 3 . 
Not officinal. 

Preparation. — By dropping pure glycerine into a mixture of sul- 
phuric and nitric acid kept cool by ice, pouring the mixture into water ; 
washing it well ; and carefully drying in a warm room. 

Properties. — A colorless transparent liquid ; aromatic taste ; slightly 
soluble in water, readily soluble in absolute alcohol and ether, soluble also 
in oils and fats. 

Dose. — ^iTo t0 oV increased to -^ grain. 

Peepaeations (Non-officinal). 1 

DOSE. 

Liquor Nitro-glycerini (1 gr. in 100 min. rectified spirit)... J-10 min. 

Pilula Nitro-glycerini ( 3 V or -jfa gr. with cacao butter) 1-2, or more. 

Trochisci Nitro-glycerini. (Nitro-glycerine tablets). ( T ^gr. 

in chocolate) 1-2, or more. 

Action. — Its action is much like that of nitrite of amyl and other 
nitrites, but is more persistent. In frogs it causes at first great rest- 
lessness, then lethargy, to which convulsions and paralysis succeed. In 
mammals it causes depression, with very rapid pulse and respiration, 
paralysis of reflex action and voluntary motion, loss of sensation, and 
death by stoppage of the respiration. It agrees with nitrites in acting 
as a poison to muscle. The spinal cord appears to be paralyzed 
before the cerebral ganglia, and the convulsions in frogs are of cerebral 
rather than spinal origin. It paralyzes the heart of the frog when 
directly applied. It diminishes the oxidizing power of the blood and 
communicates to it a chocolate color, like nitrites, and like them also it 
lessens the blood-pressure. In some persons it produces intense 
headache even in exceedingly minute doses. It is curious that its 
action upon the blood and organs should so exactly resemble that of 
nitrites, because nitro-glycerine is a nitrate and not a nitrite of glyceryl. 
Hay has shown, however, that nitro-glycerine is decomposed by alkalies, 
two-thirds of its nitric acid being reduced to nitrous acid and uniting 
with the alkali to form a nitrite, whilst the remaining third is set free 
without reduction and forms a nitrate. 

The reasons why nitro-glycerine acts more powerfully than nitrites 
probably are that the whole of it is absorbed without decomposition, and 
that nitrous acid being set free in the blood in a nascent condition is 
more active than it would otherwise be. 

USES. — Like nitrite of amyl, it is useful in angina pectoris, head- 
ache, neuralgia, epileptic vertigo, and epilepsy. Its action being more 

1 Mart judaic and Westcott, The Extra Pharmacopoeia. 



CARBON COMPOUNDS — FATTY SERIES. 669 

persistent than that of nitrite of amyl, it is sometimes more efficacious. 
It sometimes is of service in spasmodic asthma, uraemic asthma, and in 
puerperal convulsions. It frequently relieves sea-sickness, and may 
lessen pain in gastralgia and hepatic colic. By dilating the vessels it 
may cut short or prevent the cold stage of ague. By lessening the 
arterial tension and diminishing the resistance the heart has to overcome, 
it is useful when the heart is weak in old persons, or from fatty degenera- 
tion, or where the tension is abnormally high, as in Bright's disease. In 
conjunction with elaterium it is said to have proved useful in myxoedema. 

HALOID COMPOUNDS. 

These correspond to haloid salts of metals, e.g. : 

Potassium Bromide. Ethyl Bromide. 

KBr. (C 2 H 5 )Br. 

^thyl Bromidum. Bromide of Ethyl. C 2 H 5 Br (Hydro- 
bromic Ether). — Not officinal. 

Preparation. — By distilling alcohol with bromine and phosphorus. 

Characters. — A colorless volatile liquid; of peculiar odor; sweetish 
taste. Specific gravity, 1-419. 

Action and Uses. — When applied as spray it produces local anaes- 
thesia, which seems to depend on the action of the drug on the nerves 
as well as on the cold produced. It is used as a local anaesthetic in 
neuralgia. When inhaled it produces anaesthesia, and has been 
recommended as an anaesthetic either alone or as a mixture of 1 part of 
it with 3 of chloroform and 4 of alcohol. Its advantages are that it is 
not inflammable like ether, that it does not irritate the respiratory pas- 
sages, and that it causes less excitement and struggling than ether or 
chloroform, and is less depressing than chloroform. Its disadvantages 
are that it is not absolutely safe, as one death at least has occurred from 
its use. Its odor remains longer in the breath than either chloroform or 
ether, and some patients dislike its smell extremely. 

JEthyl Iodidum. Iodide OF Ethyl, C 2 H 5 I. (Hydriodic Ether). 
— Not officinal. 

Preparation. — Like bromide of ethyl, using iodine instead of 
bromine. 

Characters. — A colorless liquid, with a penetrating odor. It is 
apt to become decomposed by keeping, and acquire a brown color from 
free iodine. 

Action and Uses. — It has an anaesthetic action when inhaled, 
which is more slowly produced but is more persistent than that of ethyl 
bromide. It is decomposed in the body, and the iodine is excreted in 
the urine as iodide of potassium. It has been given internally as an 
alterative in doses of 0*2 to 0*5 Gm. in scrofula and rheumatism, and 
as a diuretic in cases of cardiac dropsy. Its chief use, however, is as 
an antispasmodic in asthmatic paroxysms, either of the purely spas- 
modic kind, or occurring in chronic bronchitis and emphysema, or in 
cardiac or laryngeal disease. In some of these cases it gives very great 



670 ORGANIC MATERIA MEDICA. 

relief, and not only cuts short the paroxysm, but benefits the bronchitic 
condition, where this is present (cf. p. 520). 

Administration. — It is best given in small glass capsules, containing 
5 minims, and incased in cotton-wool and silk. These can be readily 
carried about, and when the paroxysm comes on one is crushed between 
the finger and thumb, and the vapor inhaled from the cotton-wool, which 
becomes soaked by the iodide. 

Chloral, U.S. P.; Chloral Hydras, B.P. C 2 HCl 3 O.H 2 0; 1652. 
Chloral, U.S. P.; Hydrate of Chloral (Chloral Hydrate), B.P. 

Preparation. — By saturating absolute alcohol with dry chlorine 
gas much hydrochloric acid gas is formed, and the alcohol is first reduced 
to aldehyde, which is then attacked by the chlorine, forming XxicMoral- 
dehyde, a word which has been shortened to chloral. Chloral is an oily 
liquid, which unites with a small quantity of water to form chloral 
hydrate. 

Characters. — Whitish crystals with a peculiar very pungent odor, 
a bitterish caustic taste, and a neutral reaction. It melts when heated, 
forming colorless liquid, and volatilizes if the temperature be further 
raised. It is soluble in less than its own weight of water, alcohol, or 
ether, and in four parts of chloroform. When mixed with carbolic acid 
or camphor it liquefies. When mixed with alkalies it is decomposed 
into chloroform and a formate of the base. 

Impurities. — Hydrochloric acid and oily impurities. 

Test. — The aqueous solution should be neutral or only slightly acid. 
A solution in chloroform when shaken with sulphuric acid should not 
impart color to the acid (absence of oily impurities). 

Prepaeatiox. 

B.P. DOSE. 

Syrupus Chloral. Syrup of Chloral. Chloral in syrup 

and water, 10 grs. in each fl. dr 1 fl. dr. 

Action of Anhydrous Chloral. — Anhydrous chloral applied to 
the skin is absorbed and converted in the organism into chloral hydrate. 
When thus applied it sometimes occasions hemoglobinuria and nephritis. 
Anhydrous chloral being little used, the name "chloral" is applied in 
ordinary conversation to chloral hydrate, and in the following account of 
the action of chloral hydrate the name chloral is intended to apply to the 
hydrate. 

Action of Chloral Hydrate. — It destroys low organisms, and 
prevents the decomposition which they occasion. It is therefore some- 
times used as an antiseptic. In the mouth chloral has a hot, burning 
taste, and when applied to a raw surface, or to the mucous membrane of 
the eve it is a powerful irritant. When injected under the skin in a strong 
solution it is apt to cause inflammation and suppuration. It was intro- 
duced into medicine by Oscar Liebreich, with the object of attaining by it 
the same effect- as those of chloroform slowly administered for a length of 
time. When chloral is mixed with an alkali it is split up, yielding formic 
acid, which combines with the alkali and chloroform. Liebreich thought 
that if chloral were administered internally the alkalies of the blood 



CARBON COMPOUNDS FATTY SERIES. 671 

would slowly split it up, and that chloroform would thus be slowly gene- 
rated from it in the circulating blood for a considerable length of time. 
His expectations regarding the utility of chloral as a means of producing 
sleep and relieving pain have been fully answered, but the theory which 
led him to employ chloral appears to be erroneous, and it probably acts as a 
hypnotic and analgesic without undergoing any decomposition in the body. 
The experiments which have led to the conclusion that chloral is not 
decomposed in the body are chiefly those of Hammersten, who found that 
when a stream of carbonic acid was passed through the blood taken from 
chloralized animals, and then passed through a red-hot tube into a mixture 
of starch paste and iodine or a solution of nitrite of silver, no reaction 
occurred, and that the slightest addition of chloroform to the blood or the 
administration of the chloroform to the animal beforehand always caused 
a reaction to take place. The expired air of chloralized animals is also 
free from chloroform. The chloral is excreted in the urine as such 
so long as the urine is acid, and it is only when the urine is alkaline 
that chloroform is found in it, this being formed by the decomposition 
of the chloral by the alkali in the urine itself. In frog's, small doses slow 
the respiration, and abolish reflex action, but the animal recovers perfectly 
after several hours. When the dose is increased, the stoppage of the 
heart follows the cessation of reflex movements and the animal dies. In 
mammals, the respiration also becomes slow, the pupil contracted, and 
sleep occurs. From this the animal may first be awakened with ease, but it 
gradually becomes deeper, and the reflex movements disappear. Insensibility 
occurs first to painful impressions, so that the animal may be cut or burned 
without showing the slightest symptoms of sensation, whereas it will still 
withdraw its limb quickly when a slight pressure is made upon the toes. 
When larger doses are given, the temperature gradually falls until it can 
no longer be measured by an ordinary clinical thermometer. The respi- 
ration gets slower and weaker, and finally ceases altogether. When 
chloral is added to the blood, it causes the red corpuscles to swell up and 
become paler, but does not dissolve them. 

Action on the Circulation. — It diminishes the blood-pressure in 
two ways — first by weakening and finally paralyzing the vaso-motor 
centre, and thus dilating the vessels; and secondly, by weakening the 
heart. The pulse may at first be quickened, possibly, in consequence 
of the lessened blood-pressure, but it afterwards becomes slow. The slow- 
ing of the pulse is not due to any action of the drug upon the vagus, 
for it occurs after section of the vagi, or after the previous administration 
of nicotine, atropine, or curare. The weakening and final stoppage of the 
heart appears to be due to paralysis of the cardiac ganglia, as the heart 
still continues to contract when its muscular substance is irritated directly. 

Action on Muscles and Motor Nerves. — The muscles and 
motor nerves are not paralyzed by chloral. The paralysis and loss of 
sensibility is of spinal origin. 

Action on the Spinal Cord. — Chloral first increases and then 
diminishes the excitability of the spinal cord, and finally abolishes it 
altogether. It probably acts first upon the gray matter, as impressions 
which are usually painful are not felt at a time when tactile impressions 
still produce reflex. 



672 ORGANIC MATERIA MEDICA. 

Action on the Brain. — At first it may cause a little excitement 
of the brain, followed by sleep, and then by coma. These actions are 
probably due partly to the influence of the drug on the circulation, and 
partly to its direct action on the cerebral tissue itself. In the first stage 
of excitement the circulation in the brain is somewhat increased, but as 
sleep comes on the vessels contract and the brain becomes anaemic. 

The pupil is almost invariably contracted ; the temperature, as has 
already been mentioned, falls steadily and rapidly, and this fall appears 
to be due partly, though not entirely, to lessened production of heat, 
for it still occurs, though to a less extent, when the animal is wrapped up 
in cotton-wool, or is put in a warm place. 

The Treatment of Chloral Poisoning. — In conjunction with 
Professor Strieker, I found that animals which had received a dose of 
chloral which would certainly kill them if they were left exposed, w T ould 
recover from the effects of such a dose if they were wrapped up in cotton- 
wool. If the dose be still further increased, so as to kill the animal even 
when carefully so wrapped up, it may still be kept alive by being put in 
a warm place, so that its temperature is kept up artificially. If, how- 
ever, the dose be still further increased, the animal will die, notwith- 
standing these precautions. The treatment of cases of poisoning in man 
is the same as in animals, viz., to keep up the temperature of the patient 
by putting him in a warm room, covering him with blankets, and apply- 
ing hot bottles. 

Uses. — If equal parts of chloral and powdered camphor are rubbed 
together, they dissolve, and form a syrup. This is useful in neuralgia, 
when painted over or gently rubbed into the painful part. 

The chief use of chloral is to produce sleep. It is useful as a hypnotic 
in the sleeplessness due to overwork or worry, and the wakefulness 
depending on constitutional peculiarity, old age, or disease, such as fever, 
delirium tremens, insanity, and puerperal mania. In the later stages of 
Bright's disease, where there is great sleeplessness accompanied by high 
blood-tension, chloral is very useful. The sleep which it causes is 
generally quiet and refreshing, and as a rule it is not followed next day 
by sickness, headache, and depression, like the sleep caused by opium. 
Usually, also, the sleep is not too deep to prevent the patient being 
readily awakened for the purpose of taking food. 

Chloral may be used to lessen reflex excitability and diminish con- 
vulsions, as well as to produce sleep. For this purpose it is given in 
puerperal convulsions, in the convulsions of children, and in chorea and 
tetanus. In these two latter diseases it must be given in large doses. 
It alleviates the dyspnoea in spasmodic asthma, and the asthmatic 
attacks which occur in persons laboring under chronic bronchitis with 
emphysema. In cases of this sort, however, it is well to give it with 
care, for Ringer states that in them it often produces increased lividity 
and muttering delirium, lasting for several days. 

The action of chloral as an anaesthetic or analgesic is much slighter 
than that of chloroform, but nevertheless it sometimes relieves pain, and 
for this purpose it has been used in gastralgia, intestinal and renal colic, 
neuralgia, and chronic rheumatism. It has been recommended by Dr. 
Play fair in doses of 15 grains, repeated, if necessary in twenty minutes, 



CARBON COMPOUNDS FATTY SERIES. 673 

and before the os uteri has become completely dilated, to lessen pain in 
labor. 

Chloral is an antidote to strychnine, physostigma, and picrotoxin. 
Liebreich states that strychnia is an antidote to chloral; and while some 
observers have confirmed his statement, others have denied it, so that 
strychnine has certainly not the same power of antagonizing the action 
of chloral as chloral has of antagonizing strychnine. 

Chloral is a useful remedy in sea-sickness, and in the incontinence of 
urine in children. 

Bromal Hydrate. C 2 H 3 OH. — Not officinal. 

Preparation. — It is prepared in the same way as chloral hydrate, 
bromine vapor being employed in the place of chlorine. 

Characters. — An oily, colorless substance, with a strong smell and 
burning taste. 

Action. — It irritates the eyes and produces running at the nose. It 
has a narcotic action like chloral, but causes more excitement and less 
profound sleep. It has a more powerful paralyzing action on the heart, 
and is poisonous in smaller doses than chloral. It generally causes 
salivation, and profuse secretion from the bronchial mucous mem- 
brane accompanied by congestion. In toxic doses it produces cyanosis, 
dyspnoea, and death with convulsions, which are probably due, in great 
measure at least, to clogging of the respiratory passages. 

Use. — It is said to have been of use in epilepsy. 

Butyl Chloral Hydrate. Croton Chloral Hydrate. — Not 
officinal. 

Preparation. — By acting on aldehyde with chlorine. 

Characters. — It forms white, pearly, crystalline scales, with a pun- 
gent smell and acrid, disagreeable taste. It is sparingly soluble in water 
{1 in 100), but is readily soluble in glycerine (1 in 4). 

Dose. — To lessen pain, 1 J— 5 gr. (0*1— 0*3 Gm.) ; as hypnotic, 5-15 
gr. (0-3-1-0 Gm.). 

Action. — It acts much like chloral, though less powerfully, and has 
a less depressing effect on the heart, and is much less poisonous than 
chloral. It is said by Liebreich to affect the fifth nerve especially, and 
cause anaesthesia in the parts supplied by it before general anaesthesia 
is produced. 

Uses. — It has been used especially in facial neuralgia and migraine, 
and paroxysmal toothache. It has been used also as a hypnotic instead 
of chloral in cases of weak heart. 

Administration. — The disagreeable taste is best covered by syrup 
of tolu, and it may be suspended in almond mixture or mucilage. 

Bichloride of Methylene. CH 2 C1 2 . — Not officinal. 

Preparation. — By acting on chloroform with nascent hydrogen, 
CHCls + H 2 = CH 2 C1 2 + HC1. 

Characters. — A colorless, volatile liquid, with a smell like chloro- 
form. Sp. gr. 1-344. Boiling-point, 40° C. (104° F.). 

Action. — Like that of chloroform, but more rapid, though a larger 
quantity is required. It is said to depress the action of the heart more 
43 



674 ORGANIC MATERIA MEDICA. 

than chloroform, but it has been found a very satisfactory anaesthetic in 
ovariotomy, and is more used than other anaesthetics in this operation. 

It is very doubtful whether the substance sold as bichloride of methyl- 
ene is anything but a mixture of chloroform and alcohol, as the pure 
substance is expensive. 

Cliloroformmn Venale, U.S. P. ; Chloroformum, B.P. CHLO- 
ROFORM. CHC1 3 ; 119-2. 

Preparation. — By distilling alcohol with chlorinated lime and slaked 
lime, washing the distillate with sulphuric acid, and redistilling from 
slaked lime and calcium chloride. 

In this process the alcohol probably first becomes reduced to aldehyde. 
From the aldehyde, chloral is formed, and this is broken up by the caustic 
lime into formate of calcium and chloroform. 

Aldehyde. Chloral. 

C 2 H 4 + 3C1 2 = C 2 HC1 3 + 3HC1. 

Formate of Calcium. Chloroform. 

2C 2 HC1 3 + Ca2HO = Ca2CH0 2 + 2CHC1 3 . 

Or, disregarding the intermediate steps, the reaction may be represented 
thus : — 

Alcohol. Calcium hypochlorite. 

4C 2 H 6 + 8CaCl 2 2 = 2CHC1 3 + 3(Ca2CH0 2 + 5CaCl 2 + 8H 2 0). 

Characters and Tests. — A limpid, colorless liquid, of an agreeable 
ethereal odor, and sweet taste. Dissolves in alcohol and ether in all pro- 
portions; and slightly in water, communicating to it a sweetish taste. 
Burns, though not readily, with a green and smoky flame. Specific gravity 
1*49. It is not colored by agitation with sulphuric acid, leaves no residue 
and no unpleasant odor after evaporation. 

Impurities. — Hydrochloric acid, chlorine, hydrocarbons, alcohol. 

Tests. — The same as those of purified chloroform. 

Dose. — 3 to 10 min. 

U.S.P. Chloroformum Purificatum. Purified Chloroform. 
CHC1 3 ; 119-2. 

Preparation. — By mixing chloroform (200) with sulphuric acid (60) 
and allowing them to stand, with occasional shaking, for twenty-four 
hours ; then separating the lighter liquid and adding to it carbonate of 
sodium (10) previously dissolved in water (20). The mixture is then 
agitated thoroughly for half an hour and set aside. The chloroform is 
then separated from the supernatant layer, mixed with alcohol (2), trans- 
ferred to a dry retort, and lime (1) is added, and the liquid distilled, 
taking care that the temperature does not rise above 67°-2 C. (153° F.), 
into a well-cooled receiver, until the residue in the retort is reduced to 2 
parts. 

TESTS. — If 5 c.c. of purified chloroform be thoroughly agitated with 
10 cc. of distilled water, the latter when separated should not affect blue 
litmus paper (absence of acids), nor test solution of nitrate of silver 
(chloride), nor test solution of iodide of potassium (free chlorine). If a 
portion be digested warm with a solution of potassa, the latter should not 
become dark-colored (absence of aldehyde). On shaking 10 c.c. of the 






CARBON COMPOUNDS FATTY SERIES. 675 

chloroform with 5 c.c. of sulphuric acid, in a glass stoppered bottle, and 
allowing them to remain in contact for twenty-four hours, no color should 
be imparted to either liquid. If a few c.c. be permitted to evaporate from 
blotting-paper, no foreign odor should be perceptible after the odor of 
chloroform ceases to be recognized. 

Peepaeations. 
u.s.p. 

Linimentum Chloroformi 40 per cent. 

Mistura Chloroformi 8 per cent. 

Spiritus Chloroformi 10 per cent. 

B.P. 

Linimentum Chloroformi 1 volume in 2. 

Spiritus Chloroformi 1 volume in 20. 

Tinctura Chloroformi Composita 1 volume in 10. 

Linimentum Chloroformi, U.S.P. and B.P. LINIMENT OF CHLOEOFOEM. Com- 
mercial chloroform 40, soap liniment 60, U.S.P. ; Equal parts of chloroform and of 
camphor liniment, B.P. 

U.S.P. Mistura Chloroformi. Chloeofoem Mixtuee. Purified chloroform 8, 
camphor 2, fresh yolk of egg 10, water 80. 

Dose. — 1 to 2 tablespoonfuls. 

Spiritus Chloroformi, U.S.P. and B.P. SPIEIT OF CHLOEOFOEM. Purified chlo- 
roform 10, alcohol 90, U.S.P.; Chloroform 1 fl. oz., rectified spirit 19 fl. oz., B.P. 
Dose.— 20 to 60 min. 

B.P. Tinctura Chloroformi Composita. COMPOUND TlNCTUEE OF CHLOEO- 
foem. Chloroform 2 fl. oz., rectified spirit 8 fl. oz., compound tincture of carda- 
moms 10 fl. oz. 

Dose.— 20 to 60 min. 

Uses. — The liniment is used as a stimulant and local anaesthetic. Spirit of 
chloroform, chloroform mixture, and compound tincture are used as carminatives 
and sedatives. 

Action of Chloroform. — When mixed with albumen, chloroform 
produces a precipitate, but renders the supernatant albumen more easily 
filtered than before. It is a powerful solvent of protogon, which 
forms the essential ingredient both of the nerve centres, of the nerves 
themselves, and of the red blood corpuscles, and some authors have 
considered that to this solvent property the action of chloroform as 
an anaesthetic was, in some measure at least, due. This, however, is 
at present hypothetical. It appears to lessen the oxidizing power of 
the blood, although not to a very great extent, for the diminution of 
this power is hardly perceptible in the blood of animals poisoned by 
chloroform, although distinct in blood which has been mixed with it. When 
applied to the skin, it evaporates rapidly, and produces a feeling of cold. 
When its evaporation is prevented, it passes through the epidermis, and 
acts as an irritant on the skin, producing rubefaction, and leaving behind 
a painful burning spot, or even vesication. It greatly assists the absorp- 
tion of organic alkaloids by the skin, so that a number of them will pass 
through the epidermis and be absorbed with considerable ease when 
mixed with chloroform, although they would not pass through at all if 
applied as an alcoholic solution. In the mouth it has an exceedingly 
sweet taste, and stimulates the secretion of saliva. When swallowed in 
large quantities, it acts first as an irritant, producing gastro-enteritis, 
and afterwards, from its absorption, will cause anaesthesia and coma, so 
that the vomiting, pain at the epigastrium, and purging, which are first 



676 ORGANIC MATERIA MEDICA. 

observed, gradually pass off, and are succeeded by stupor, coma, and 
abolition of reflex sensibility, which may either end in death or may pass 
off, while the irritation of the intestines and stomach may continue for 
some time afterwards. In small doses it probably stimulates the secre- 
tion of gastric juice and the movements of the stomach, and both 
increases and co-ordinates more perfectly the movements of the stomach 
and intestines, so that it causes expulsion of flatulence and relieves 
griping. 

After absorption into the blood, either from the stomach or from the 
lungs, it acts on the nervous system in somewhat the same way as 
alcohol, paralyzing the nerve-centres in much the same order. Its action, 
however, is more rapid than that of alcohol, and it does not appear to pro- 
duce the stimulation without derangement of the mental faculties which 
marks the first stage of the action of alcohol. Chloroform appears to 
derange the mental faculties from the very first. The effect of chloro- 
form may generally be divided into three stages: (1) of imperfect 
consciousness, (2) of excitement, and (3) of anaesthesia ; or perhaps one 
might divide it more exactly into four stages (p. 188), and add a fourth 
stage, that of paralysis. Its first effect is to produce a feeling of 
warmth over the surface, with affection of the optic and auditory nerves, 
noises being heard in the ears, and a sensation of light experienced in 
the eyes. There is also a feeling of oppression at the chest, and some- 
times a choking sensation, occasionally accompanied by cough. The 
choking and cough are more especially felt if the vapor is administered 
in too concentrated a form, and not unfrequently the patient will put up 
his hand to try and take away the cloth containing the chloroform. 
External impressions are now slightly felt, sounds are faintly heard, 
questions are slowly and imperfectly answered, and any sensation of pain 
which may be present becomes greatly diminished or entirely disappears. 
In children and weak persons this stage may pass into that of complete 
anaesthesia, but in most cases it is succeeded by the stage of excitement. 
The patient is no longer conscious of what is going on around him, but 
he may, according to his temperament, sing, shout, or struggle violently. 
The violent struggles are more especially noticed in men of irritable 
temperament, who have been accustomed to the use of alcoholic stimulants. 
In them the excitement is greater, and more chloroform is required in 
order to produce the stage of complete anaesthesia. During the violent 
struggles, the efforts of the patient may induce him to hold his breath 
until suffocation seems impending ; the face becomes livid, the eyes 
prominent, and the jugulars distended. The struggling is usually less 
in women than in men, and is less in patients exhausted by previous 
illness. In women, hysterical sobbing or crying may occur ; occasionally 
indications of venereal excitement have been observed, and even a com- 
plete venereal orgasm. When the chloroform is pushed, this stage soon 
subsides, and the patient passes into the state of complete anaesthesia. 
The limbs become flaccid; when the hand is taken up it falls like that of 
a corpse ; painful stimuli produce neither reflex action nor any indication 
of sensation. The last reflex actions to disappear are those from the con- 
junctiva, the anus, and the vagina. When touching the conjunctiva no 
longer causes reflex contraction of the eyelid, anaesthesia may be regarded 






CARBON COMPOUNDS — FATTY SERIES. 677 

as complete, and surgical operations may be commenced. During the 
administration of chloroform the respiration is generally first rendered 
somewhat slow, then quicker, and lastly steady, unless the anaesthetic be 
pushed too far, when it again becomes slower and weaker, and finally 
ceases altogether. The pulse is usually affected in a similar manner. 
The reason of this appears to be that the chloroform vapor, as it descends 
the respiratory passages, successively irritates those parts with which it 
comes immediately in contact, (1) the nasal mucous membrane, (2) the 
larynx, and (3) the lungs. It causes, through the nerves of the nose 
and larynx (p. 216), reflex slowing of the respiration and reflex slowing 
of the pulse. As these nerves gradually become paralyzed by the action 
of the drug, its stimulating effect on the branches of the vagus distributed 
to the lung becomes manifest in accelerated respiration, usually accom- 
panied by a quickened pulse. Next, as the drug continues to act, it 
paralyzes those nerves also, and the respiratory centre being now no 
longer affected by any reflex irritation, continues to keep up the respira- 
tory movements with a somewhat slow and steady rhythm. If the drug 
be now pushed still further, the respiratory centre itself becomes para- 
lyzed, the respirations become still slower aud feebler, and finally cease 
altogether. These alterations in the respiratory rhythm during the 
administration of chloroform may sometimes be more or less interfered 
with by the effect upon the respiratory centre of blood which has become 
venous in consequence of the altered respiratory movements. The action 
of the heart is also modified by chloroform, the pulse usually becoming 
somewhat slower just at first ; then accelerated during the whole period 
of excitement ; and afterwards steady, at or below its normal rate. The 
"blood-pressure is usually lowered, and if the chloroform vapor be 
strong the pressure may fall very considerably, and may even be reduced 
to zero. The fall of blood-pressure is probably due in great measure to 
the dilatation of the vessels, but it may also be partly owing to enfeebled 
action of the heart, even at the beginning of the anaesthesia. When the 
chloroform has been pushed so far as greatly to lower the blood-pressure, 
the fall is caused, to a great extent, by the weakening of the heart. The 
dilatation of the vessels is not due to paralysis of the vaso-motor nerves, 
for these, when irritated directly, will still cause the artery to contract 
during chloroform narcosis. It appears to be due to paralysis of the vaso- 
motor centre. The reflex power of this centre is first diminished, and 
then abolished, by chloroform, so that irritation of a sensory nerve, during 
imperfect chloroform narcosis, causes only a slight rise of blood-pressure, 
and in perfect narcosis no rise at all. 

The tension of the intercellular fluid and the lymph in the eye 
appear to be diminished, so that the mammae become flaccid, the intra- 
ocular tension is diminished, and irregular astigmatism may occur. 

The nervous system appears to be paralyzed in the following 
order : first, the cerebral hemispheres ; next, the gray matter of the 
cord ; next, the white matter ; next, the reflex power of the medulla 
oblongata; next, the automatic power of the respiratory centre, and 
lastly, the cardiac ganglia. 

The order in which the nerve-centres are paralyzed may sometimes 
be changed, and the heart may be affected before the respiration. 



678 ORGANIC MATERIA MEDICA. 

Dangers of Chloroform. — Cases may arise where it is impossible 
to obtain assistance, but whenever it is possible to obtain help, anaes- 
thetics should never be given without the presence of a third person, both 
for the sake of the administrator and of the patient. In consequence of 
neglecting this rule a number of medical men have suffered severely from 
false charges of assault and rape brought against them by female patients. 
These charges, though perfectly false, have frequently been brought by 
patients in all good faith, and under the belief that they were true. The 
action of alcohol on the sexual centres in the brain (pp. 386 and 362) is 
surpassed by that of chloroform, and sexual excitement caused by the 
latter (p. 676) may be accompanied by delusions, which are afterwards 
remembered and believed by the patients to have been real events. By 
having an assistant in the room false charges arising from such delusions 
may be disproved. 

For the patient's sake also no one should attempt, if it can possibly 
be avoided, both to administer anaesthetics and to operate, for this is more 
than a single man can do, and the attempt to do both is likely to lead to 
failure in either one or both. 

The dangers resulting from the employment of chloroform are : (1) 
death by stoppage of respiration ; (2) death by stoppage of the 
heart. Usually the respiration stops before the heart. This order, however, 
may be somewhat varied, because occasionally the heart will fail before the 
respiration. This may sometimes be due to the employment of too 
strong- chloroform vapor, because this very quickly paralyzes the 
heart ; but sometimes the stoppage of the heart before the respiration 
may be due to the shock of the operation, and not to the chloroform. 
The respiration may stop from (1) obstruction to the entrance of 
air into the glottis by the tongue, by vomited matters, or by blood, (2) 
by mechanical interference with the respiratory movements, (3) by 
paralysis of the respiratory centre. 

Precautions. — (1) If the patient should partially wake from chlo- 
roform narcosis during an operation, sickness is very likely to occur. In 
order to prevent this, it is well that the patient should take no solid food for 
four or five hours before the operation ; but, at the same time, his 
strength should be kept from sinking by the administration of beef-tea, 
along with some alcoholic stimulant three hours before. When vomiting 
does occur, the head of the patient should be turned on one side, so as to 
allow an easy exit to the vomited matters, which should, if necessary, be 
removed from the mouth. Mr. Mills tells me that the most common 
causes of obstruction to the respiration are either falling back of the 
tongue or depression of the chin. Both of these may be remedied by 
changing the position of the head by turning it on one side, or forcibly 
dniwing the chin away from the sternum at each inspiration. Very sel- 
dom it may be necessary to draw the tongue forwards with dressing for- 
ceps. (2) Mechanical interference with the respiratory movements may 
occur from unwary pressure upon the chest, interfering with the thoracic 
movements. The most common cause of this is the weight of the 
patient's own body, when any operation upon the back requires him to 
be laid upon his face. In such cases, special watch should be kept upon 
the respiratory movements. Mechanical interference with respiration 



CARBON COMPOUNDS FATTY SERIES. . 679 

may occur in old people who have lost their teeth. The flaccid lips and 
the alae nasi are in them drawn inwards at each inspiration, and, acting as 
valves, prevent the entrance of air into the trachea. In such cases the 
mouth should be opened by the fingers (Esmarch). 

Stoppage of the respiration may occur from the patient spasmodically 
holding his breath during the stage of excitement, but this usually soon 
passes off if the anaesthetic be pushed. The struggling is less if the 
anaesthetic be given gradually. (3) Paralysis of the respiratory centre 
takes place when the drug is pushed too far. It may sometimes occur 
suddenly, after a fresh quantity of chloroform has been poured upon the 
cloth used in administration. If the respiration ceases the administra- 
tion of chloroform should be discontinued, and the patient roused by flick- 
ing the cheeks and breast with a wet towel. The tongue should be drawn 
forward with forceps and artificial respiration begun if necessary. As a 
rule the patient can be restored with comparative ease by means of arti- 
ficial respiration, provided the heart continues to beat, but on rare occa- 
sions even the prolonged use of this means does not induce any further 
voluntary respiratory movement. The easiest way of performing artifi- 
cial respiration is to press the sternum forcibly inwards, and allow it to 
return to its normal position by its own elasticity. The pressure should 
be exercised synchronously with the operator's own respiration. Each 
time the sternum is depressed the ends of the fingers may be pressed 
under the cartilages of the ribs on the left side, so as to stimulate the 
heart mechanically also. 

Stoppage of the heart may occur suddenly, and may take place while 
respiration is still going on. It is usually ascribed to the chloroform, and 
no doubt concentrated chloroform vapor inhaled into the lungs may arrest 
the heart. Very commonly, however, it is reflex, and when death occurs 
in such a case it is to be attributed to the want of chloroform rather than 
to its excess. It is worthy of note that in the greater number of the 
cases recorded as deaths from chloroform, the statement is made that the 
quantity administered was very small, and that anaesthesia was incom- 
plete. Before anaesthetics were used at all, death from shock during 
operation was by no means uncommon, and no doubt it still occurs during 
imperfect anaesthesia, although complete anaesthesia tends to prevent it. 
The operations in which death during chloroform chiefly occurs are short 
and comparatively slight, though painful, such as extraction of teeth, 
and evulsion of the toe-nail — operations in which the introduction of 
deep chloroform anaesthesia might be regarded as superfluous, and 
involving a waste of time. These operations appear to be dangerous 
during imperfect narcosis, and not so when either no anaesthetic at all 
has been given, or complete anaesthesia has been produced. The reason 
of this probably is that when no anaesthetic is given, irritation of the 
sensory nerves during the operation causes two effects — slowing or stop- 
page of the heart, and reflex contraction of the vessels. This contraction 
neutralizes the result of cardiac weakness or stoppage, maintains the 
blood-pressure, and thus prevents syncope. During imperfect anaesthesia 
the reflex contraction of the vessels is destroyed, whereas the effect on 
the heart may still persist, so that irritation of a sensory nerve may pro- 
duce syncope by stopping the supply of arterial blood from the heart, 



680 ORGANIC MATERIA MEDICA. 

while the blood still flows rapidly from the arterial system through the 
capillaries into the veins. When the anaesthesia is complete, both 
reflexes are paralyzed, and the circulation remains unaffected by any 
impression made upon the sensory nerves. Even when chloroform 
anaesthesia appears perfectly complete, death from shock may still occur, 
at any rate in the case of animals. I have noticed this on two occasions 
when engaged in making gastric fistula in a dog. The animal was com- 
pletely anaesthetized, but in both instances, when drawing upon the 
stomach in the process of inserting a cannula, the animal died suddenly. 
On mentioning this to Professor Schiff, he informed me that he had had 
many similar experiences, so that he had entirely abandoned the use of 
chloroform in such operations, and substituted ether. 

When the heart stops, the treatment to be adopted is to lay the 
patient's head lower than his body (p. 230), to keep up artificial respira- 
tion, and to administer nitrite of amyl by inhalation. 

Instead of the plan of artificial respiration already mentioned, Syl- 
vester's may be used. Howard's plan may be used for very strong 
patients, but is not suitable for delicate ones. Respiration may be 
assisted by stimulating the diaphragm by the application of a faradaic 
current to the phrenic nerve. One pole is applied to the epigastrium 
and the other to the side of the neck during the time that the inspiratory 
movement is being made artificially. 

Uses. — The vapor of chloroform may be applied to the eye in photo- 
phobia, to the os uteri in pruritus pudendi, neuralgia, ulceration, or 
cancer of the uterus, in order to relieve pain. A few drops held in the 
hand of the nurse, and inhaled by a child when a paroxysm of whooping- 
cough comes on, will lessen its violence. 

The power of chloroform to aid the absorption of vegetable alkaloids 
may be employed in order to assist their action when applied externally, 
but care must be taken not to apply them over too large a surface when 
using such drugs as aconite or veratrine in combination with chloroform 
or chloroform liniment. A pledget of cotton-wool dipped in chloroform 
is frequently employed as a remedy in toothache ; but as the chloroform 
irritates the pulp, and may increase pain afterwards, Ringer recommends 
a piece of linen moistened with chloroform to be folded over the tooth, 
so that the vapor may act upon the pulp without irritating it. It relieves 
vomiting from gastric catarrh or sea-sickness, lessens flatulent distention 
of the stomach and intestines, and may be used in dyspepsia and diar- 
rhoea after the irritant has been removed. 

Chloroform, in combination with small doses of morphia and with 
some adhesive vehicle such as glycerine, is a useful remedy in coughs, 
more especially the coughs of phthisis. When inhaled to an extent quite 
insufficient to produce even the earlier stages of anaesthesia it may 
relieve the paroxysms of asthma. The first stage of chloroform action, 
viz., partial anaesthesia and partial loss of consciousness, is useful in 
biliary and renal colic, and in very severe pain, such as intestinal colic, 
severe neuralgia, aneurism, and during labor. A most ingenious plan 
of administering chloroform in such cases has been devised by Mr. 
Image, of Bury St. Edmunds. A piece of blotting-paper or lint is put 
in the bottom of a tumbler, and moistened with chloroform. The patient 



CAKBON COMPOUNDS — FATTY SEEIES. 681 

then takes the tumbler in the hand and inhales the vapor. The shape of 
the tumbler prevents it from being brought too close to the face, so that 
the vapor is always inhaled with a free admixture of air. As soon as it 
begins to take effect, the patient's hand and the tumbler drop, so that 
the inhalation ceases. When the effect begins to pass off, the patient 
again raises the tumbler and inhales anew, and so the process may go on 
for a long time, without any further care on the part of the attendant 
than to keep the lint or blotting-paper in the tumbler moist with chloro- 
form. 

In the administration of chloroform for surgical operations, the towel 
or napkin may be folded so as to form an imperfect cone, into the cavity 
of which a little chloroform is poured. The towel is then held over the 
patient's face, a few inches from his nose, the apex of the cone touching 
the bridge of the nose, its base being directed downwards, and its margin 
a couple of inches from the face. Care should be taken that no part of 
the towel which is wet with chloroform touches the face, on account of 
the burning sensation which it produces, and that a free admixture of air 
be allowed and the vapor not administered in a too concentrated state. 

Another way of giving it is to spread a single fold of the napkin over 
the patient's face, and allow the chloroform to fall, a drop at a time, 
upon the napkin a little in front of the nose. The drug may be admin- 
istered in a similar way upon a wire mask covered with a single layer of 
flannel. In order to avoid the possibility of the patient inhaling too 
concentrated a vapor, an apparatus has been devised by Mr. Clover, con- 
sisting of a bag of 10,000 cubic inches capacity, which is filled with air 
containing 4 per cent, of chloroform vapor, and from this the patient is 
allowed to inhale by means of a flexible tube and a mask. The apparatus 
is filled by pumping successive quantities of air from a bellows holding 
1000 cubic inches through a box heated by hot water, into which 32J 
minims of chloroform have been injected, a quantity just sufficient to 
charge the air with the proper amount of chloroform. 

A mixture of 1 part of alcohol with 2 of chloroform and 3 of ether, 
known under the name of the A, C, E mixture, is sometimes used instead 
of chloroform. It is supposed to have the advantage of being more stim- 
ulant and less depressing to the heart than chloroform. One disadvantage 
of it is that the three constituents evaporate with unequal rapidity, so 
that at the ead of an operation a patient may get a much larger propor- 
tion of chloroform than of the other two. 

U.S. P. Iocloformum. Iodoform, CHI 3 ; 392*8. — Iodoform 
should be kept in well-stopped bottles, in a cool place. 

Preparation. — By mixing alcoholic solution of potash with tincture 
of iodine, and evaporating ; or by acting on dilute alcohol with iodine 
and carbonate of potash or soda. 

Characters. — Small, lemon-yellow, lustrous crystals of the hexa- 
gonal system, having a saffron-like and almost insuppressible odor, and 
an unpleasant, slightly sweetish, iodine-like taste. Not perceptibly sol- 
uble in water, to which it imparts a slight odor and taste ; soluble in 80 
parts of alcohol at 15° C (59° F.), in 12 parts of boiling alcohol, in 5*2 
parts of ether, and in chloroform, benzol, benzine, disulphide of carbon, 



682 ORGANIC MATERIA MEDICA. 

fixed or volatile oils. Its solutions have a neutral reaction. Sp. gr. 
2*000. It sublimes slightly at ordinary temperatures, and distils slowly 
with water; at "about 115° C. (239° F.) it melts to a brown liquid, and 
at a higher temperature yields vapors containing iodine and carbonaceous 
matter. If iodoform be digested with an alcoholic solution of potassa, 
the mixture, when acidulated with diluted nitric acid, will give a blue 
color with gelatinized starch. 

Distilled water shaken with iodoform should not change the color of 
blue litmus paper, and when filtered, should give no precipitate with 
test solution of nitrate of silver (absence of iodide). Upon full combus- 
tion, iodoform should leave no residue. 

Dose. — 1-3 grains. 

Peepaeation. 
Unguentum Iodoformi (1 part to 9 of benzoated lard). 

Administration. — It may be given in the form of pill, made up 
with sugar of milk, tragacanth and glycerine, or as a suppository made 
up with cacao butter. 

As an inhalation in phthisis a solution may be used containing 20 
grains of iodoform, 20 minims of oil of eucalyptus, or 10 of creasote, J 
fl. oz. rectified spirit, and J fl. oz. of ether. This is used with an inhaler 
of horse-hair matting lined with cotton-wool, on the interior of which the 
solution is dropped (Dreschfeld). 

The disagreeable smell of iodoform may be covered by Tonquin bean 
or Coumarin. 

As an external application it may simply be dusted over the sore and 
covered with cotton-wool, or cotton-wool may be soaked in an ethereal 
solution of it and then dried. The quantity of iodoform in the cotton- 
wool should be at least 10 per cent. It may be applied to the nose or 
throat as snuff, or mixed with half its weight of starch as insufflation, or 
an ethereal solution may be applied as spray. The nozzle of the spray- 
producer is apt to become choked and must be washed out frequently 
with pure ether. It may also be applied to the nose in the form of a 
bougie containing -|— J a grain made up with gelatine and glycerine. 

Actions. — Iodoform destroys bacilli, and is an antiseptic and 
deodorizer of very considerable power. It also destroys leucocytes. 
When applied in substance or strong solution it produces no local irrita- 
tion, but acts as a local anaesthetic. Its power in this, respect is so 
great that a suppository containing it when introduced into the rectum 
may so diminish sensibility that defecation may occur without the knowl- 
edge of the person or animal (Wood). 

Its absorption from the intestine is probably aided by fat. 

It weakens the circulation when taken for some time, and when 
applied to the frog's heart it has a powerful paralyzing action on the 
cardiac ganglia in the same way as chloral and iodal (p. 286). 

It lias a marked -action on the nervous system. In cats and dogs 
it produces narcosis, but not in rabbits. It may be absorbed from 
wounds and affect the nervous system in man, but this affection instead 
of sleep or anaesthesia, usually appears in slight cases as sleeplessness, 
headache, irritability and loss of memory. In severe cases it appears in 
the form <»f maniacal attacks, hallucinations, or melancholia. 



CAEBON COMPOUNDS. 683 

These disagreeable effects appear to be diminished by bicarbonate of 
potash in doses of 10 grains hourly. 1 It appears to have an extraordi- 
nary power to prevent the development of giant-cells and may thus pre- 
vent morbid tissue growth. 

Uses. — Its local anaesthetic and antiseptic actions render it 
useful as a dressing after operations instead of carbolic acid, and it is 
especially useful where a regular antiseptic dressing cannot be applied, 
as in operations on the bladder or rectum, or wounds or ulcers of these 
parts. It is a most useful application to poisoned wounds, chancres, 
phagedenic or syphilitic sores, and to fungating growths generally. It 
induces healthy action in indolent sores. It lessens the discharge and 
disagreeable smell of ozsena. It has been used as a vapor in cases of 
phthisis, and also given internally but with doubtful result. 



CHAPTER XXX. 

CAEBON COMPOUNDS. 
Aromatic Series. 



In this series the carbon atoms are supposed to be linked so as to 
form a closed chain or chains. The lowest member of the series con- 
tains six atoms of carbon, which are so linked that the group has six 
free affinities, thus : 

I 

-C C- 

II I 

-c c- 

I 

For convenience' sake, this carbon ring, or nucleus, is often graphi- 
cally represented simply thus: 

/\ 

I I 
\/ 

When five of the free affinities are saturated by hydrogen, the group 
forms an organic radical with one free affinity, termed phenyl : 



H H 

/ - \ 
\_/ 
H H 



Behring, Wien. Med. Bltitt., 1884, No. 9. 



684 ORGANIC MATERIA MEDICA. 

When this free affinity is also saturated by hydrogen, the group 
H H 

H\ /H forms phenyl hydride, or benzine, or benzol, which must be 

H~H 
carefully distinguished from the benzin already mentioned (p. 646). 

Bodies belonging to the aromatic group differ from those of the fatty 
series in the fact that they do not readily link on other substances to 
themselves, and so form compounds by addition. They rather form 
them by substitution. 

When one atom of hydrogen in benzine is replaced by hydroxy! 
(OH), phenyl-alcohol or carbolic acid is formed: 

<_>0-H, or C 6 H 5 OH. 

The name of phenol has been given to this body as it is more con- 
venient than the names phenyl-alcohol or carbolic acid, and its termina- 
tion, "ol," indicates that it resembles alcohol in its constitution. 

The relations of some of the other members of the aromatic group 
to each other may be more easily seen if they are put in a tabular form : 

Benzine, \ /H, or C 6 H 5 .H. 



Phenol, \_)OH, or C 6 H 5 .OH, 
in which 1 atom of hydroxyl (OH) replaces 1 of H in benzine. 

Nitrobenzine, (_/N\ I or C 6 H 5 .N0 2 , 

in which 1 atom of nitroxyl (N0 2 ) replaces 1 of H in benzine. 
Amido^ne,or/-\ N< H orCANH9 

in which 1 atom of amidogen (XH 2 ) replaces 1 of H in benzine. 

Benzoic acid, or y —\ „//§ n -rj nr\ au 

m, if • -i ;Cf^ TT or C 6 H 5 .C0.0H, 

rhenylformic acid, N /^\0— H, 

in which 1 atom of carboxyl (COHO) replaces 1 of H in benzine. 

As the carbon atoms in the benzine ring or nucleus are supposed to 
be arranged symmetrically, it does not matter which atom of hydrogen 
is replaced by another radical if the substitution takes place only in one 
atom, e.g., in phenol. 

If we number the carbon atoms so as to distinguish them from one 
another, thus: 



CARBON COMPOUNDS. 685 

5\/3 



it is evident that phenol is always the same, whether the hydroxyl is 
attached to the carbon atom, 1, 2, or 3, &c, &c. : 

HO 

/\ /\HO /\ 

II II II 

\/ \/ \/HO 

But this is not the case when substitution occurs at two or more 
points in the benzine ring. 

Thus when substitution in the benzine ring occurs at two points, 
these may take three different positions : 

-I -^ The substitution products ^ 

■j /\2 1 an d 6 are the same 6/\ 

a 9 || as 1 and 2, and are usually | | 

\/ termed ortho compounds. \/ 

ill and 5 are the same 1 

and /\ as 1 and 3, and are usually /\ 

3 \/3 termed nieta compounds. 5\/ 



1 



1 






, /\ 1 and 4 are usually termed 

and I J -, 

a KJ para compounds. 

4 

Thus three isomeric forms may occur. 

When two atoms of hydrogen are replaced by two of hydroxyl, 
instead of by one, as in phenol, we have three isomeric substances, 
differing from one another only in the relative position of the substituted 
■atoms. These three bodies are pyrocatechin, in which the position is 
1 and 2, resorcin, 1 and 3, and hydroquinone, 1 and 4. The relative 
position of the hydroxyl groups in these three bodies is indicated in 
their formulae by the figures (1 : 2), (1 : 3), and (1 : 4), or by the terms 
ortho, meta, or para respectively. 

H H H 

















rv°- H 


■ /\ 

1 1 




1 1 


i i 


1 1 

\/\ 



\ 

H 




1 1 

\/ 

1 


H 


Pyrocatechin. 

) 6 H 4 .(OH) 2 (l:2) 


Resorcin. 

C 6 H 4 .(OH) 2 (l:3) 


Hydroquinone. 

0^.(0^,(1:4) 



686 OKGANIC MATEEIA MEDICA. 

When two atoms of hydrogen in benzine are replaced, the one by 
hydroxyl (OH) and the other by carboxyl (CO. OH), we get three 
isomers, salicylic acid, oxybenzoic acid, and paraoxybenzoic acid. 



H 

i 


H 

i 


H 

■ 


6 

\/ U \ H 


1 



1 

. o 


1 1 






c = o 


i 




\ 


/0% 












\ 


/ 




H 


H 


Salicylic Acid. 


Oxybenzoic Acid. 


Paraoxybenzoic A 



Pyridine (C 5 H 5 N) is probably formed by one atom of tetrad C in 
the benzine ring being replaced by triad N: 

H\ c /N^ c /H 
II I 

k 

Naphthaline (C 10 H 8 ) is formed by the union of two benzine 
groups, thus: 

H H 

H J)\ yQ % H 

\C C C/ 

I II I 

o c c 

H/%C/ \C^\H 

k k 

Chinoline (C 9 H 7 N) is formed by the union of benzine and pyridine 
groups : 

H 



I 



S0\ /*K 

H-C C C-H 

I II I 
H-C C C-H 

k k 

Chinoline is closely connected with quinine, from which it may be 
produced, and it is probable that many of the organic alkaloids are 
closely related to the aromatic series. 






CAKBON COMPOUNDS. 687 

That morphine, for example, is related to phenol is shown by the fact 
that when morphine is treated with nitric acid and heated with water 
under pressure, it yields trinitrophenol, or picric acid. 1 

General Action. — The distinctive action of the lower members of 
the fatty series is their stimulant and anaesthetic action on the nerve- 
centres (p. 644). The most marked action of the lower members of the 
aromatic series is their antiseptic and antipyretic power. The anti- 
septic action appears to be very easily modified by slight changes in some 
substances of this group. Thus salicylic acid is antiseptic, but its sodium 
salt is not; and meta- and para-oxybenzoic acids, which are isomeric 
with salicylic acid have no antiseptic power. 

As alterations in the physiological action of the carbon compounds of 
this group can be aifected by slightly changing their chemical compo- 
sition, several attempts have been recently made to obtain artificial alka- 
loids which should possess a strong antipyretic action without depressing 
the heart or causing sickness. Antipyrin, the most recent introduction, 
appears to be the best as yet, but further attempts in this direction may 
be still more successful. 

U.S. P. Acidum Carbolicum Crudum. Crude Carbolic Acid. 

Characters. — A nearly colorless or reddish-brown liquid of a 
strongly empyreumatic and disagreeable odor, having a benumbing, 
blanching, and caustic effect on the skin or mucous membrane, and a 
neutral reaction. Bromine water produces in an aqueous solution of 
carbolic or cresylic acid a white flocculent precipitate. 

Tests. — Crude carbolic acid should not dissolve in less than 15 parts 
of water at 15° C. (59° F.), nor should the solution have an alkaline 
reaction (absence of alkalis). If 50 volumes of crude carbolic acid be 
diluted with warm water to measure 1000 volumes, the mixture well 
shaken, cooled, and allowed to separate, the amount of undissolved 
impurities should not exceed 5 volumes or 10 per cent, by volume of the 
crude acid. 

Acidum Carbolicum. XJ.S.P. and B.P. CARBOLIC Acid. 
Phenol. Phenyl- Alcohol. C 6 H 5 HO ; 94. 

An acid obtained from coal-tar oil by fractional distillation and sub- 
sequent purification. 

Characters and Tests. — In colorless acicular crystals, which at a 
temperature of 95° become an oily liquid, having a strong odor and 
taste, resembling those of creasote, which it also resembles in many of 
its characters and properties. Its specific gravity is 1*065 ; boiling- 
point, 370°. The crystals readily absorb moisture on exposure to the 
air, and they are thus liquefied ; the acid, however, is but slightly solu- 
ble in water, but it is freely soluble in alcohol, ether, and glycerine. It 
does not redden blue litmus paper. A slip of deal dipped into it, and 
afterwards into hydrochloric acid, and then allowed to dry in the air, 
acquires a greenish-blue color. It coagulates albumen. It does not affect 
the plane of polarization of a ray of polarized light. 

Dose. — 1 to 3 grains. 



1 Chastaing, Cornet. Bend., xciv., 44. 



688 ORGANIC MATERIA MEDICA. 

Peepaeatioxs. 

U.S. P. 
Unguentum Acidi CarboUci (with ointment 1 in 10). 

B.P. 

Giyceriniiui Acidi Carbolici. Glycerine of Carbolic Acid (Car- 
bolic acid (1) Glycerine (4) by measure) 1 part in 6 by weight. 

Suppositoria Acidi Carbolici cuin Sapone. Carbolic Acid Sup- 
positories. Carbolic acid, 1 gr.; curd soap, 15 gr.; starch, 
q.s. to give consistence. 

ACTION. — Carbolic acid is a powerful deodorizer and disinfectant 

(p. 108). It precipitates albumen, and destroys low organisms. It 
prevents the decomposition of albuminous fluids by bacteria, and the 
fermentation of sugar by yeast. Quantities smaller than those which 
are sufficient to kill these organisms suffice to prevent their development. 
It does not appear to destroy the action of all organic ferments so 
readily, although it does so when applied for a long time, or in concen- 
trated solution ; it prevents the conversion of starch into sugar, the con- 
version of albumen into peptones, and the decomposition of amygdalin 
with formation of hydrocyanic acid. When applied to the skin it pro- 
duces a white stain, and greatly diminishes the sensibility of the part. 
The stain afterwards becomes brownish, and of a parchment-like con- 
sistence, and the epidermis by and by peels off. Carbolic acid does not 
act as a vesicant, but appears to cause anaesthesia of the part to which it 
is applied, extending to some distance below the surface. If applied 
over a large surface of skin, it may be absorbed to such a degree as to 
cause poisoning, and even death. The symptoms are weakness, delirium, 
and collapse. When applied to mucous membranes it has a similar 
action. In the mouth it causes a burning pain, and when swallowed 
produces symptoms of gastro-enteritis, pain in the stomach, and some- 
times vomiting and purging. Along with this there is great collapse, 
delirium, and death, sometimes, though not always, preceded by convul- 
sions. After death the blood is found to be very dark, and its coagula- 
bility greatly diminished. Carbolic acid appears to be a powerful poison 
to all the tissues, paralyzing both muscle and nerve when applied 
directly to them without previously stimulating them. After absorption 
it acts especially on the medulla oblongata, but acts also on the 
spinal cord, first stimulating and then paralyzing these centres. From 
its action on the cord it produces in frogs convulsions resembling those 
of strychnine, these being followed by paralysis. It first stimulates the 
respiratory and vaso-motor centres, and afterwards paralyzes them. 
It thus produces at first quickened respiration with rise of blood-pres- 
sure, and it also quickens the pulse. As the centres become paralyzed 
the blood-pressure falls greatly, the respiration becomes slower, and the 
pulse also becomes slower. When it is injected directly into the blood, 
so that it can act in large quantity on the nerve-centres, it paralyzes the 
vaso-motor centre at once, and causes the blood-pressure to fall very 
greatly without much alteration being observed in the action of the heart 
itself. That the vaso-motor centre is completely paralyzed by carbolic 
acid is shown by the fact that after its injection the blood-pressure is not 
raised either by stimulation of sensory nerves, or by asphyxia. Although 



CARBON COMPOUNDS. 689 

carbolic acid acts first and most markedly on the nerve-centres in the 
medulla oblongata, it affects the cerebral centres also. This effect is 
evidenced in man by headache, giddiness, and lassitude, followed by 
unconsciousness. In animals it also affects the cerebrum, as shown by 
alterations in sensibility and motor power. It stimulates the sweat 
centre and salivary centres, producing perspiration and salivation. 
Medium doses appear to cause death by paralysis of the respiration, so 
that artificial respiration may be of some use in preventing it, but large 
doses paralyze the heart also, so that death occurs in spite of artificial 
respiration. It diminishes the temperature in cases of poisoning, and 
also when given to animals in a febrile condition, though when the fever 
is very high it does not seem to have much effect. It is excreted by 
the kidneys, and can be readily detected in the urine by bromine water. 
It sometimes gives rise to a very dark coloration of the urine^ due to 
some oxidation product of the carbolic acid, probably hydroquinone 
{p. 685). 

Part of the carbolic acid appears in the urine, in combination with 
sulphuric acid, as sulpho-carbolates, and if the quantity administered 
has been large, the ordinary sulphates may completely disappear. The 
hydroquinone occurs also to a great extent in the urine in combination 
with sulphuric acid.* The compound is colorless, and thus the urine, 
when freshly passed, has a normal appearance ; on standing, the hydro- 
quinone becomes free, undergoes further oxidation, and causes the urine 
to assume a brown color. 

Uses. — It has sometimes been applied externally to produce local 
anaesthesia for slight operations, such as opening abscesses, and, when 
mixed with oil, in the proportion of ten minims to an ounce of oil, it 
relieves the pain of burns. One of the best means for removing the pain 
of toothache is to dip a little cotton-wool into carbolic acid melted by the 
aid of heat, and insert the pledget into the cavity of the tooth, covering 
it over with dry cotton-wool, to prevent the tongue being burned by 
contact with the acid. It is used as a stimulant to indolent ulcers and 
wounds, and to destroy condylomata, and has been applied to the throat 
in cases of diphtheria, ulceration, and aphtha . It has been employed as 
an injection into deep-seated inflammations, such as chronic synovitis, 
inflamed glands, boils, hydrocele, erysipelas, and poisoned wounds. Its 
ehief application, however, is to destroy the minute organisms which 
cause putrefaction in albuminous fluids, and to prevent the untoward 
results which would arise from the absorption of putrid discharges. 

According to Sir Joseph Lister, the untoward consequences of opera- 
tions are frequently due, not to the operation itself, but to the poisoning 
of the wound by the products of decomposing discharges, and poisoning 
of the system generally by absorption of these products. The decom- 
position is due to low organisms, such as bacteria, introduced from with- 
out, and it may be prevented by the use of such substances as will prevent 
their development or destroy them when present. In performing opera- 
tions, therefore, he advises that the skin should first be washed with a 
watery solution of carbolic acid (1 in 40), that the knife also should be 
treated with a similar solution, and that the incision should be made 
under a spray of carbolic acid (1 in 20). After the operation is concluded 
44 



690 ORGANIC MATERIA MEDICA. 

under a constant use of the spray, the wound is covered with a protec- 
tive consisting of varnished linen dipped in a solution of carbolic acid 
(1 in 40), above which are laid eight layers of gauze, steeped in a 
mixture of carbolic acid (1), resin (4), and paraffin (4). Between the 
sixth and seventh layers is put a piece of water-proof tissue, in order to 
distribute the discharge and prevent it from oozing out at one spot. If 
the discharge be great the dressings ought to be changed once in twenty- 
four hours, under the spray, but as it heals, the intervals between the 
dressings may be lengthened. 

A solution of carbolic acid in oil is frequently used to lubricate, and 
at the same time disinfect, catheters (p. 107), but, as Koch's experiments 
show, such a solution has no antiseptic power, and they ought to be dis- 
infected, first with an aqueous solution and afterwards oiled. 

Carbolic acid is very useful in what is sometimes known as an influ- 
enza cold, beginning with coryza, spreading down the throat to the air- 
passages, leading to severe bronchitis with much depression, and occa- 
sionally also to gastro-intestinal catarrh. This form of cold appears, 
like true influenza, to be extremely infectious, and to be easily commu- 
nicated, not only by one member of a family to another, but even by 
casual visitors. It may sometimes be arrested, and may frequently be 
rendered less severe, by carbolic acid spray applied to the nostrils and 
by the use of a gargle containing carbolic acid. Other forms of sore 
throat are also relieved by gargles containing about 1 per cent, of car- 
bolic acid. Considerable care must be taken in using the gargle not to 
swallow it, on account of the poisonous properties of the acid. When 
the cold begins in the nose the solution of carbolic acid for spray may 
contain 1 per cent., but perhaps a still better method of applying it is 
by a small ear syringe, as a J or J per cent, solution. A mixture of 1 
part of carbolic acid with 3 of creasote has been used for continuous 
inhalation in phthisis by means of the oro-nasal respirator. 

Carbolic acid is also used as an injection to wash out serous cavities, 
after the evacuation of fluids ; for example, the cavity of the pleura after 
the evacuation of the fluid in pleurisy, and the cavity of an abscess after 
the removal of the pus. Internally, the acid has been given in cases of 
flatulent dyspepsia. It is a useful application to the uterus in chronic 
inflammation, excoriation, catarrh and cancer, and as an injection in 
leucorrhoea. 

Creasotum, U.S.P. and B.P. Creasote. 

A product of the distillation of wood tar. 

Characters and Tests. — A liquid, colorless or with a yellowish 
tinge, and a strong empyreumatic odor. It is sparingly dissolved by 
water, but freely by alcohol, ether and glacial acetic acid. Specific 
gravity 1-071. It coagulates albumen. A slip of deal dipped into it, 
and afterwards in hydrochloric acid, acquires on exposure for a short 
time to the air a greenish-blue color. Dropped on white filtering paper 
and exposed to a heat of 212°, it leaves no translucent stain. It turns 
the plane of polarization of a ray of polarized light to the right. It is 
not solidified by the cold produced by a mixture of hydrochloric acid 
and sulphate of soda. 

Dose. — 1 to 3 drops. 



CAKBON COMPOUNDS. 691 

Preparations, 
u.s. p. dose. b.p. dose. 

Aqua Creasoti 1-4 fl. dr. Mistura Creasoti (1 min. in 1 fl. oz.) 1-2 fl. oz. 

Unguentum Creasoti (simple ointment) 

1 part in 9 

Vapor Creasoti 

U.S.P. Aqua Creasoti. Creasote Water. Creasote, 1 ; distilled water, 99 ; 
agitate and filter. 

B.P. Mistura Creasoti. Creasote Mixture. Take of creasote 16 min., gla- 
cial acetic acid 16 min., spirit of juniper 1 oz., syrup 1 oz., distilled water 15 ozs. 

B.P. Vapor Creasoti. INHALATION OF CREASOTE. Mix creasote (12 min.) 
and water (8 fl. ozs.) in an apparatus so arranged that air may be made to pass 
through the solution, and may afterwards be inhaled. 

Action. — Creasote destroys low vegetable organisms, and prevents 
the fermentation which they cause. When administered to small animals, 
it causes great dyspnoea, weakening of the heart's action, paralysis, and 
often sudden death. Its action differs from that of carbolic acid 
in the absence of convulsions and increased coagulability of 
the blood. 

Creasote is a powerful muscular poison. It coagulates albumen and 
blood. When applied to the skin it destroys the epithelium, and has 
a similar action upon mucous membranes. In the mouth it produces a 
burning sensation and much salivation. Large doses taken internally 
cause nausea, vomiting, colicky pains, and diarrhoea. The pulse is 
quickened, there is giddiness and headache, the respiration is slow and 
labored, and the secretion of urine is increased. 

Uses. — It is often employed as a remedy in toothache, a small 
pledget of cotton-wool being dipped into it and placed in the cavity of 
the decayed tooth. Care should be taken to cover this with fresh cotton- 
wool, to prevent the tongue from being burned. Internally, it is given 
in cases of vomiting depending upon abnormal processes of fermentation 
in the stomach, and it is said to relieve vomiting due to other causes, 
such as ulceration of the stomach, cancer, Bright's disease, sea-sickness, 
and pregnancy. It is useful in diarrhoea, especially that of children, 
where the diarrhoea depends upon irritation due to abnormal fermenta- 
tion processes in the intestinal contents. The vapor is used in phthisis 
and foetid bronchitis. 

Resorcin.— Not officinal. CeH 4 (OH) 2 (l : 3) {vide p. 685). 

Characters. — White, crystalline plates, somewhat like benzoic acid, 
melting at 99° C. It has a sweetish, harsh taste. It is soluble in less 
than 2 parts of water and 20 of olive oil. The aqueous solution gives a 
dark violet color with ferric salts. 

Dose. — 5-30 grs. (0-3-2 Gm.). It is best given with syrup of 
oranges and freely diluted. 

Action. — It is a powerful antiseptic. It coagulates albumen. A 
saturated solution has a caustic action on the skin, but a weak solution, 
e.g., 5 per cent., is not irritating to the skin or mucous membranes. In 
frog-s it produces stupor, collapse, clonic spasms, and dyspnoea like car- 
bolic acid. In warm-blooded animals it also causes clonic convul- 
sions, dyspnoea, dilatation of the vessels and increased secretion of saliva 



692 ORGAXIC MATERIA MEDICA. 

and tears. Death occurs through paralysis. Large doses in man, 30 
grs. or more, cause giddiness, singing in the ears, symptoms of intoxica- 
tion, like those of alcohol, convulsive tremors and collapse. In febrile 
conditions it greatly lowers the temperature. 

Uses. — It is a powerful antiseptic and has been employed locally in 
diphtheria. As an antipyretic it has proved useful. A 5 per cent, solu- 
tion has been used as an application to syphilitic sores and skin diseases, 
and as an injection into the bladder in cystitis. A 1 per cent, solution 
has been used as a colly rium. In infantile cholera it has proved 
very useful in doses of 1J-5 grs. (04-0-3 Gm.) given in infusion of 
chamomile. As an antipyretic it lessens the temperature in phthisis 
and in typhoid, less so in pneumonia and erysipelas. It has also been 
used in ague. 

Its disadvantages are the profuse perspiration which it produces, the 
short duration of its antipyretic action, and the rapidity with which the 
temperature again rises. 

Hydroquinone, C 6 H 4 (OH) 2 (l : 4), not officinal (p. 685). 
Characters. — In crystals or plates with a slight sweetish taste. 
Action. — Like that of resorcin, but about four times stronger. 
Uses. — Similar to those of resorcin. 

Pyrocatecliin, C 6 H 4 (OH) 2 (l : 2). Not officinal (p. 685). 

Characters. — It forms crystals or plates readily soluble in water, 
alcohol and ether. It reduces cupric sulphate. 

Action. — Like that of resorcin, but it is about three times stronger. 

Uses. — Like those of resorcin. 

U.S.P. Acidum Salicylicum. Salicylic Acid, HC 7 H 5 3 ; 138 
(p. 686). 

Characters. — Fine, white, light, prismatic, needle-shaped crystals, 
permanent in the air, free from odor of carbolic acid, but sometimes 
having a slight, aromatic odor, of a sweetish and slightly acrid taste and 
an acid reaction. Soluble in 450 parts of water, and in 2*5 parts of 
alcohol at 15° C. (59° F.) ; in 14 parts of boiling water ; very soluble 
in boiling alcohol ; also soluble in 2 parts of ether, in 2 parts of absolute 
alcohol, in 3*5 parts of amylic alcohol, and in 80 parts of chloroform. 
When heated to about 175° C. (347° F.) the crystals melt, and at about 
200° C. (392° F.) they begin to sublime ; at a higher temperature they 
are volatilized and decomposed with odor of carbolic acid. The 
aqueous solution is colored intensely violet-red by test solution of ferric 
chloride. 

Impurities.— Hydrochloric acid,organic matter, iron and carbolic acid. 

Tests. — A solution of one part of salicylic acid in 10 parts of alco- 
hol, mixed with a few drops of nitric acid, should not become turbid 
upon the addition of a few drops of test solution of nitrate of silver 
(absence of hydrochloric acid). A saturated solution in absolute alcohol, 
when allowed to evaporate spontaneously in an atmosphere free from 
dust, should leave a perfectly white crystalline residue, without a trace 
of color at the points of the crystals (absence of organic impurities ; also 
of iron). On agitating a portion of salicylic acid with 15 parts of concen- 
trated sulphuric acid, no color should be imparted to the latter within 



CARBON COMPOUNDS. 693 

fifteen minutes (absence of foreign organic matter). If 5 c.c. of a saturated 
aqueous solution of salicylic acid be poured into a test-tube, into which 
had been introduced, shortly before, a crystal of chlorate of potassium 
and 2 c.c. of hydrochloric acid, and some water of ammonia be now care- 
fully poured on top, the latter should not assume a reddish or brownish 
tint (absence of carbolic acid). 

Dose. — 5 grs.-15 grs. 

Action. — When mixed in a proportion of 1 to 10 per cent, with fluids 
containing the germs of "bacteria it will prevent their development, and 
in the proportion of 1 in 60 will destroy bacteria when swarming in a 
fluid (p. 96). Salicylic acid likewise destroys the life of the torula, and pre- 
vents alcoholic fermentation, as well as the fermentation caused by the 
organic ferments, &c, (p. 86). 

It has little power to reduce the temperature in health, but is a 
most powerful agent in lowering the temperature of fever. When injected 
into the blood, or administered by the stomach in large quantities, it 
lowers the pulse rate, blood-pressure, and respiration. When taken in 
medicinal doses for some time, it produces noises in the ears, deafness, 
giddiness, and headache, in this respect resembling quinine. Occasionally 
it has caused sudden depression of the circulation and collapse. 

In large doses salicylic acid causes feeble circulation, lowers the 
blood-pressure, and produces death through paralysis of the respiration. 
It is excreted in the perspiration, saliva, and urine. During its excre- 
tion it frequently irritates the kidneys and produces albuminuria. It 
appears in the urine partly as salts of salicylic acid, and partly in combi- 
nation with glycol as salicyluric acid. After its use the urine is not unfre- 
quently brown by reflected and green by transmitted light, and contains 
a substance which reduces copper solution. 

Uses. — Externally it has been employed as an antiseptic instead of 
carbolic acid, and has been used by insufflation in diphtheria successfully. 
A mixture of 2 parts with 100 of tallow applied directly to the feet, not 
to the stockings, has been found most useful in preventing sweating and 
soreness of the feet in soldiers after a long march. It has been recom- 
mended for soft sores, which should be kept covered with the pure acid for 
two days, and then treated with emollient ointment. It is usually employed 
internally in the form of salicylate of soda (p. 532). As already men- 
tioned it is useful both in acute and chronic rheumatism, and it has been 
found also useful in gonorrhoeal rheumatism. It is of much less use 
in typhoid fever than in rheumatism, and although it has some anti- 
periodic action, is not such a powerful remedy in malarious affections as 
quinine. 

Salicylic acid dissolved in collodion flexile (gr. xxx. to 5 j-) is very use- 
ful for corns and warts ; also to hasten the peeling of palms and soles after 
scarlet fever. 

Salicylate of soda is useful in phegmasia alba. As already mentioned, 
it relieves headache. It seems to have a peculiar power of increasing the 
secretion of bile and rendering it more watery. In this it differs from 
most other cholagogues, which increase the proportion of solids in the bile. 
It is therefore indicated in cases where there is a tendency to the forma- 
tion of gall-stones. 



694 ORGANIC MATERIA MEDICA. 

Naphtlialin. C 10 H 8 (vide p. 686). Not officinal. 

Source. — It is prepared from' tar. 

Characters. — Colorless micaceous crystals, with a peculiar smell, 
insoluble in water, dilute acids or alkalis. Sparingly soluble in cold alco- 
hol, more readily in hot alcohol. 

As the commercial naphthalin is often impure it should be purified 
by washing it with alcohol on a filter until the alcohol is colorless, then 
drying and subliming. 

Dose. — For adults 1J-8 grains as a single dose. As much as 80 
grains may be given during the day. For children 1J-3 grains every 
three hours. 

Administration. — In the form of powder mixed with sugar and 
scented with oil of bergamot it may be taken in wafers or capsules. It 
may be used as enema, but as it is quite insoluble in water it must be sus- 
pended in a mucilagenous vehicle, such as decoction of marsh-mallow. 
The best way of doing this is to mix the quantity of naphthalin required 
(15-75 grains) with 2 or 3 fluid ounces of boiling distilled water, and 
stirring until the naphthalin is diffused in very fine drops throughout the 
liquid. It should then be poured into 15 or 30 fluid ounces of boiling 
marsh-mallow tea and vigorously stirred. The liquid is then allowed to 
cool and introduced into the rectum by a soft tube and funnel (p. 414). 

Action. — It destroys low organisms and prevents the germination of 
their spores. It is a powerful antiseptic but it must be intimately mixed 
with the substances on which it is to have this action. It has little or no 
poisonous action on the higher animals when given either by inhalation 
or internally, the reason probably being that it is so sparingly soluble 
that it is not absorbed in sufficient quantity from the intestinal canal to 
be injurious to the organism. When given internally it disinfects the 
whole contents of the intestinal canal so that the faeces have either no 
smell at all or a faint smell of naphthalin. It is so sparingly soluble that 
most of it remains in the intestine and acts on the contents of the intes- 
tinal tube along its whole length from the stomach to the rectum. 

Uses. — It may be used wherever it is desirable to destroy germs and 
stop processes of putrefaction or fermentation in the intestine. It has 
proved useful in typhoid fever, diarrhoea, acute and chronic, vomiting and 
diarrhoea in children, and tubercular diarrhoea. 1 It is possible that it may 
be useful in cholera. 

Naphthol. C ](J II 7 OH. There are several kinds of naphthol. The 
only one hitherto used is the beta- or iso-naphthol. Not officinal. 

Characters. — In white crystals, with a somewhat agreeable smell. 
Sparingly soluble even in hot water. Soluble in alcohol, ether and chlo- 
roform, in olive oil and vaseline. 

Action. — It has a therapeutic action on the skin like tar. When 
absorbed it causes vomiting, loss of consciousness, convulsions, and 
hematuria. 

Uses. — It is used in scabies, eczema, and local sweating. It may be 
applied ill \ to 5 per cent, alcoholic solution, or as an ointment (10 per 
cent.). 

1 Rossbach, Berlin, klin. Wochenschr., 1884, No. 42. 



CAEBON COMPOUNDS. 695 

Hydrochlorate of Rosaniline. Synonyms — Fuchsin, Magenta, 
Roseine, Aniline Red. C 20 H 10 N 3 .HC1. Not officinal. 

Preparation. — Rosaniline is a colorless substance prepared by 
acting on aniline with oxidizing agents such as arsenic acid. The com- 
pounds of rosaniline with monobasic acids have brilliant colors. 

Characters. — Elongated crystals with a brilliant green lustre, 
readily soluble in water, and giving a bright red solution. 

Dose. — J-4 gr. 

Actions. — Rosaniline hydrochlorate when perfectly pure is said to 
have no marked physiological action. Fabrics dyed with it have acted 
as local irritants, producing eczema ; but it is probable that this effect 
may be due, at least in great part, to the presence of arsenic. When 
given internally it has produced salivation, vomiting, diarrhoea, and 
when injected into the veins it has caused trembling, staggering, albumi- 
nuria, and fatty degeneration of the kidneys. These symptoms may 
possibly be due to the presence of aniline or of arsenic as impurities. It 
is excreted by the kidneys, saliva, and bile, and probably also by the 
intestinal mucous membrane. It gives a magenta color to the urine. 

Use. — To lessen or remove albumen from the urine in albuminuria. 

Cliinoline. C 6 H 7 N (p. 686). Not officinal. 

Characters. — A colorless liquid with an aromatic odor. It forms 
crystalline salts. 

Dose.— Of the tartrate 7-15 grs. (0-5-1 Gm.). 

Action. — It is a powerful antiseptic and antipyretic. In mod- 
erate doses it lowers temperature and pulse rate. In large doses it 
produces languor, diminished reflex excitability, dyspnoea, paralysis and 
collapse. 

Uses. — It has been used in typhoid fever, rheumatism, and erysip- 
elas, apparently with benefit. It is little used in pneumonia; and in 
phthisis it is apt to irritate the stomach and produce collapse. 

Kairin. Hydrochlorate of oxyethyl-chinoline hydride. Not offi- 
cinal. 

Dose. — 3-30 grs. Best given in wafer-paper or a capsule. 

Action. — It is a powerful antipyretic. 

Uses. — Used in febrile conditions to lower the temperature. Filehne 
recommends that doses of 8 grains should be given every hour at first for 
four times, or until the temperature has fallen to 100° F. If the tem- 
perature falls after four doses, 4 grains should be given hourly until the 
temperature again begins to rise, when the dose should be increased. If 
the temperature has not fallen to 100° after four doses of 8 grains, 12 or 
16 grains should be given hourly, until the temperature of 100° is reached, 
when the dose should be lowered as before. Like resorcin, it produces 
profuse sweating. 

Antipyrin. Not officinal. A synthetically prepared alkaloid. 
There are two substances bearing this name, viz., methyloxychinicine 
and dimethyloxychinicine. The latter is the commercial drug. 

Characters. — A white powder, very readily soluble in water; taste 
sweetish bitter and rather pleasant. Its solutions give with ferric chloride 



696 ORGANIC MATERIA MEDICA. 

a deep red, and with nitrous acid a greenish-blue. Chinicine or quinicine 
is a hypothetical base. The supposed constitution of chinicine and methyl- 
oxy chinicine may be thus graphically represented: — 

XT XT 

N-H I /N-H 



C 



H-C C C-H H-C C C-CH. 

I II I I II I 

H-C C C-H H-C C C-H 

^ / \ / % / \ S\ 

C C\ C C H 



H 



I H || 

H HO 



Chinicine or Quinicine. Methyloxychinicine. 

Dose. — Thirty grains hourly for three hours. For children a grain 
and a half for every year of the child's age may be given hourly for 
three hours. If it causes vomiting it may be dissolved in half its weight 
of hot water and injected subcutaneously. 

Action. — It reduces the temperature for several (1-20) hours when 
given as above in two or three doses, and when its effect has passed 
off, the rise of temperature which then occurs is less frequently accom- 
panied by rigor than is the case with Kairin. It causes profuse per- 
spiration. It slightly increases the blood-pressure. It has no 
action on the respiration. It is excreted in the urine. It some- 
times, though rarely, causes vomiting, and very seldom causes collapse. 

Uses. — In febrile diseases generally. It seems specially useful in 
typhoid fever and phthisis, but it is also useful in erysipelas, surgical 
fever, pleurisy, and pneumonia. 



SECTION V. 



VEGETABLE MATERIA MEDICA. 



CHAPTER XXXI. 

THALAMIFLOK^. 

Class I.— EXOGEN^E.— Exogens. 

Sub-Class I.— THALAMIFLOEJE. 

RANUlSrCIILACEJE. 

B.P. Aconiti Folia. Aconite Leaves. — The fresh leaves and 
flowering tops of Aconitum napellus, gathered when about one-third of 
the flowers are expanded, from plants cultivated in Britain. 

Characters. — Leaves have deeply-cut wedge-shaped segments, by 
which even a fragment of the leaf can be recognized; exciting slowly, 
when chewed, a sensation of tingling. Flowers are deep blue, helmet- 
shaped. 

Officinal Peepaeation. 
b.p. DOSE. 

Extractum Aconiti (green-extract) 1-2 gr. 

B.P. Aconiti Radix. Aconite Root. — The dried root of 
Aconitum napettus, collected in winter or early spring before the leaves 
have appeared. 

U.S. P. Aconitum. — The tuberous root of Aconitum napellus. 

Characters. — Conical and tapering, usually from one to three 
inches long, not thicker than the finger at the crown, blackish-brown, 
internally whitish. A minute portion, cautiously chewed, causes prolonged 
tingling and numbness. 

(697) 




698 VEGETABLE MATEEIA MEDICA. 

Properties axd Composition. — The chief active princi- 
ple in both leaves and roots is an alkaloid aconitine or aconitia, 
which is combined with aconitic acid. It is only present in 
small quantity in the leaves. In the root resinous and fatty 
matters and several other active principles are also present. 
Nepaul aconite, or Bikh, the root of A.ferox, contains an alka- 
loid pseudaconitine, which is much more active than aconitine. 
Japanese aconite is said to contain an alkaloid which is much 
more powerful even than pseudaconitine. It is therefore very 
important that officinal preparations should be made only from 
the root of A. napellus. Aconite! 

Officinal Peepaeations. 
u.s.p. DOSE. 

Abstractnm Aconiti £-1 gr. ("OS-'SS Gin.) 

Extractnni Aconiti H gr. (/01--02 Gm.) 

Extractum Aconiti FTuidum J-2 niin. (•OS-'liJ c.c.) 

B.P. DOSE. 

Tinctura Aconiti 1-5 min. 

Linimentum Aconiti 

U.S.P. Abstractum Aconiti. — Exhaust powdered aconite 200 parts, with alcohol 
containing 2 parts of tartaric acid. Eetain the first 170 parts of the percolate, evap- 
orate the remainder to 30, at a temperature not exceeding 50° C. (122° F.), and mix 
with the reserve portion. Place the mixture in an evaporating dish, and, having 
added 50 parts of sugar of milk, cover it with a piece of thin muslin gauze and set 
aside in a warm place, where the temperature will not rise above 50° C. (122° F.), 
until the mixture is dry. Lastly, having added enough sugar of milk to make the 
mixture weigh 100 parts, reduce it to a fine uniform powder. 

B.P. Aconitia. — A white, usually amorphous, solid alkaloid. 

When rubbed on the skin it causes a tingling sensation, followed by 
prolonged numbness. It is a very active poison. 

Preparation. — The aconitate of aconitia is dissolved out of the 
pounded root by macerating in spirit. If ammonia were now added, the 
aconitia would be set free, but being soluble in spirit would not be pre- 
cipitated. The spirit is therefore recovered by distillation, and the 
residual extract dissolved in water, in which the aconitate of aconitia is 
soluble, although the alkaloid is very sparingly so. By adding ammonia, 
aconitia is precipitated mixed with coloring matter and other principles. 
It is then dissolved in ether, which leaves the coloring matter behind. 
The ether is recovered by distillation, and the aconitia farther purified 
by dissolving in water acidulated with sulphuric acid and reprecipitating 
by ammonia. 

Characters axd Tests. — A white, usually amorphous, solid, soluble 
in 150 parts of cold and 50 of hot water, and much more soluble in alco- 
hol and in ether; strongly alkaline to reddened litmus, neutralizing 
acids, and precipitated from them by the caustic alkalies, but not by 
carbonate of ammonia or the bicarbonates of soda or potash. It melts 
with beat, and burns with a smoky flame, leaving no residue when burned 
with free access of air. 

Officinal Preparation. 

B.P. Unguentnm Aconite. — Aconitia 8 gr., dissolved in rectified spirit \ fi. dr., 
and mixed with prepared lard 1 oz. For external application only. 



THALAMIFLORJE. 699 

Physiological Actiox — General Action. — Its action is exerted 
most markedly on the peripheral ends of sensory nerves, on the heart, 
and on the respiration. 

In frog-s it produces steady loss of motion, both voluntary and reflex, 
with gradually increasing weakness of respiration, and of the heart, which 
finally stops in diastole, usually about the same time as the respiration. 

In man one of the most marked symptoms is the local tingling- and 
numbness produced in the mouth by aconite or aconitine if they come 
into actual contact with it. This irritation is not limited to the mouth, 
but occurs also in the gullet and stomach, where it produces belching, 
nausea, and vomiting. If aconite preparations, or aconitine, are taken 
in capsules so that they do not touch the mouth or tongue, this local 
tingling and numbness are hardly felt at all. 

After absorption, however, the poison is carried by the circulation 
throughout the body, and then causes a tingling in all parts of the body 
in the order of their sensitiveness as determined by Weber. The most 
sensitive p§rts are affected first, viz., the tongue and lips, the finger-tips, 
face, perineum, breast, belly, and last the back. 

The heart is quickly affected even by very small doses, and a single 
drop of the tincture (B.P.) given in water twice or thrice at intervals of 
a quarter of an hour will in many cases greatly reduce the rate of the 
pulse. This slowness of the pulse is due to an action of the aconite upon 
the vagus roots, and does not occur after the administration of atropine. 
In some cases of disease also the pulse seems little affected by aconite. 
In larger doses the vaso-motor centre becomes gradually paralyzed, while 
the heart remains slow, the blood-pressure falls greatly, and the pulse is 
not only slow but exceedingly weak and irregular. 

Great muscular weakness and dyspnoea occur, the respirations being 
slow, shallow, and feeble. The dyspnoea, and probably the weakness 
also, depend to a considerable extent upon the feebleness of the circula- 
tion and consequent imperfect nutrition of the nerve-centres, for the 
administration of atropine lessens the dyspnoea. 

In addition to this, however, there must be a direct paralyzing action 
on the respiratory centre, and death usually occurs from stoppage of 
the respiration. 

When the heart is examined immediately after death, it is generally 
found to be still pulsating, although sometimes it is found to have stopped 
and even lost its irritability. In the latter stage of aconite poisoning the 
effects of imperfect respiration may become manifest in the livid color 
and anxious appearance of the face, the cold sweat on the skin, and 
sometimes protrusion of the eyes with dilatation of the pupil. 

Death is sometimes preceded by convulsions which do not appear to 
be entirely due to asphyxia. 

Action on Individual Organs. — The muscles are little if at all 
affected by aconite. The terminations of the motor nerves appear to 
be first irritated, so that fibrillary twitchings of the muscles occur in a 
frog; afterwards they are paralyzed. The peripheral ends of sensory 
nerves in the skin and mucous membranes are first irritated, so that the 
peculiar tingling and numbness is felt, and sometimes also intense neu- 
ralgia, affecting branches of the fifth nerve: afterwards they are paralyzed. 



700 VEGETABLE MATERIA MEDICA. 

The motor centres of the spinal cord, and the respiratory and vaso- 
motor centres in the niedulla, appear first to be slightly stimulated, so 
that clonic convulsions may occur. The reflex power of the cord is 
diminished, the sensory ganglia being affected before the motor ganglia. 
The paralysis of the cord is probably to a great extent, however, due to 
its imperfect nutrition from failure of circulation. The brain remains 
unaffected, the mental faculties being usually clear up till death. Some- 
times drowsiness occurs, which may, however, be due to the circulation ; 
and headache is also observed, which seems to involve the interior of the 
head, and is distinct from the facial neuralgia observed in earlier stages 
of the poisoning. Like the motor centres in the cord, the vaso-motor 
centre in the medulla oblongata appears to be first stimulated and then 
paralyzed, so that the blood-pressure in rabbits rises at first, but in dogs 
and cats it falls, apparently from the slowing of the pulse produced by 
stimulation of the vagus roots. Later on, the vaso-motor centre becomes 
paralyzed to a considerable extent, though not entirely, so that the blood- 
pressure falls greatly. Although not completely paralyzed, ^t becomes 
insensible to reflex stimulation, so that irritation of a sensory nerve will 
no longer raise the blood-pressure. 

The heart in the frog is first quickened and then slowed. In man 
or mammals there is first slowness of the pulse, but shortly before death 
it may become more rapid. This effect appears to depend chiefly upon 
primary stimulation succeeded by paralysis of the motor ganglia in the 
heart, the effect in mammals being altered by the simultaneous action of 
the drug upon the vagus roots in the medulla. 

The respiration is at first slow and deep with marked expiratory 
effort ; afterwards slow, shallow, and labored. 

This effect appears to be due to the direct action of the poison on the 
respiratory centre, together with its indirect action through weakening 
of the circulation (p. 213). Before death, convulsions occasionally occur, 
and these are, to a great extent, due to the indirect effect through the 
circulation, but possibly also, to a direct irritating effect of the drug on a 
convulsive centre in the medulla. 

The temperature falls constantly throughout. The stomach is 
irritated immediately by the poison taken directly into it, so that violent 
vomiting may occur; but it may also be irritated by the poison being 
eliminated by the gastric mucous membrane after injection subcutaneously 
or into the blood, so that the effects are similar to those produced by the 
direct introduction of the drug into the stomach (p. 55). The secre- 
tion of the salivary gland is increased, and usually the sweat also, 
possibly other secretions. The intestines are irritated like the stomach, 
and diarrhoea occurs in consequence. 

The pupil at the commencement of poisoning alternately contracts 
and dilates, the tendency to contraction being best marked ; and a simi- 
lar result occurs from the local application of aconitine to the eye. 
Later on there is extreme dilatation. This dilatation may be due to 
reflex irritation from the gastro-intestinal mucous membrane (p. 198). 
Aconite quickly passes from the blood into the tissues, for if the greater 
part of the blood of a poisoned dog is transfused into the veins of a healthy 
one within a few minutes after poisoning has begun, it produces no effect. 



THALAMIFLOR^E. 701 

Therapeutic Uses of Aconite. — Aconitine is applied locally in 
the form of ointment in cases of severe neuralgia, a small piece about 
the size of a pea being rubbed into the painful part. If the neuralgia 
affects the temple, great care must be taken that the ointment does 
not get into the eye, as rapid absorption occurs from the conjunctiva, and 
general poisoning may result. 

Aconite liniment is frequently employed in muscular rheumatism ; in 
various forms of neuralgia, such as sciatica ; and over swollen and pain- 
ful joints. Admixture with chloroform facilitates the absorption of alka- 
loids through the skin, so that a mixture of aconite liniment with 
chloroform liniment may be more efficacious than either the one or the 
other separately ; but the mixture should be employed with care, 
and not over too large a surface, to prevent any risk of too rapid 
absorption. 

As a local sedative to the stomach, it has been employed in full 
doses to check the vomiting of pregnancy. Its chief use, however, is in 
the febrile condition depending upon local inflammations, such as 
tonsillitis, sore throat, pleurisy, pneumonia, phthisis, peritonitis, pericar- 
ditis, acute rheumatism, gout, erysipelas, otitis, gonorrhoea, and in urethral 
fever. In many of those conditions small doses of aconite slow the 
pulse, lower the temperature, and give much relief to the patient. In 
cardiac disease its action is somewhat uncertain. In nervous palpita- 
tion it is sometimes useful, and it may give relief in palpitation 
depending upon hypertrophy, but frequently it is of no use in this 
condition. In diseases of the nervous system its internal application 
alone, or combined with its external use, sometimes gives relief in head- 
ache, toothache, noises in the ear, neuralgia, especially of the face, in 
intercostal neuralgia, and neuralgia accompanying herpes-zoster. It 
has been found useful, also, in some cases of amenorrhoea depending 
on a sudden check to the menstrual flow, and also in severe menorrhagia. 

Mode of Application. — Externally it may be applied in the form 
of ointment or liniment, internally in the form of tincture or extract. 
The extract is uncertain in its strength, and death has occurred from 
the two grains laid down as a maximum by the British Pharmacopoeia. 
The tincture should also be administered in very small doses, as it is 
difficult to counteract its effect when too much has been given. Instead 
of giving a large dose, therefore, all at once, it is much better to give it 
in divided doses, such as one drop in a little water, every quarter or half 
an hour until the pulse has begun to be affected, and then every hour or 
two hours afterwards, according to the necessities of the case, so as to 
maintain the action (Ringer). 

U.S.P. Stapliisag-ria. Staphisagria. Stavesacre. — The seed 
of Delphinium staphisagria. 

Characters. — From one-eighth to one-sixth of an inch (3 to 4 
millimetres) broad, flattish-tetrahedral, one side convex, brown or brown- 
ish-gray, with reticulate ridges, containing a whitish, oily albumen and 
a straight embryo ; nearly inodorous ; taste bitter and acrid. 

Composition. — It contains several alkaloids, the most important 
being delphinine and staphisagrine. 



702 VEGETABLE MATERIA MEDICA. 

Action. — Staphisagrine paralyzes the niotor nerves in 

like curare, and kills mammals without convulsions by paralyzing the 
respiration. Delpliinine resembles aconitine in many respects, and like 
it causes slowness of the pulse and respiration, paralysis of the spinal 
cord, and death by asphyxia. It stimulates the vagus centre in the 
medulla, and also the accelerating centre for the heart (p. 279). It 
slows the respiration, apparently by an action on slowing fibres of the 
vagus, for when the vagi are cut, it quickens respiration, probably 
by stimulating the respiratory centre in the medulla. In advanced stages 
of poisoning it paralyzes the ends of the vagus in the heart and also the 
cardiac muscle. It removes the still-stand caused by muscarine and digi- 
talin (Boehm). By depressing the action of the spinal cord it arrests the 
convulsions caused by strychnine. 

Uses. — Stavesacre is sometimes used externally as a parasiticide in 
the form of an ointment (3 parts of ground seeds to 5 of lard). 

U.S.P. Pulsatilla. Pulsatilla. — The herb of Anemone Pulsa- 
tilla and Anemone pratensis, and of Anemone j^atens, var. Nuttalliana, 
collected soon after flowering. 

It should be carefully preserved and not be kept longer than one year. 

Characters. — Leaves radical, petiolate, silky-villous, twice or thrice 
deeply three-parted or pinnately cleft, with linear, acute lobes, appearing 
after the large, purple, (or, in the last-named species, sometimes whitish) 
flowers ; inodorous ; very acrid. 

Dose. — 1J-6 grains. 

Composition. — The fresh plant yields by distillation with water, an 
acrid, oily principle, with a burning, peppery taste. A similar oil is got 
from Ranunculus bulb >osus, R. flammula, and R. sceleratus. Its thera- 
peutic value is not great. When kept for some time, this oily substance 
becomes decomposed into anemonic acid and anemonin. 

Action. — The oil acts as a vesicant when applied to the skin. 
Anemonic acid appears to be inert. Anemonin sometimes causes 
local inflammation and gangrene when subcutaneously injected; vomiting 
and purging when given internally. It is uncertain whether these symp- 
toms are due to anemonin itself or to some impurity in it. The chief 
action of pure anemonin is a depressant one on the circulation, res- 
piration and spinal cord, to a certain extent resembling that of 
aconite. The symptoms are slow and feeble pulse, slow respiration, cold- 
ness, paralysis affecting first the hind and then the fore-legs, dyspnoea, 
and death without convulsions. In poisoning by extract of pulsatilla 
convulsions are always present. Their absence in poisoning by anemo- 
nin appears to be due to its paralyzing action on motor centres in the 
brain (p. 1 68) ; it does not paralyze the muscles and motor nerves in frogs. 

CFSES. — It is supposed to be diaphoretic and emmenagogue. It 
lias been used in amenorrhcea, dysmenorrhea, catarrh of various mucous 
membranes, bronchitis and asthma. 

Adonis Vernalis. Not officinal. — This plant is considered by some 
to be a apecies of Anemone. 

I JOMPOSITION. — It contains a glucoside adonidin. 



THALAMIFLOR.E. 703 

Action. — Adonidin has an action almost exactly like that of cligi- 
talin, but is much stronger, and is said not to be cumulative. It appears 
to be about ten times as powerful as digitoxin. 

Use. — It may be used instead of digitalis, and sometimes succeeds 
when digitalis fails. It is, however, less certainly beneficial in valvular 
disease than digitalis, and should be used only when digitalis fails (Noth- 
nagel). It appears to produce vomiting and diarrhoea more readily 
than digitalis (Bubnoif). 

Administration. — It may be given in the form of infusion (j-2 
dr. of the root to 6 fl. oz. of water) in doses of J fl. oz. every two to 
four hours. 

U.S. P. Cimicifuga. Cimicifuga. Black Snakeroot. — The 
rhizome and rootlets of Cimicifuga racemosa (synonym : Aetearacemosa). 

Characters. — The rhizome is horizontal, hard, two inches (5 centi- 
metres) or more long, about one inch (25 millimetres) thick, with 
numerous stout, upright or curved branches, terminated by a cup- 
shaped scar, and with numerous wiry, brittle, obtusely quadrangular 
rootlets, about one-twelfth of an inch (2 millimetres) thick; the whole 
brownish-black, nearly inodorous, and having a bitter, acrid taste. 
Rhizome and branches have a smooth fracture, with a large pith, 
surrounded by numerous sub-linear, whitish wood-rays, and a thin, 
firm bark. The rootlets break with a short fracture, have a thick 
bark, and contain a ligneous cord branching into about four rays. 

Officinal Prepakations. 

dose. 

Extractum Cimicifugse Fluidum 30-60 min. 

Tinctura Cimicifugse %-2 fl. drm. 

Composition. — It contains, when fresh, a volatile oil, a resin, and a 
bitter neutral substance, but it is not known to which of these its activity 
is due. 

Action. — In large doses this drug produces nausea, vomiting, depres- 
sion, headache and giddiness. Its action on the heart is said to be like 
that of digitalis, but is less powerful. 

Uses. — It is used as a stomachic and cardiac tonic in various 
conditions of weakened heart. It has been used in chorea, rheumatic 
affections, headache and neuralgia, and is useful as an expectorant in 
bronchitis or acute catarrh, and in phthisis. Under the name of Actea 
racemosa it obtained a great reputation as a cure for acute rheumatism, 
but this was not confirmed on a more extensive trial. 

Podophyllum, TJ.S.P. ; Podophylli Radix, B.P. PODOPHYL- 
LUM Root. — The dried rhizome and rootlets of Podophyllum peltatum. 
North America. 




Fig. 139.— Podophyllum. 



Characters. — In pieces of variable length, about I of an inch 
thick, dark reddish-brown externally, whitish within, breaking with a 



704 VEGETABLE MATERIA MEDICA. 

short fracture. At intervals of about 2 inches the rhizome is thick- 
ened, and from each swollen part or joint a number of pale brown root- 
lets spring. These are brittle, and many of them break short off close 
to the rhizome, leaving little round white spots which help to distinguish 
podophyllum easily from other roots. Powder yellowish-gray, sweetish 
in odor, bitterish, subacrid and nauseous in taste. 

Properties and Composition. — Its most important constituents 
are podophyllin, which is a resinous substance, and berberine, which is 
a yellow alkaloid, having little physiological action. 

Kesina Podophylli, U.S. P. ; Podophylli Resina, B.P. Resin 

of Podophyllum. 

Preparation. — The resin is dissolved out of the powdered root by 
exhausting with spirit, the greater part of which is recovered by distilla- 
tion, and the remainder holding the resin in solution is poured into 
water slightly acidulated with hydrochloric acid, when the resin is pre- 
cipitated as a fine powder, as it is insoluble in water. The resin itself 
consists to a great extent of a fatty and resinous acid, and subsides more 
quickly in acidulated than in pure water. It is afterwards washed and 
dried. 

Characters and Composition. — A pale greenish-brown amorphous 
powder, soluble in rectified spirit and in ammonia ; precipitated from the 
former solution by water, from the latter by acids. Almost entirely solu- 
ble in pure ether. It consists chiefly of a fatty and a resinous acid, 
having little physiological action, and two active substances, podophyl- 
lotoxin and picropodophyllin, the former being much the more powerful. 

Officinal Pkeparations of Podophyllum. 

u.s.p. DOSE. 

Eesina Podophylli H gr. (0'008-0'03 Gm.) 

Abstractum " 5-10 gr. (033-0'67 Gm.) 

Extractum " 1-3 gr. (0'06-0-2 Gm.) 

Extractum " Fluidum 5-15 min. (0"3-0"9 c.c.) 

B.P. 

Podophylli Eesina (Podophyllin) -g-1 gr. 

Physiological Action. — The resin is the part chiefly employed. It 
acts as a drastic purgative, increasing the secretions of the intestinal 
mucous membrane, and of the liver (p. 351). It acts on the bowels, 
when injected subcutaneously as well as when introduced into the 
intestinal canal. Like many other hepatic stimulants, it does not 
increase the secretion of bile so much when it acts as a purgative 
(p. 354,. 

Uses. — It is used in cases of biliousness associated with dark stools 
(Ringer). When the stools are pale, mercurial pill is usually employed. 
It is often employed in combination with other purgatives, such as 
colocynth, aloes or rhubarb. It is useful in congestion of the liver and 
of the portal circulation, in ague with congested liver, and in sick 
headache with biliousness. Its action is uncertain and it frequentty 
causes griping. 

Externally it act^ a- an irritant: if incautiously handled it often 
produces conjunctivitis. 



THALAMIFLOR.E. 705 

U.S. P. Hydrastis. Hydrastis. Golden Seal. — The rhizome 
and rootlets of Hydrastis Canadensis. 

Characters. — Rhizome about an inch and a half (4 centimetres) 
long and a quarter of an inch (6 millimetres) thick ; oblique, with short 
branches, somewhat annulate and longitudinally wrinkled ; externally 
yellowish-gray ; fracture short, waxy, bright reddish-yellow, with a 
thickish bark, about ten narrow wood-wedges, broad medullary rays and 
large pith. Rootlets thin, brittle, with a thick, yellow bark, and sub- 
quadrangular, woody centre. Odor slight ; taste bitter. 

Officinal Peepaeations. 

dose. 

Extractum. Hydrastis Fluidum 1-2 fl. drm. 

Tinctura Hydrastis 2-5 fl. drm. 

Composition. — It contains the yellow, bitter alkaloid berberine, and 
the colorless, also bitter, hydrastia, or hydrastine, besides a third alkaloid 
and a volatile principle not yet isolated. 

Uses. — Its uses are similar to those of the simple bitters. Professor 
Rutherford found the resinous substance obtained from the root to be an 
hepatic stimulant of moderate power (p. 351). This substance, which 
is also called hydrastin, must not be confounded with the alkaloid. It 
consists of a mixture of hydrastine, berberine, and resin in varying pro- 
portions. The pure alkaloid hydrastine is said to be antiperioclic, and 
causes ringing in the ears like quinine. 

MAGNOLIACE^E. 

U.S. P. Illiciuni. Star- anise. — The fruit of Illicium anisatum. 

Character. — The fruit consists of 8 brown, boat-shaped carpels, 
joined at their inner ends so as to form a star. Each contains 1 seed 
with an oily taste. The taste of the fruit is sweet and aromatic. 

Composition. — It contains a volatile oil which so closely resembles 
that of true anise as to be officinal. 

Oleum Anisi, U.S. P. and B.P. — A volatile oil distilled from 
Illicium or Anise. For preparations and action vide Anise. 

MENISPERMACEJE. 

U.S. P. Menispermum. Menispermum. Canadian Moon- 
seed. — The rhizome and rootlets of Menispermum Canadense. 

Characters. — Rhizome several feet long, about a quarter of an inch 
{6 millimetres) thick, yellowish-brown or brown, finely wrinkled longitu- 
dinally and beset with numerous thin, rather brittle rootlets ; fracture 
tough, woody; internally yellowish, with a thickish bark, a circle of 
porous, short, nearly square wood-wedges, and a large, central pith ; 
nearly inodorous ; taste bitter. 

Dose. — 5-20 gr. in infusion. 

Composition. — It contains a small quantity of berberine and a color- 
less alkaloid. 

Uses. — It acts as a bitter tonic, and is sometimes used also as a 
substitute for sarsaparilla. 
45 



706 VEGETABLE MATERIA MEDICA. 

Calumba, U.S.P. ; Calumbse Radix, B.P. Calumba Root. — 
The root, cut transversely and dried, of Jateorrhiza Calumba (Cocculus 
palmatus, DC). From the forests of Eastern Africa, between Ibo and 
the Zambezi. 

Characters. — Slices, flat, circular, or oval, about two inches in 
diameter, from ^ to J of an inch thick, softer and thinner towards the 
centre, so as to present the appearance of biconcave discs, grayish- 
yellow, bitter. 

Composition. — It contains a neutral principle, calumbin, a yellow 
alkaloid, berberine, to which it owes its color, and calumbic acid. All 
these are bitter. It contains much starch, which is dissolved by hot 




Fig. 140.— Calumba. 

water, so that a decoction is blackened by iodine. The infusion is con- 
sequently made with cold water to leave the starch behind, as it renders 
the infusion liable to decompose, especially in hot weather. It contains 
no tannin, and the infusion can therefore be prescribed along with salts 
of iron. 

Peepaeatioxs. 
u.s.p. dose. 

Extractum Calumbse Fluidum 15-30 min. (0"9-l"9 c.c.) 

Tinctura Calumbse 1-4 fl. dr. (3-75-15 c.c.) 

B.P. 

Extractum Calumbse 2-10 gr. or more. 

Infusum Calumbse (1 oz. to 1 piut) 1-2 fl. oz. 

Tinctura Calumbse £-2 fl. drm. 

Also contained in Mistura Ferri Aromatica. 

Action. — Calumba is a pure bitter stomachic tonic. 

Neither the berberine nor calumbin which it contains has any powerful 
physiological action. Berberine in doses of 1 J grains given subcutane- 
ously kills rabbits, with symptoms of prostration and fall of temperature; 
but a dose eight times as great given to them by the mouth has no action, 
and 15 grains only produce in man slight colicky pains and diarrhoea. 
It is said to cause contraction of the intestines and of the spleen, and to 
lessen oxidation in the blood. Calumbin seems to have still less action. 
In small doses it seems, like other bitters, to raise the blood-pressure 
slightly, and in large doses to lower it. 

Uses. — Calumba is used as a bitter tonic in atonic dyspepsia and 
debility of the digestive organs. It is said to have a soothing effect, and 
La therefore given in irritable conditions of the stomach. It is frequently 
employed in combination with iron, chiefly in the form of infusion; the 



THALAMIFLOK.E. 707 

advantage it possesses over other bitter infusions, except quassia, for this 
purpose, being, that it contains no tannin and consequently does not 
form an inky-looking mixture. It may be used as a general tonic during 
convalescence from various acute diseases, and may be prescribed in com- 
bination with either acids or alkalis. 

Pareira, U.S.P. ; Pareirce Radix, B.P. Pareira Root. — 
The dried root of Chondodendron Tomentosum. Brazil. 

Characters. — Generally seen in more or less cylindrical pieces, 
about f of an inch in diameter and four inches or more in length. The 
bark is grayish-brown, and the wood grayish yellow. It is recognized 
by the well-marked rings and medullary rays on the wood. The rings 
are irregularly concentric. 

Composition. — It contains an alkaloid pelosine or buxine, which 
appears to be identical with beberine. 

Prepakatioxs. 

U.S.P. DOSE. 

Extractum Pareirse Fluidum 1-2 fl. dr. (3'75-7'50). 

B.P. 

Decoctum Pareirte 1£ ounce to pint l£-2 fl. oz. 

Extractum Pareirae 10-20 gr. 

Extractum Pareirse Liquidum 1 ounce to 1 fluid ounce £-2 fl. drm. 

Physiological Action and Uses. — Pareira is a bitter tonic, but 
is chiefly employed as a stimulant to the mucous membrane of the 
genito-urinary tract, in chronic catarrh of the bladder. It is usually 
given in the form of decoction or liquid extract, frequently combined 
with an acid or an alkali, according to the condition of the urine. 

U.S.P. Picrotoxinum. Picrotoxin. C 9 H 10 O 4 ; 182. — A neu- 
tral principle prepared from the seeds of Anamirta paniculata. 

Characters. — Colorless, flexible, shining, prismatic crystals, per- 
manent in the air, odorless, having a very bitter taste, and a neutral 
reaction. When heated to about 200° C. (392° F.), the crystals melt, 
forming a yellow liquid; when heated on platinum foil, they char and 
are finally completely dissipated. Concentrated sulphuric acid dissolves 
picrotoxin with a golden-yellow color, which turns violet-red on the 
addition of a trace of bichromate of potassium. When mixed with three 
times its weight of nitrate of potassium, moistened with sulphuric acid, 
and then treated with strong solution of soda in excess, picrotoxin assumes 
a brick-red color of short duration. The aqueous solution should remain 
unaffected by solutions of salts of mercury or platinum, tannic acid, iodide 
of mercury and potassium, or other reagents for alkaloids (absence of, 
and difference from, alkaloids). 

Action. — It stimulates all the motor and inhibitory centres in the 
medulla, especially the respiratory and vagus centres. It also irritates 
motor centres, either in the cerebrum or in the medulla and cord, 
producing in all vertebrates alternating epileptiform spasms, with periodic 
stoppage of the motions of the diaphragm and slowness of the pulse. 
The spasms often take the form of swimming, running backwards or 
round in a circle {manege movements), or rolling of the body on its axis 
(pp. 172 and 196). The temperature is somewhat raised. 



708 VEGETABLE MATERIA MEDICA. 

Use. — It is employed as an ointment (10 gr. to 1 oz. of lard) in 
tinea capitis, and to destroy pediculi. It should be used with care, as 
its application to the head has been followed by convulsions and death. 

BERBERIDACEiE. 

U.S. P. Caul opliy Hum. Caulophyllum. Blue Cohosh. — The 
rhizome and rootlets of Caulophyllum thalictroides. 

Characters. — Rhizome about four inches (10 centimetres) long, 
and about one-fourth to two-fifths of an inch (6 to 10 millimetres) thick, 
bent ; on the upper side, with broad, concave stem-scars and short, knotty 
branches; externally gray-brown, internally whitish, tough and woody. 
Rootlets numerous, matted, about four inches (10 centimetres) long, and 
one twenty-fifth of an inch (1 millimetre) thick, rather tough ; nearly 
inodorous ; taste sweetish, slightly bitter and somewhat acrid. 

Dose. — 1-5 gr. in infusion. 

Composition. — It contains the glucoside saponin and resins. 

Uses. — It has little medicinal virtue, though it has been recom- 
mended as a diuretic, antispasmodic, and emmenag-og'ue. 

PAPAVERACE^E. 

B.P. Papaveris Capsular. Poppy Capsules. — The nearly ripe 
dried capsules of the white poppy, Papaver somniferum. Cultivated in 
Britain. 




Fig. 141.— Poppy capsule. 

Characters. — Globular, two or three inches in diameter, crowned 
by a sessile stellate stigma, which distinguishes them from colocynth and 
bael fruits. 

Prepaeations. 
u.s. p. b.p. dose. 

None. Decoctum Papaveris (2 oz. boiled for ten minutes \ 

in 1| pints of water, strained, and made up to >- For fomentations. 

1 pint) J 

Extractum Papaveris 2-5 gr. 

Syrupus Papaveris 1 fl. drrn.-£ fl. oz. 

Composition. — The capsules contain a small amount of morphine 
(more being found when unripe than when ripe), together with meconic 
acid, and very minute quantities of papaverine and papaverosine. The 
seeds are devoid of these principles, but contain much bland oil. 



THALAMIFLOK.E. 709 

Action and Uses. — Poppy capsules act in a similar manner to 
opium, but are much weaker, and not so certain in their action. They 
are employed in the form of syrup of poppies, and given chiefly to chil- 
dren as an opiate. Considering the uncertainty of its action, and in view 
of the fact that children are very readily affected by any preparation of 
opium, the drug should be used with caution. Externally the decoction 
is used for sedative fomentations to allay pain. 

Opium, U.S. P. and B.P. Opium. — The inspissated juice 
obtained from the poppy, Papaver somniferum, grown in Asia Minor. 

The unripe capsules are incised, or rather deeply scratched. The milky juice 
which exudes becomes inspissated by spontaneous evaporation, and is scraped 
off and made into lumps. As these ought to consist only of the tears of thickened 
juice from the incisions, the lump should tear with an irregular surface, and 
when drawn across a piece of paper should leave a light-brown interrupted streak. 
Sometimes vegetable extracts are used to adulterate opium, and then it has a 
more even fracture, and makes a more or less even streak on a piece of paper. 

Characters. — Irregular lumps weighing from four ounces to two 
pounds ; enveloped in the remains of poppy leaves, and generally covered 
with the chaffy fruits of a species of rumex ; when fresh, plastic, tearing 
with an irregular, slightly moist chestnut-brown surface, shining when 
rubbed smooth with the finger, having a peculiar odor and bitter taste. 

Test. — 100 grains of opium should yield, when assayed, 9 grains of 
morphia, U.S. P., and at least 6 to 8 according to the B.P. 

Prepaeations. 

U.S. P. DOSE. 

Extractum Opii £-1 gr. (0-031-0*065 Gm.) 

Emplastrum Opii (6 parts in 100) \ PreTiarpd from Fxt rao- 
Trochisci Glycyrrhizas et Opii (A \ tlZoxAi 
gr. in each lozenge) J F 

B.P. DOSE. 
Confectio Opii (Pulv. Opii Co. 1 ., . . Ark , _ nrk 

192 gr. ; Syrup 1 oz.).„ j 1 P art m 40 > nearl y 5 " 20 « r - 

B X^C.. . P " ™,-. eS !? } J P art in 10 for ^ternal use. 

Enema Opii { ? n - drm - tincture to 2 fl. oz. starch 

\ mucilage. 

Extractum Opii About 1 part from 2 5-3 gr. or more. 

Extractum Opii liquidum 22 gr. extract in 1 fl. oz., nearly 4-40 Tt\,or more. 

Iiinimentum Opii f 1 in 2 (Laudanum, 1 ; Soap Lini- 

1 ment, 1). 

Morphias Acetas About 1 part from 8 or 10 i-lgr. 

Morphias Acetatis Liquor 4 gr. acetate in 1 fl. oz 10-60 TT\, 

Morphias Hydrochloras About 1 part from 8 or 10 £-1 gr. 

Morphias Hydrochloratis Liquor..4 gr. hydrochlorate in 1 fl. oz 10-60 rr\, 

Pilula Ipecacuanhas cum Scilla...l part in 16J, nearly 5-10 gr. 

Pilula Pluuibi cum Opio 1 part in 8 - 4-8 gr. 

'gMEg£ £Wfc«) I 1 partin 6 - neariy 3 - 5gr - 

1 Pilula Saponis Composita is purely a preparation of opium. It is sometimes 
convenient to give opium to patients "without their knowledge. If the pill were 
called Pilula Opii the patients would see from the prescription what they were 
taking, while they learn nothing about the nature of the medicine from the name 
Pil. Saponis Co. The name of this pill was changed from Pil. Saponis Co. to Pilula 
Opii in the B.P. of 1864, but the inconveniences which arose from this were so great 
that the name was altered again. 



710 VEGETABLE MATERIA MEDICA. 

Peepaeatioxs — (continued ). 
b.p. DOSE. 

Pulvis Cretae Aromaticus cum Opio, 1 part in 40 10-60 gr. 

Pulvis Ipecacuanha? Conipositus...l part in 10 5-15 gr. 

Pulvis Kino Compositus 1 part in 20 5-20 gr. 

Pulvis Opii Compositus 1 part in 10 2-5 gr. 

Tinctura Caniphorse Composita 2 grains to 1 fl. oz 15 rr^-l fl. drrn. 

Tinctura Opii (Laudanum) 33 grains to 1 fl. oz., nearly 4-40 tr^or more. 

Tinctura Opii Amiuoniata 5 grains to 1 fl. oz |-1 fl. drm. 

Trocliisci Opii T Vth grain of extract in each 1-4. 

Unguentum Gallse cum Opio 32 grains to 1 oz. galls ointment... for external use. 

Tinum Opii 22 gr. extract in 1 fl. oz., nearly. ..4-40 tt\,or more. 

B.P. Pulvis Kino Compositus. COMPOUND POWDEE OF KlNO. — Kino, 3f ; 

opium, \ ; cinnamon bark, 1. 

B.P. Pulvis Opii Compositus. COMPOUND POWDEE OF OPIUM. — Opium, 1J ; 
black pepper, 2 ; ginger, 5 ; caraway fruit, 6 ; tragacanth, J. 

B.P. Tinctura Camphoree Composita. COMPOUND TlNCTUEE OF CAMPHOE 

(English Paeegoeic). — Opium, 40 gr.; benzoic acid, 40 gr.; camphor, 30 gr.; oil 
of anise, \ fl. drm. ; proof spirit, 1 pint. 

B.P. Tinctura Opii Ammoniata. AMMONIATED TlNCTUEE OF OPIUM (SCOTCH 
Paeegoeic). — Opium, in coarse powder, 100 gr. ; saffron, 180 gr. ; benzoic acid, 180 
gr. ; oil of anise, 1 fl. drm. ; strong solution of ammonia, 4 fl. oz. ; rectified spirit, 
16 fl. oz. 

B.P. Vinum Opii. Wine of Opium. — Extract of opium, 1 oz. ; cinnamon bark, 
75 gr. ; cloves, 75 gr. ; sherry, 1 pint. 

U.S. P. Opii Pulvis. Powdered Opium. — Opium dried at a 
temperature not exceeding 85° C. (185° F.), and reduced to a moderately 
fine powder. It ought not to contain less than 12 nor more than 16 per 
cent, of morphine. 

Peepaeations. 

U.S. p. DOSE. 

Acetum Opii (Black Drop) 10-15 min. (0'60-l c.c.) 

Opium Denarcotisatum J-2 gr. (0-016-013 Gm.) 

Pilulse Opii (Opium, 1 gr.; Soap, \ gr.) One pill. 

Pulvis Ipecacuanha? et Opii (1 in 10) 5-15 gr. (0'32-l Gm.) 

Tinctura Ipecacuanha? et Opii 4-15 min. (025-1 c.c.) 

Tinctura Opii 6 min. 

Tinctura Opii Camphorata 4-15 min. (\-\ c.c.) 

Tinctura Opii Deodorata 6 min. 

Vinum Opii 6 min. (0"37 c.c.) 

U.S.P. Acetmn Opii. VlNEGAE OF Opium. — Opium, 10 ; nutmeg, 3 ; extracted 
with diluted acetic acid by maceration and percolation up to 80 parts of liquid ; 
then sugar, 20, is added. 

U.S.P. Opium Denarcotisatum. Denaecotized Opium. — Prepared by removing 
narcotine and odorous principles by extraction with stronger ether, and adding suf- 
ficient sugar of milk to make up the weight to that of opium containing 14 per cent, 
of morphine. 

U.S.P. Tinctura Opii Deodorata. DeODOEIZED TlNCTUEE OF OPIUM. — Macerate 

opium, 10, with water, 40, evaporate down to 10, shake with ether, 20, pour off the 
ether, and evaporate until the whole of the ether is gone. Mix with water, 50, filter, 
adding water up to 80, then add alcohol, 20. 

u.s.p. Tinctura ipecacuanha et Opii. Tinctuee of Ipecac and Opium. — 
Deodorized tincture of opium, 100, evaporated to 85, then fluid extract of ipecac, 10, 
is added, the mixture filtered, and diluted alcohol added up to 100. 

u.s.p. Tinctura Opii Camphorata. Camphoeated Tinctuee of Opium — 
Powdered opium, 4 ; benzoic acid, 4; camphor, 4; oil of anise, 4; glycerine, 40; 
diluted alcohol up to 1000. 



THALAMIFLOILE. 711 

U.S.P. Vinum OpiL Wine of Opium. — Powdered opium, 10 ; cinnamon, 1 ; 
cloves, 1; stronger white wine up to 100. 

Composition of Opium. — Besides the usual constituents of vegetable 
products, such as mucilage, albumen, pectous substances, caoutchouc-like 
substance, fat, volatile substances, some sugar, salts of ammonia, calcium, 
and magnesia, it contains seventeen or eighteen alkaloids and two neutral 
substances, as well as a peculiar acid — meconic acid. The alkaloids 
are chiefly combined with meconic acid or sulphuric acid, but may be 
partly free. The three most important alkaloids are morphine, codeine, 
and thebaine. The others are papaverine, pseudomorphine or oxymor- 
phine, gnoscopine, codamine, laudanine, laudanosine, meconidine, lantho- 
pine, protopine, cryptopine, narcotine, oxynarcotine, hydrocotarnine, 
narceine, rhoeadine. The neutral substances are meconin and 
meconiasin. Some, at least, of the alkaloids in opium may be regarded 
as derivatives from morphine. Thus codeine and pseudomorphine or 
oxymorphine can be produced from morphine artificially. 

Besides the derivatives of morphine found naturally in opium, various 
series of alkaloids can be artificially prepared from morphine by (a) 
the addition of alcohol radicals, or by (b) oxidation, or (<?) by dehydration. 
To the series of alkaloids produced from morphine by the addition of 
alcohol radicals, the name of codeines has been given. An example of 
these is codethyline, obtained from morphine by the introduction of ether. 
Among the alkaloids produced by oxidation are oxymorphine and oxydi- 
morphine. Apomorphine is produced by dehydration. 

Meconic Acid. — This acid has very little physiological action. 
It has been stated to have a narcotic action, but this is very feeble. It 
possesses marked reactions, and these are important, as they serve to 
detect the presence of opium. With perchloride of iron and soluble 
protosalts of iron, meconic acid and its salts give a blood-red color even 
when considerably diluted. Acetates and sulphocyanides give a similar 
color, but that due to meconic acid is distinguished from that due to 
acetates by not disappearing on heating, or on the addition of hydro- 
chloric acid, and from that due to sulphocyanides by not disappearing 
on the addition of chloride of gold. 

U.S.P. Morphina. Morphine. C 17 H 19 N0 3 ,H 2 ; 303.— An 
alkaloid prepared from opium. 

Characters. — Colorless or white shining prismatic crystals, or a 
crystalline powder. Permanent in air, having a bitter taste and alkaline 
reaction. Heated on platinum foil, they fuse, char, and disappear. 
Solubility — slight in cold water; complete in 500 parts boiling water; in 
100 alcohol at 15° C. (59° F.) ; in 36 boiling alcohol; in 13 boiling abso- 
lute alcohol; almost insoluble in ether; slightly soluble in chloroform. 

Reactions. — Morphine is first reddened, and then rendered yellow 
by nitric acid. With ferric chloride it gives a blue color, changed to 
green by excess of the reagent, and destroyed by free acids or alcohol, 
but not by alkalies. A solution of morphine acidified by acetic or sul- 
phuric acid, is not precipitated by tannic acid. 

Impurities. — Other alkaloids. 



712 VEGETABLE MATERIA MEDICA. 

Tests. — On adding 20 parts of colorless solution of soda or potassa 
to 1 part of morphine, a clear, colorless solution should result without a 
residue (absence of other alkaloids). Morphine yields a colorless solu- 
tion with cold, concentrated, sulphuric acid, which should not acquire 
more than a reddish tint by standing for some time, and which should 
not assume a purple or violet, but merely a greenish color, on the addi- 
tion of a small crystal of bichromate of potassium (absence of and differ- 
ence from strychnine, brucine, &c). 

Morpliinse Hydrochloras, U.S. P.; Morpliise Hydrochloras, 

B.P. Hydrochlorate of Morphine, U.S. P., or of Morphia, B.P. 
C 17 H 19 N0 3 .HC1.3H 2 0. 

Characters and Tests. — White, feathery, acicular prisms of a 
silky lustre, permanent in air, and soluble in water and spirit. The 
aqueous solution gives a white curdy precipitate with nitrate of silver 
(HC1), and a white one with potash, soluble in excess (morphine). It 
exhibits the reactions of morphine. Heated on platinum foil, it leaves 
no residue (no inorganic salts). Soluble in 24 parts of water at 15° C. 

Preparation. — Mix concentrated infusion of opium with chloride 
of calcium, decolorize by animal charcoal, precipitate the morphine by 
ammonia, and neutralize with hydrochloric acid. 

Preparations, 
u.s.p. b.p. dose. 

Xone. Liquor Morphiae Hydrochloratis...4 grs. in 1 fl. oz 10-60 min. 

Suppositoria Morphia? £ gr. in each suppository... 

" cum Sapone..^ gr. in each suppository... 

Trochisci Morphiae -^ gr. in each lozenge one to four. 

" " et Ipecacuanhas.. ■£% gr. in each lozenge one to four. 

Liquor Morphia? Hydrochloratis. SOLUTION OF HYDEOCHLOEATE OF MOE- 
phia. — Add diluted hydrochloric acid (8 min.), rectified spirit (2 fl. dr.) to distilled 
water (6 fl. dr.), and dissolve hydrochlorate of morphia (4 gr.) in the mixture. 

Morpliinse Acetas, U.S.P. ; Morphiae Acetas, B.P. Acetate 
of Morphine, U.S.P. ; Acetate or Morphia, B.P. C 17 H 19 N0 3 .C 2 H 4 2 . 

Characters and Tests. — A white powder, with a faintly acetous 
odor, soluble in water and in spirit. Potash or soda gives a precipitate 
soluble in excess, and exhibiting the reactions of morphine, U.S.P. 
"When sulphuric acid is added to the salt, acetous vapors are evolved. 
When freshly prepared it is soluble in 12 parts of water at 15° C. 

Preparation. — In the U.S.P. morphine is officinal, and requires 
only to be dissolved in acetic acid. According to the B.P., obtain 
morphia by precipitating it from the hydrochlorate by ammonia, dissolve 
it in acetic acid and crystallize. 

Preparations, 
u.s.p. b.p. dose. 

None. Liquor Morphia Acetatis 4 gr. in 1 fl. oz 60 min. 

Injectio Morphia Hypodermica 1 gr. in 12 rr^ 2-6 min. or more. 

Liquor Morphia Acetatis. SOLUTION of Acetate of Morphia.— It is prepared 
like the solution of the hydrochlorate, using the acetate of morphia and acetic acid. 

injectio Morphia) Hypodermica. Hypodermic Injection of Morphia. — 
Acetate of morphia is freshly prepared by precipitating morphia from a solution of 



THALAMIFLOR^E. 713 

88 grains of hydrochlorate of morphia in 2 ounces of warm distilled water, with 
sufficient ammonia to render the solution alkaline. The morphia is washed on a 
filter, dissolved in about an ounce of distilled water, with the addition of acetic 
acid, until the whole of the morphia is dissolved and a slightly acid solution formed. 
Enough distilled water is now added to make up the solution to 2 fluid ounces 
exactly. It is then filtered, and kept from the light in a stoppered bottle. 

U.S.P. Morpliinse Sulplias. Sulphate op Morphine. (C 17 
H 19 N0 3 ) 2 .H 2 S0 4 .5H 2 ; 758. 

Characters. — White feathery silk crystals, permanent in air, no 
smell, bitter taste. Soluble in 24 parts of water at 15° C. In its 
reactions it corresponds to the hydrochlorate, but is known to be a sul- 
phate by giving with chloride of barium a white precipitate insoluble in 
hydrochloric acid. 

Peepaeations. 

dose. 

Pulvis Morphinse Compositus 10 grs. (065 Gm.) 

Trochisci Morphinse et Ipecacuanhse 

Pulvis Morphinse Compositus. COMPOUND POWDEE OF MOEPHINE (Tully's 
Powder). — Sulphate of Morphine, 1 ; camphor, 20 ; glycyrrhiza, 20 ; precipitated 
carbonate of calcium, 20 ; alcohol, q.s. to mix the camphor intimately with the other 
ingredients. It is intended as a substitute for Dover's powder. 

U.S.P. ApoHiorpliinae Hydro cMoras. HYDROCHLORATE OP 
Apomorphine. C 17 H 17 N0 2 HC1 ; 303 4. — The hydrochlorate of an 
artificial alkaloid prepared from morphine. It should be kept in small, 
well-stoppered vials, in a dark place. 

Preparation. — By heating morphine with concentrated hydrochloric 
acid. 

Characters. — Minute, colorless, or grayish-white, shining crystals, 
turning greenish on exposure to light and air, odorless, having a bitter 
taste, and a neutral or faintly acid reaction. Soluble in 6 # 8 parts of 
water and in 50 parts of alcohol at 15° C. (59° F.) ; slowly decomposed 
by boiling water or boiling alcohol ; almost insoluble in ether or chloro- 
form ; should it impart color to either of these liquids, it should be 
rejected, or it may be purified by thoroughly agitating it with either 
liquid, filtering, and then rapidly drying the salt on bibulous paper, in a 
dark place. The aqueous solution, on gentle warming, rapidly turns 
green, but retains a neutral reaction. Solution of bicarbonate of sodium, 
added to an aqueous solution of the salt, throws down the white, amor- 
phous alkaloid, which soon turns green on exposure to air, and forms a 
bluish-green solution with alcohol, a purple one with ether or pure ben- 
zol, and a violet or blue one with chloroform. Addition of test solution 
of nitrate of silver to an aqueous solution of the salt produces a white 
precipitate, insoluble in nitric acid, but instantly reduced to metallic silver 
by water of ammonia. 

Dose. — 1 1 Q - I grain (-006--012 Gm.) hypodermically as emetic. 

Action. — When given internally or injected hypodermically apo- 
morphine acts as an emetic, producing nausea and vomiting in from 
five to twenty minutes. After vomiting has occurred the nausea usually 
disappears quickly. It usually produces less depression than tartar 
emetic, but collapse has occurred from its use in children. It probably 
causes vomiting, partly reflexly and partly directly, in the same way as 



714 VEGETABLE MATERIA MEDIC A. 

tartar emetic (p. 325). It stimulates the inotor centres' in the brain 
and the respiratory and vomiting centres in the medulla, and afterwards 
paralyzes them. 

In rabbits, which cannot vomit, apomorphine causes constant move- 
ment, rapid breathing, convulsions, paralysis, and death. In cats and 
dogs small doses cause vomiting, while large doses do not, but produce 
manege movements and paralysis. 

It paralyzes muscular fibre, voluntary and involuntary, but does 
not affect motor or sensory nerves. The pulse is at first quickened, 
while the blood-pressure is unaltered ; but large doses paralyze the heart. 
The secretion of bronchial mucus is increased (p. 226). 

Uses. — It is used as an emetic for the purposes already mentioned 
(p. 326). Its special advantages are the readiness with which it can be 
administered by hypodermic injection without causing any local irritation, 
and the short duration of the nausea it occasions. It is useful also as 
an expectorant, alone or along with morphine (p. 226). 

TJ.S.P. Codeina. Codeine. C 18 H 21 N0 3 .H 2 ; 317.— An alka- 
loid prepared from opium. It is probably methyl-morphine. Morphine 

= C 17 H 18 N0 2 (OH); codeine = C 17 Hi 8 N0 2 (OCH 3 ). 

Characters. — White, or yellowish-white, more or less translucent, 
rhombic prisms, somewhat efflorescent in warm air, odorless, having a 
slightly bitter taste and an alkaline reaction. Soluble in 80 parts of 
water, at 15° C. (59° F.), and in 17 parts of boiling water ; very solu- 
ble in alcohol and in chloroform ; also soluble in 6 parts of ether and in 
10 parts of benzol, but almost insoluble in benzin. When heated to 
120° C. (248° F.), codeine loses its water of crystallization. At about 
150° C. (302° F.) it melts, and, on ignition, it is completely dissipated. 
Codeine is dissolved by sulphuric acid containing 1 per cent, of molyb- 
date of sodium, to a liquid having, at first, a dirty green color, which, 
after awhile, becomes pure blue, and gradually fades, within a few 
hours, to pale yellow. On dissolving codeine in sulphuric acid, a color- 
less liquid results, which, on the addition of a trace of ferric chloride, 
and gentle warming, becomes deep blue. An aqueous solution of 
codeine, added to a test solution of mercuric chloride, should produce no 
precipitate ; and if codeine be added to nitric acid of sp. gr. 1*200, it 
will dissolve to a yellow liquid which should not become red (difference 
from and absence of morphine). 

Dose. — For diabetes J grain gradually increased to 5 grains or more 
three times a day, unless it produces great drowsiness or the sugar disap- 
pears. For cough J of a grain every three or four hours. 

Action. — Codeine has only a slight hypnotic action, and may some-' 
times be given in doses of 15 grains daily without producing any marked 
drowsiness in diabetic patients. Others again are rendered drowsy by 5 
or 6 grains daily. Its most marked action appears to be on the nerves 
of the abdominal viscera and on motor centres in the brain. When 
given for several days it lessens the irritability of the digestive tract so 
that irritant poisons, like arsenic, produce neither vomiting nor purging. 

It increases the irritability of the spinal cord, and produces in 
frogs languor succeeded by convulsions and paralysis. In mammals it 



THALAMIFLOK^E. 715 

appears rather to stimulate motor centres in the brain (p. 174). It 
causes some drowsiness, but the motor phenomena are most marked. 
These are twitchings, manege or swimming movements, paralysis of the 
hind-legs, and weakened circulation, followed by a sudden shriek and 
convulsions. Death may occur at once or recovery occur. 

I have observed symptoms very like these in poisoning by pure 
brucine, and in some points they resemble those of picrotoxin (p. 707). 

Uses. — Although it is not a powerful hypnotic like morphia, codeine 
has been strongly recommended in nervous insomnia, and also in cases 
where sleep is prevented by the pain of rheumatism or cancer or by dis- 
tressing cough. Its power to lessen the irritability of the intestinal 
nerves has been already mentioned, and possibly it exerts a similar action 
on the nerves of other viscera, such as those of the respiratory organs, 
&c. Such an action would explain its beneficial effects in cough when 
morphia cannot be borne. Its chief use is in diabetes. 1 It certainly 
lessens, and sometimes entirely removes, the sugar from the urine. As 
Claude Bernard found that irritation of the central end of the cut vagus 
caused dilatation of the hepatic vessels and the appearance of sugar in 
the urine, it seems not improbable that the utility of codeine in diabetes 
is due to its power of lessening the irritability of the afferent fibres in the 
nerves of the abdominal viscera. This is rendered all the more likely by 
the fact that codeine does not prevent the occurrence of sugar in the 
urine in carbonic oxide poisoning, 2 where alterations in tissue change, 
leading to glycosuria, are probably of a more general nature, and less 
dependent on local alterations in the hepatic circulation. 

Physiological Action of Opium. 

General Action. — Opium, and all its alkaloids hitherto examined, 
act almost exclusively on the central nervous system, and in mam- 
mals especially on the brain, the brain symptoms preponderating in pro- 
portion as the organ is developed relatively to the other nerve centres. 
This conclusion holds good only for mammals, and must be qualified in 
regard to the frog, for in it narcotine, codeine, papaverine, and thebaine 
have also a paralyzing action on the motor ganglia of the heart. Opium 
and its alkaloids agree not only in the organ they affect, but in the nature 
of their action. The symptoms may be divided into two stages : — 

(1) Narcosis, due to a paralytic action on the brain, followed by 

(2) Tetanus, due to increased irritability of the spinal cord. 
Action on Frogs. — If the drug be introduced by injection under 

the skin of a frog, the functions of the nerve centres are abolished 
in the order of their development, the highest centres being first affected 
p. 168). 
The first symptom to appear after the injection of the drug is a 
diminution of the power of voluntary movement ; the frog remains quiet, 
making no effort at voluntary movement, but, when irritated, responds to 
the stimulation by springing in the usual way. Next, the power of 



1 Pavy, Guy's Hospital Reports. 

2 The late Otto Schultzen. 



716 VEGETABLE MATERIA MEDICA. 

co-ordination is lost ; the frog springs as before when irritated, but has 
no control over the direction of its leaps. It then gradually loses the 
power of springing in response to stimulation, and finally reflex action 
cannot be excited. The heart is unaffected. 

After a time increased excitability of the spinal cord comes on, so that 
the slightest irritation causes muscular spasms like those of strychnine 
poisoning. During this condition the spinal cord of the frog does not 
react to stimuli in the ordinary way, but responds as it were by one 
violent explosion, after which it seems to become exhausted for a time, 
but after an interval another violent spasm can be induced, so that there 
are alternating periods of spasm and exhaustion. If the action of the 
drug be not pushed beyond this point, the phenomena will pass off in the 
reverse order of their appearance. If pushed further, there succeeds 
a deepening paralysis, and respiration becomes first slower and then stops. 

Action on Birds. — Birds are peculiarly insusceptible to the action 
of opium or morphine. 

Action on Mammals. — Opium causes partial abolition of voluntary 
movement, sometimes preceded by a certain amount of increased excita- 
bility, followed by sleep. Sometimes the spinal cord shows signs of 
increased excitability with diminished conducting power, evidenced by 
convulsions with a tendency to paralysis of the hinder limbs. 

Action on Man. — In man the action of opium is chiefly upon the 
brain, producing sleep. When taken in small doses of \ gr. to 1 gr. 
there is, first, a stage of excitement of the circulation, as evidenced by 
the pulse being fuller and quicker, and by the surface of the skin being 
warm and flushed. During this stage the individual has the power of 
directing his energies to any particular object, and the action of the drug 
causes him to do well whatever he wishes to do. Thus, if he wishes to 
sleep, and surrounding circumstances be favorable, an agreeable languor 
followed by quiet sleep comes on. He can be easily aroused from this 
sleep ; and after a few hours the effect passes off, leaving, however, slight 
headache and languor, with dryness of mouth and slight nausea. If, on 
the other hand, he wishes to work, he can do this with increased energy ; 
or, if he desires to exert the mind, he will find his imagination more 
vivid, his thoughts more brilliant, and his power of expression greater 
(Christison). The after-effects are the same as after sleep. 

With moderate doses of 1 gr. to 2 grs. the stage of excitement 
is short and is followed by deep sleep, from which the person can still 
be aroused. The after-effects are severe headache, with nausea, furred 
tongue, and loss of appetite. During the stage of sleep the brain is 
anaemic, both the arteries and veins being empty (vide p. 179). 

With large doses of 3 grs. or more the first stage is very short. 
Sleep rapidly follows, becomes deeper and deeper, and passes into coma, 
from which the patient can no longer be aroused. The arms and limbs 
are limp ; the face is generally pale, with a bluish tinge at times ; the 
eyes are sunken, the pupils very much contracted, almost to the size of a 
pin's point; respiration slow and stertorous. The pulse during sleep 
and coma is slow and full ; as coma proceeds it becomes feebler. Finally 
(loath by asphyxia occurs, the respiration ceasing before the heart. It 
may occasionally be preceded by convulsions, though this is rare. 



THALAMIFLOILiE. 717 

Post-niortem the ordinary appearances of death by asphyxia are 
found, viz., congestion of the brain and lungs, etc., the ventricles of the 
brain contain serous fluid, the veins of the brain and spinal cord are dis- 
tended with dark blood ; and there may be slight extravasation of blood 
in some of the tissues. 

Diagnosis between Opium Poisoning", Intoxication, and 
Apoplexy. — One should obtain the history of the case where it is pos- 
sible. When this cannot be done, for instance in cases where the 
patient is found lying unconscious, the diagnosis is sometimes extremely 
difficult. 

Notice first the odor of breath ; the smell guides one in opium 
poisoning. The smell of alcohol does not assist one much, as it may be 
taken with opium ; and in apoplexy brandy is frequently given by the 
person who first finds the unconscious patient. 

Secondly, the pupil, which is very much contracted in opium, but 
dilated in alcoholic, poisoning, and often unequally contracted in apoplexy. 
It must be borne in mind that in apoplexy of the pons varolii, the pupils 
may be equally and extremely contracted, just as in opium poisoning. 
In apoplexy, the arms, on being raised and then relaxed, fall unequally 
on the two sides, one being more rigid or flaccid than the other. In no 
case should the individual be treated roughly or exposed to the slightest 
chance of a chill, but on the contrary he must be kept warm ; and if it 
appears to be a case of poisoning by alcohol or opium, and not apoplexy, 
the stomach should be washed out and strong coffee injected. 

Treatment in Opium Poisoning-. — Evacuate the stomach as soon 
as possible by administering 20 grs. of zinc sulphate in a little water ; if 
this acts, then give some strong coffee. Sometimes the zinc will not 
produce vomiting on account of the insensibility of the stomach and 
vomiting centre, due to the action of the opium. If such be the case, 
employ the stomach pump ; wash out the stomach with warm water, and 
inject coffee. Keep the patient awake by walking him about the room, 
tapping on the forehead with the finger-nails, or flicking him with a wet 
towel. Apply mustard leaves to various parts of the body, or use a 
galvanic battery. Cold affusion is a good adjunct, but the alternate use 
of hot and cold water is better, both as a stimulant and as preventing the 
risk of chilling the patient. Lastly, give a subcutaneous injection of 4 
minims of liq. atropise, B.P., every ten minutes, until symptoms of 
recovery show themselves or the pulse is quickened or the pupil dilated. 

Precautions. — Do not allow the patient to become cold while trying 
to rouse him, and take care not to chill him when applying cold affusions, 
as death may result from syncope after recovery from the comatose con- 
dition. The average length of insensibility is twelve hours, and if this 
period be passed, recovery is nearly certain, but sometimes the symptoms 
may reappear, and death from asphyxia or syncope occur. 

Treatment of the Symptoms after an Ordinary Dose. — 
Strong coffee, with or without brandy, or lemon-juice and water, should 
be administered. The patient should be kept in bed. 

Action on Special Organs. — Opium has little action on muscular 
contractility. The action of opium on the motor nerves is doubtful. 
According to some observers, it first increases and then diminishes their 



718 VEGETABLE MATERIA MEDICA. 

excitability, the action commencing at the centres and proceeding towards 
the periphery. Others, however, have found that opium has little or no 
action on them, except towards the end of poisoning, when all the func- 
tions are paralyzed. 

The sensory nerves are first excited and then paralyzed. Opium 
applied locally is said by some observers to have no action on the sensory 
nerves, but it has been found to have a paralyzing action by Baxt. 
The results of his experiments are confirmed by clinical experience, for 
when the drug is injected subcutaneously it lessens sensibility, diminishes 
the power of distinguishing tactile impressions, and relieves pain when 
present. 

When applied externally to the eye, or to the skin denuded of its 
epidermis, opium also relieves pain. 

Opium lessens first the conducting power of the spinal cord, then 
the reflex functions, producing, first, inco-ordination of the movements 
of the hind limbs, and then paralysis of reflex action. 

Opium acts on the centres of the brain in the order of their impor- 
tance ; thus in the frog, there is, first, loss of voluntary motion, such as 
may be produced by extirpation of the cerebral hemispheres ; next, loss 
of co-ordination, such as is produced by extirpation of the optic lobes ; 
and lastly, effects like those produced by destruction of the medulla 
(p. 168). 

The pupil is markedly contracted by opium, the action of the drug 
being probably central and not peripheral ; but the exact mode of action 
has not been definitely made out. Stimulation of sensory nerves causes 
reflex dilatation of the pupil, and it is not improbable that the contrac- 
tion which opium produces is due to its paralyzing this reflex action more 
or less completely (p. 198). 

The pupil sometimes dilates just before death. This dilatation is 
probably due to the excessively venous condition of the blood, as in the 
later stages of chloroform poisoning. 

The first effect which opium has on the circulation is to cause a 
dilatation of the vessels of the skin, sometimes giving rise to a cutaneous 
eruption of a roseolar character, accompanied by itching, and coming on 
either before or after sleep. 

The vaso-motor centre in the medulla is slightly, if at all, affected 
by small doses of opium. Large doses paralyze it. 

The drug appears to have a peculiar action on the peripheral vaso- 
motor apparatus. It is well known that stimulation of the chorda 
tympani causes dilatation of the vessels of the submaxillary gland, but I 
found that after the exhibition of opium the vessels of the gland no longer 
dilated, but on the contrary contracted, on stimulation of the chorda 
tympani, so that the blood which issued from the gland was not of a 
bright arterial hue, but was very dark, and flowed drop by drop. This 
observation requires confirmation; but if it be confirmed, this result 
might serve to explain the effect of opium in cutting short inflammations, 
e.g., of the peritoneum. 

In peritonitis as in other inflammations the blood-vessels are greatly 
dilated. Opium by its action on the vaso-motor centre, and (if these 
experiments be correct) by its action also on" the peripheral terminations 



THALAMIFLOR.E. 719 

of vaso-motor nerves, will prevent or diminish the reflex dilatation of the 
vessels which the local irritation would otherwise produce. Congestion 
will thus be diminished and inflammation will thus be relieved. The 
action of opium in peritonitis is therefore probably twofold. First, it 
lessens peristaltic movements of the intestines and thus diminishes local 
irritation. Secondly, it lessens the reflex activity of the centres through 
which local irritation causes dilatation of the vessels and thus diminishes 
peritoneal congestion. The late Sir Robert Christison used to say that 
not only coryza but probably all inflammations could be nipped in the 
bud by opium if it were only given sufficiently early and sufficiently 
freely. 

Tlie "blood-pressure appears to be but little affected by opium. 
It varies after the injection of the drug, but this variation is probably 
due to an alteration in the general functions of the body, for example, 
great quiet, &c. 

Opium has little direct action on the heart, which continues to beat 
after the nervous centres have been experimentally destroyed in animals. 

On Secretion. — The secretions of the body, except those of urine 
and of sweat, are lessened by opium. 

If the lingual nerve of an animal be stimulated, a reflex flow of saliva 
takes place; but when opium has been given in sufficient quantity this 
reflex action is paralyzed, and stimulation of the nerve no longer excites 
a flow. Very large doses may cause salivation (p. 313) however. Opium 
also diminishes the other secretions of the alimentary canal, causing 
impairment of digestion, and this action serves partially to explain the 
constipation produced by opium. 

The quantity of sweat secreted is increased by opium, and especially 
so when it is combined with ipecacuanha. Just before death by opium 
the secretion of sweat is greatly increased, so that the surface is bathed 
in it, but this is due to stimulation of the sweat centres in the spinal cord 
\ by the increasing venosity of the blood (p. 378). 
\ The quantity of urine is frequently lessened. Sometimes it may 
be really increased, but appear diminished in consequence of paralysis 
of the bladder preventing its being evacuated. Sometimes there is con- 
stant desire to pass water. 

On the Intestines. — The action of opium on the intestines varies 
with the dose. On isolating a piece of intestine and supplying it arti- 
ficially with blood, the action of opium may be observed by mixing it 
with the blood (p. 333). When used in large quantity all peristaltic 
action ceases, and the intestine becomes tetanically contracted. Hence 
in large doses, injected directly into the jugular vein, it acts as a most 
powerful purgative, causing one very copious evacuation. It acts chiefly 
on the small intestines. In moderate doses it lessens peristaltic action 
and causes constipation. In very small doses it generally increases 
peristalsis and acts as a purgative, but not invariably so. This property 
is made use of in cases of constipation due to reflex irritation starting 
from the ovary. The mode of action has already been discussed at p. 336. 

Elimination. — Morphine is eliminated by the gastric mucous mem- 
brane (p. 55), and may be found in the stomach after subcutaneous 
injection. It is excreted also in the bile, but may remain a long time 



720 VEGETABLE MATERIA MEDICA. 

in the liver. It is found unchanged in the urine. In cases where its 
use has been continued for some time, some of it probably becomes 
changed in the body, as a substance with the chemical reactions of oxydi- 
morphine has been found in the liver and kidneys in such cases. 

Circumstances Modifying the Action of Opium. 

Age — In childhood the brain is proportionately larger than in adult 
life, hence the effect of opium is greater than in adults, and children bear 
it very badly ; consequently smaller doses must be given than are pro- 
portionate to their ages. Care is necessary from the age of 6 months to 
1 year, as one minim has produced fatal results. In old age the dose 
must be diminished according to the advance in years. 

Sex. — Women are more readily affected than men, and are more 
liable to nausea and headache after its administration. 

Idiosyncrasy. — Small doses easily affect some, and on the other 
hand large doses are nearly inert in other subjects. Excitement and 
delirium, instead of quietness and sleep, are not unfrequently produced. 
In such cases it is best to give a few whiffs of chloroform to quiet the 
patient and induce sleep, if the excitement has already come on. 1 If it 
is necessary to give opium or morphine to a patient having this idiosyn- 
crasy, it ought to be combined with chloral or a bromide, or with both. 
In some persons excitement and wakefulness occur on the night imme- 
diately succeeding the dose, and sleep only occurs on the second night. 

Habit. — The effect of habit is perceived in two ways — in some cases 
large quantities are required to produce a result — in others a long inter- 
val is necessary for the drug to take effect. As much as two pints of the 
tincture have been taken in the course of a day ; and as much as 12 gr. 
of morphine have been subcutaneously injected. Both slowness and 
weakness of action may result from its continued use, so that it may be 
necessary not only to give a larger dose but to give it a considerable 
time beforehand. In one case with which I am acquainted, after a few 
months, during which the time gradually increased, it became necessary 
to give the dose 24 hours before its effect was desired. 

The explanation of this tardy action probably is that the absorptive 
power of the intestines is diminished by the continual use of the drug, 
for it is well known that opium-eaters can take large doses of corrosive 
sublimate without experiencing any ill effects, the drug being but slowly 
absorbed. 

But it is quite possible, indeed probable, that there is, besides 
delayed absorption, another factor in the tolerance of opium induced by 
repeated doses. It is possible that part of the morphine introduced is 
converted in the organism into oxydimorphine, which appears, to a cer- 
tain extent, to counteract the soporific action of morphine, 2 or into other 
substances which may have this action. Each dose of morphine will 
thus leave in the body substances having an action antagonistic to the 



1 Morrant Baker, St. Bartholomew's Hospital Reports. 

2 Diedrich, " Ueber Oxydiniorphiu," Inaug. Diss. Gbttingen, 1883. 



THALAMIFLOR.E. 721 

next dose unless a sufficient interval should elapse between them to allow 
them to be completely eliminated. 

Opium Eating-. — When opium is first taken, its action is to stimu- 
late and afterwards depress ; to remove this depression the individual 
takes another dose ; a habit of taking the drug thus becomes estab- 
lished. The nervous system suffers, the mental powers become enfeebled, 
the moral faculties perverted, and there is inability to distinguish between 
truth and falsehood. Then the motor powers are attacked, the gait 
becomes shuffling and uncertain, and digestion is impaired. The bowels 
may be constipated, but are generally loose. 

When morphine is taken for some time in medicinal doses, obstinate 
vomiting sometimes sets in and will not yield to ordinary remedies. It 
is usually checked by discontinuing the administration of the drug. This 
vomiting may possibly be due to the morphine being converted into oxydi- 
morphine 1 or apomorphine in the system. 

If the patient has been accustomed to the use of hypodermic injec- 
tions of morphine, hypodermic injections of water should be substituted in 
such cases. 

Disease. — When a patient is suffering intense pain, opium is well 
borne, and must be given in large quantities ; as, for example, to a per- 
son suffering from peritonitis. In cases of Bright's disease small doses 
may produce disproportionately great effects (p. 56). Hence in these 
cases the drug must not be given in large quantities, and the effect of 
each dose must be carefully watched. 

Combination with, other Drugs. — Chloroform sometimes modi- 
fies the action of opium, the chloroform narcosis passing into opium 
sleep, or the opium sleep may more resemble chloroform anaesthesia ; 
hence the use of the two drugs together may be of advantage in certain 
operations, such as excision of the jaw, where it is difficult to continue to 
administer an anaesthetic (p. 190). 

In some cases opium will not produce sleep even in large doses, and 
it is then advisable to combine it with a small dose of hydrate of chloral. 
Sometimes when opium has been given to produce sleep, and has only 
caused excitement, a few whiffs of chloroform will quiet the excitement, 
and the patient sinks into a quiet sleep. 

Action of the Alkaloids of Opium. — The action of the opium 
alkaloids has not been fully made out, and various results have been 
obtained by different observers. It is certain, however, that morphine is 
in mammals almost entirely narcotic, whilst thebaine is purely convul- 
sive. Between these extremes the other alkaloids probably range them- 
selves in such an order that they may be divided in two sub-groups, the 
first of which may be called the morphine group, characterized by the 
prominence of the narcotic stage, while in the other, which may be called 
the codeine group, the tetanic stage is more prominent, and the narcosis 
less so. The members of these groups may be arranged as follows, so 
that each subsequent member has a weaker narcotic, and in the codeine 
group has at the same time a stronger convulsive, action : 



1 Diedrich, op. tit. 

46 



722 VEGETABLE MATERIA MEDICA. 

Morphine Group. Codeine Group. 

Morphine. Papaverine. 

Oxydimorphine. Codeine. 

Narcotine. 

Thebaine. 

The codeine group contains also hydrocotarnine, laudanosine, and 
cryptopine ; but at present we know too little about them to assign a 
place in the group to them with certainty. The same may be said of 
codethyline. The codeine group becomes closely allied by its last mem- 
bers with the strychnine group. 

By the addition of alcoliol radicals to morphine, substances to 
which the name of codeines has been given are produced. In some of 
these, such as codethyline, C 17 H 18 N0 2 (OC 2 H 5 ), obtained from morphine 
by the introduction of ethyl, the narcotic action is diminished, whilst, 
according to Von Schroeder, the convulsive action is increased in pro- 
portion to the number of atoms of hydrogen substituted by alcoholic 
radicals. If such be the case it is remarkable that by the addition of 
alcohol radicals to codeine or thebaine, their tetanizing action should be 
altered into a paralyzing action, methyl-thebaine producing paralysis 
like methyl-strychnine. 1 

In the alkaloids produced from morphine by oxidation (oxydimor- 
phine and oxymorphine), their narcotic action is diminished, without the 
convulsant action being increased. Narceine has no apparent physio- 
logical action. 2 

Apomorphine has no narcotic action, but is an emetic acting on the 
vomiting centre in the medulla. In large doses it does not produce 
vomiting, but causes peculiar manege movements. 

Morphine is said to be less constipating, less diaphoretic, and less 
nauseating than opium. Others affirm that opium is less nauseating. It 
is also said that opium quickens the pulse and raises the temperature at 
first, and then depresses both, while morphine depresses them both from 
the first. 

The activity of morphine appears to depend on the presence of 
hydroxyl (HO) in it. When this is replaced by S0 4 its activity is 
greatly diminished. 3 

Therapeutics. General Uses. — The general uses of opium in 
disease are (1) to lessen pain ; (2) to produce sleep ; (3) to lessen irrita- 
tion in various organs. 

Local Uses. — Opium is a local sedative, and is applied to the skin 
and irritable surfaces to relieve pain, thus : — 

Fomentations or liniments containing it are used for inflamed joints, 
myalgia, lumbago, pleurisy, peritonitis, herpes zoster, etc. 

Morphine dissolved in glycerine and spread on lint is used to allay 
pain in cancer ; and, applied either by the endermic or hypodermic 
method, is useful in neuralgia. In many cases, however, the injection of 

1 Crum-Brown and Fraser, Trans. Roy. Soe. of Edinburgh, vol. xxv. 

2 Von Schroeder, Archie f. exper. Path, und Pharm., p. 96, vol. xvii. 
8 Stolnikow, Ztschr. f. Physiol. Chemie, viii., p. 23G. 



THALAMIFLOK^E. 723 

pure water will relieve the pain, and hence part of the relief is probably 
due to the local irritation caused by the injection. 

Opium lessens pain in conjunctivitis, earache, and toothache. In 
conjunctivitis it may be used in the form of liquid extract of opium 
dropped into the eye ; and in toothache applied to the cavity of the 
tooth, as laudanum on a pledget of cotton-wool. In the latter malady it 
is well to add a little sodium bicarbonate to neutralize the acid secretions 
in the mouth. 

Opium, used in the form of ointment of galls and opium, or of opium 
or morphine suppositories, relieves pain in the rectum caused either by 
ulcers, fissure, or haemorrhoids. 

Morphine subcutaneously injected has been used to produce local 
anaesthesia, as in evulsion of toe-nails. 

Digestive System. — Opium often relieves salivation when due to 
reflex irritation in the mouth ; if this fails, belladonna may succeed 
(p. 318). 

It relieves the pain and vomiting due to irritability of the stomach, 
as in cancer and ulcer of the stomach, but if they are due to simple neu- 
ralgia of the stomach, small doses of arsenic are preferable. 

In biliary colic opium or morphine is given either by the stomach or 
hypodermically. It may be used either with, or instead of, the inhalation 
of chloroform (pp. 190 and 191). 

In diarrhoea opium is often useful when other astringents fail. 

In dysentery it is generally combined with ipecacuanha. 

In cholera opium is frequently given, but during the cold stage 
absorption is so slow that it has very little action. In these cases 
patients have been known to die from opium poisoning, as soon as partial 
recovery had taken place and absorption was re-established. 

In peritonitis it is used both internally and externally. It should be 
given freely in doses of 1-2 gr. every four hours or oftener, and fomen- 
tations to the abdomen should be used externally. The action of the 
opium in this disease is twofold and possibly threefold : — (i.) It stops the 
peristalsis of the bowel, (ii.) It relieves pain, (iii.) It has possibly an 
action on the blood-vessels, lessening congestion in the manner already 
discussed (p. 719). 

Very small doses (1 or even J drop of tinct. opii in syrup or pepper- 
mint water) relieve certain forms of constipation, e.g., that caused 
reflexly by ovarian irritation. The opium probably acts on some reflex 
centre in the lumbar portion of the cord, and the minute dose probably 
just turns the reflex impulse from the inhibitory to the motor fibres of 
the splanchnic (p. 336). If these small doses are insufficient, the opium 
may be gradually increased, until it is clear that it is increasing instead 
of lessening the constipation. 

Respiratory Tract. — Opium will cut short catarrhal conditions of 
the respiratory tract, and 10 grains of Dover's powder at night is very 
useful when a a cold " is coming on. It is also used in phthisis to cut 
short an acute exacerbation due to taking cold (p. 293). 

It relieves cough, and is best given in the form of linctus, so as to 
act locally as well as generally (p. 223). Applied locally it is used to 
relieve cough and pain on swallowing in tubercular disease of larynx, 



724 VEGETABLE MATERIA MEDICA. 

and a very good method is to mix ^ to J gr. of morphine with 1 gr. of 
starch or 3 grs. of subnitrate of bismuth, and blow the mixture well 
down into the larynx, the patient taking a deep inspiration at the same 
time (vide p. 411). Opium is used in asthma and bronchitis, but one 
should be careful of its use when the secretion from the bronchial mucous 
membrane is profuse, for during sleep, when the respiratory and other 
centres are dulled by the opium, the fluid may increase to such an extent 
as to suffocate the patient, who is unable to expectorate it on awaking. 

Circulatory System. — It is useful in cardiac dyspnoea with sleep- 
lessness, and in angina pectoris it sometimes gives relief. 

It is useful in haemorrhages, especially those from the uterus. It 
may be combined with digitalis (tinct. opii TTL xxx., tinct. digitalis 

m xxx.). 

G-enito -Urinary Tract. — Opium is used in diabetes to lessen the 
amount of urine and of sugar, but codeine (J— 5 grs. ter die) is often used 
instead, the advantage it possesses being that it does not render the 
patient so drowsy. Opium allays irritability and pain, as in renal colic 
or irritable bladder. 

Skin. — If the skin is too dry, Dover's powder will cause diaphoresis, 
and yet it will check the night-sweats of phthisis. 

For the probable cause of this peculiar action vide p. 383. 

The two most important uses of opium and morphine are to relieve 
pain and produce sleep. In their power to relieve pain opium and 
morphine stand unrivalled, for they can be more generally applied than 
anaesthetics, such as chloroform. They frequently relieve pain even in 
doses too small to produce any other marked effect. When the pain is 
great, large doses may be required, but even then the other effects they 
would usually produce seem frequently to be counteracted by the pain, 
so that they relieve it without causing drowsiness or stupor. Opium and 
morphine are employed in neuralgias of various kinds, such as tic, 
sciatica, or intercostal neuralgia, in dysmenorrhoea, and in cancer. It is 
used to lessen both pain and inflammation in rheumatism and inflamma- 
tory conditions, such as pleurisy, pneumonia, peritonitis, cystitis. It is 
used to lessen pain and spasm in ordinary colic, lead colic, and in hepatic 
and renal colic. 

Nervous System. — Opium or morphia is used to relieve sleepless- 
ness due to almost any cause, but in cases of worry or worn-out condi- 
tions of the nervous system it is better to use bromide of potassium or 
chloral, as opium-taking becomes a habit. If these will not act, it may 
be necessary to use opium. 

In fevers and delirium 10 TTL tinct. opii may be given with J gr. of 
tartar emetic, and the effect watched. 

In mania, delirium tremens, and chorea, morphine may be given 
subcutaneously, but bromide of potassium and chloral are often preferable. 

In intense melancholia subcutaneous injection of morphine may be 
used, but care must be taken not to establish the opium habit. Small 
doses of tincture of opium (5-10 min.) by the mouth are also very useful. 
Care should be taken to disguise the drug so that the patient may not 
know what he is taking, and thus to prevent the risk of his taking opium 
afterwards at his own pleasure. Morphine is sometimes employed to 



THALAMIFLORiE. 725 

prolong the anaesthesia of chloroform, as in excision of upper jaw, where 
it is inconvenient to continue the administration of chloroform. 

In malarial poisoning there appears to be a hyper-sensibility of the 
vaso-motor centre, so that a draught of cold air blowing on the surface, 
slight gastric irritation, or even slight distention of the bladder, will 
cause contraction of the cutaneous vessels and shivering, in one suffering 
from such poisoning. Opium appears to be useful in such conditions, 
probably by lessening the excitability of the vaso-motor centre. 

Opium-eaters are frequently found in the fen districts, and in some 
forms of ague in the tropics opium has been of service when quinine has 
failed, and the two drugs combined have been still more serviceable than 
either alone. 

Contra-indications : — 

(1) Childhood, till the age of 5 years. Either abstain totally, or be 
most cautious in the use of opium and its preparations, as small doses act 
with disproportionate power. 

(2) Blocking of the bronchial tubes by excessive secretion. 

(3) Congestion of the brain, with suffused eyes and contracted pupils. 

B.P. Rhoeados Petala. Red Poppy Petals. — The fresh petals 
of Papaver Rhoeas. From indigenous plants. 

Characters. — Of a scarlet color and heavy poppy odor. On dry- 
ing, they become dull in color and lose their odor. 

Composition. — They contain a red coloring matter soluble in water 
and spirit, but none of the alkaloids of opium. An alkaloid, rhoeadine, 
which they do contain has no poisonous action. 

Use. — They have little or no physiological action, and are only used 
for coloring. 

Peepakation. 

B.P. DOSE. 

Syrupus Rhceados 1 fl. dr. or more. 

XJ.S.P. Sanguinaria. Sanguinaria. Bloodroot. — The rhizome 
of Sanguinaria canadensis, collected in autumn. 

Characters. — About two inches (5 centimetres) long, and two-fifths 
of an inch (10 millimetres) thick, horizontal, cylindrical, somewhat 
branched, faintly annulate, wrinkled, reddish-brown ; fracture short, 
somewhat waxy, whitish, with numerous small, red resin-cells, or of a 
nearly uniform, brownish-red color ; bark thin ; odor slight ; taste per- 
sistently bitter and acrid. 

Composition. — It contains an alkaloid — sanguinarine. 

Action. — Sanguinarine appears to irritate the intestinal canal, 
producing vomiting and diarrhoea. Small doses, after absorption, stimu- 
late the medullary centres for respiration and circulation, and motor 
centres in the brain and spinal cord. They thus cause increased 
respiration, rapid pulse, and increased blood-pressure. Larger doses 
produce convulsions which are clonic in mammals and tetanic in frogs. 
In the latter they still persist after section of the cord. Large doses 
paralyze all these centres, and cause death by paralysis of respiration. 

Uses. — Except as a stimulant expectorant in chronic bronchitis it is 
rarely employed. 



726 VEGETABLE MATERIA MEDICA. 

Officixal Pbepakations. 

U.S.P. DOSE. 

Acetuni Sanguinariae 15-30 min. 

Extracturn Sanguinarice Fluidum 1-5 min. 

Tinctura Sanguinariae 1-3 fl. drm. 

U.S.P. Chelidonium. Chelidonium. Celandine. — Chelido- 
nium majus. 

Characters. — Root several-headed, branching, red-brown ; stem 
about twenty inches (50 centimetres) long, light green, hairy ; leaves 
about six inches (15 centimetres) long, petiolate, the upper ones smaller 
and sessile, light green, on the lower side glaucous, lyrate-pinnatifid, the 
pinnae ovate-oblong, obtuse, coarsely crenate or incised, and the terminal 
one often three-lobed ; flowers in small, long-peduncled umbels with two 
sepals and four yellow petals ; capsule linear, two-valved and many- 
seeded. The fresh plant contains a saffron-colored milk-juice, and has 
an unpleasant odor and acrid taste. 

Dose. — 10 to 30 grains. 

Composition. — It contains two alkaloids — chelidonine and chelery- 
thrine — the latter being supposed to be identical with sanguinarine. 
Chelerythrine, however, as obtained from chelidonium, has no tetanizing 
action, but produces paralysis and loss of reflex action (Schroff, jun.). 
Chelidonine has a bitter, acrid taste, but appears to have little physio- 
logical action. 

Uses. — Externally the fresh juice acts as a local irritant, and is 
used to destroy corns or warts, and to lessen itching in skin diseases. 
When given internally in large doses it excites violent purging. It was 
formerly much used in jaundice. It appears to act as a bitter tonic 
and alterative, and is employed in phthisis and scrofula. 

CRUCIFERJE. 

B.P. Sinapis. Mustard. The seeds of Sinapis niger and 
Sinapis alba. Also the seeds reduced to powder, mixed. 

U.S.P. Sinapis Alba. White Mustard. — The seed of Sinapis 
alba. 

U.S.P. Sinapis Nigra. Black Mustard. — The seed of Sinapis 
nigra. 

The seeds of black mustard are very small, round, and brownish- 
black outside ; those of the white are larger and yellow. Both are 
yellow inside. 

Characters of the Powder. — Greenish-yellow, of an acrid, pun- 
gent taste, scentless when dry, but exhaling when moist a pungent, 
penetrating, peculiar odor. 

Dose. — As an emetic, from one teaspoonful to a tablespoonful of 
mustard flour, mixed with a little water. 

Adulterations. — Starch. 

Test. — A decoction cooled is not made blue by tincture of iodine. 

Composition. — The pungency of the moist powder is due to oil of 
mustard, but this does not exist in the seeds or fresh powder. Both 
black and white mustard contain a crystallizable substance, called in the 



THALAMIFLOR.E. 727 

black sinigrin, and in the white sinalbin, and an albuminous body 
nryrosine. When moistened, both sinigrin and sinalbin are split up by 
the myrosine, which acts as a ferment, and yield a volatile oil. This is 
not quite the same in the two mustards, that from the black being more 
pungent; but the oil from both possesses powerful vesicating properties. 
The action of myrosine as a ferment is destroyed by a heat of 60° C. ; 
so mustard poultices should not be made with boiling water. Black 
mustard contains less myrosine than white, too little, indeed, to decom- 
pose the sinigrin completely, so that its pungency may be increased by 
admixture with white, as directed by the B.P., and as found in ordinary 
table mustard. Both mustards also contain a fixed oil. 

Peepaeatioxs (of Black Mustard). 

U.S.P. B.P. 

Charta Sinapis. Cataplasma Sinapis. 

Oleum Sinapis Volatile. Charta Sinapis. 

Oleum Sinapis. 

Charta Sinapis, U.S.P. and B.P. MUSTAED PAPEE. — In the U.S.P. the fixed 
oil is removed from the mustard by percolation from benzin before it is spread on 
the paper. Consists in the B.P. of black mustard in powder, mixed with solution 
of gutta-percha, so as to make it stick to the paper upon which it is spread, and 
then dried. It is used as a substitute for a mustard poultice by immersing it for a 
few seconds in tepid water and then applying it to the skin. Rigollot's mustard 
leaves are more frequently used than those of the Pharmacopceia. They cause, as 
a rule, sharper pain than the ordinary mustard poultice, and can rarely be borne as 
long. They are, however, more convenient and readily applied, and in cases of 
narcotic poisoning the sharp pain they cause renders them preferable to the ordi- 
nary poultice. 

B.P. Cataplasma Sinapis. MUSTAED POULTICE. — Mix linseed meal (2J ounces) 
gradually with boiling water (10 fluid ounces), and add powdered mustard (2 J 
ounces), with constant stirring. The mixture of linseed meal and water gets some- 
what cooled before the mustard is added, and so the formation of the volatile oil 
is not completely prevented ; but it would increase the irritant power of the poul- 
tice if the mustard were mixed with a little cold water a few minutes before adding 
it to the linseed. 

Oleuin Sinapis Volatile, U.S.P.; Oleum Sinapis, B.P. Vol- 
atile Oil of Mustard, U.S.P. A volatile oil obtained from black 
mustard by maceration with water, and subsequent distillation. Oil of 
Mustard, B.P. — The oil distilled with water from the seeds of black 
mustard, Sinapis nigra, after the expression of the fixed oil. It is sul- 
phocyanide of allyl (C 3 H 5 ,CNS). 

Characters. — Colorless or pale yellow. Has an intensely pungent, 
acrid odor, and burning taste. Soluble in alcohol and ether, slightly in 
water. 

Action. — Applied to the skin, it produces almost instant vesication. 

Peepaeations. 

U.S.P. B.P. 

Linimentum Sinapis Compositum. Linimentum Sinapis Compositum. 

3 parts by weight in 100, 1 volume in 42. 1 volume in 41. 

Linimentum Sinapis Compositum. COMPOUND LlNIMENT OFMUSTAED. — Volatile 
oil of mustard, 3 ; extract bf mezereon, 2 ; camphor, 6 ; castor oil, 15 ; alcohol up to 
100 parts by weight, U.S.P. The liniment of the B.P. is slightly stronger. 

Physiological Action. — Locally applied to the skin or mucous 
membranes, mustard acts as a stimulant causing warmth, redness, pain 



728 VEGETABLE MATERIA MEDICA. 

passing off if the application is short, but if the action is prolonged vesi- 
cation is produced. Internally, it is a prompt direct emetic (a table- 
spoonful of mustard in a tumbler of hot water). 

Therapeutics. — Externally it is used as a counter-irritant in 
myalgia, lumbago, headache, in the form of poultice or paper to the back 
of neck ; in congestion of the brain, apoplexy, and opium poisoning, in 
the form of poultices or leaves to the calves of, the legs and other parts of 
the body. It is applied to the chest in catarrh, bronchitis, congestion of 
the lung, and catarrhal pneumonia. In phthisis, mustard leaves applied 
to the chest are useful to check the spread of consolidation when the 
patient has taken cold. It is applied to the spine for the relief of pains 
in the loins, and loss of power in walking accompanying spinal irritation. 
For this purpose a very useful application is the linimentum sinapis com- 
positum sprinkled on some spongio-piline. Mustard baths to the feet 
are used in amenorrhoea (p. 390) and sleeplessness (p. 180). 

When Rigollot's leaves are used, the pain they cause in persons with 
delicate skins renders them almost unbearable, and in such cases two or 
three layers of damped muslin should be placed next to the skin, to 
modify their action. 

With the leaves of the B.P. it is advisable to use one layer of muslin, 
to prevent the mustard coming off the leaf and sticking to the skin. 

Internally mustard is used as a condiment, to increase the appetite by 
stimulating the mucous membrane. One important use is that of an 
emetic in indigestion or narcotic poisoning. In irritant poisoning, e.g., 
by croton oil, it is best given in linseed tea or thin gruel. 

B.P. Armoraciae Radix. NotinTJ.S.P. Horse-radish Root. 
The fresh root of Cochlearia Armoracia. Cultivated in Britain. 



Fig. 142. — Horse-radish Root. 

Characters.^A long, cylindrical, fleshy root, internally white. It 
has a pungent taste and smell. Aconite root, which has been mistaken 
for it, is short, and conical, and has a numbing instead of a pungent 
taste. 

Composition. — A volatile oil identical with that of black mustard is 
developed in it after it has been cut. 

Peepaeation. 

B.P. DOSE. 

Spiritus Armoracia) Compositus 1-2 fl. drm. 

B.P. Spiritus Armoracia; Compositus. COMPOUND SPIEIT OF HOESE-EADISH. — 
Sliced horse-radish, dried orange peel, and bruised nutmeg are mixed with diluted 
proof-spirit and distilled. 

Therapeutics. — Horse-radish is chiefly used as a condiment in cases 
of deficient digestion; also as a masticatory in hoarseness. It is some- 
times used in atonic dyspepsia, and as a diuretic in dropsies. The spirit 
is used as a pleasant vehicle. 



THALAMIFLOK^. 729 

VIOLACE^E. 

U.S. P. Viola Tricolor. Viola Tricolor. [Pansy.] — The wild- 
grown, flowering herb of Viola tricolor. 

Characters. — Stem angular and nearly smooth ; leaves alternate, 
petiolate, ovate or oblong, crenate, with leaf-like, pinnatifid stipules ; 
flowers with an obtuse spur, and the variegated petals shorter or longer 
than the calyx ; inodorous ; taste somewhat bitter and acrid. 

Composition. — It contains a little violine, a substance similar to 
emetine, and having an emeto-cathartic action. 

Uses. — It is used externally in the form of an ointment or a poultice 
in eczema and impetigo. It is sometimes given internally in bronchitis. 

Dose. — 15 to 17 gr. (1-5 Gm.) in decoction. 

LINACE^E. 

Linum, U.S.P. ; Lini Semina, B.P. Linseed, U.S.P. and 
B.P. Flax Seed, U.S.P. The seed of Linum usitatissimum. 

Characters. — About one-sixth of an inch long, oval, pointed, flattened, 
smooth, shining, brown externally, yellowish-white within. 

CoMPOSiTiON.-^-The covering of the seeds contains much mucilage, 
and the seed itself contains nearly one-third of its weight of oil. The 
oil is obtained by expression, and the remaining cake, when powdered, 
forms linseed meal. 

Prepakations. 
u.s.p. b.p. dose. 

Oleum Lini. Farina Lini 

Infusum Lini 2fl. oz., ad lib. 

Oleum Lini 

B.P. Infusum Iani. Linseed Tea. — Infuse 160 grains of linseed, with 60 grains 
of fresh liquorice root sliced, in. 10 ounces of water for four hours and strain. 

Action. — Linseed tea is a most useful demulcent in coughs, 
depending in whole or in part on irritation of the pharynx and upper part 
of the respiratory passages. It may be kept warm all night in a baby's 
food-warmer, and a sip taken whenever the patient awakes. This often 
prevents troublesome paroxysms of coughing, and enables the patient to 
obtain a fair night's rest. 

Use. — Internally it is used as a demulcent drink in enteritis, diar- 
rhoea, dysentery, catarrh, and irritation of urinary organs, also in phos- 
phorus poisoning. 

B.P. Lini Farina. Linseed Meal. — The cake of linseed from 
which the oil has been pressed reduced to powder. It is used not only 
in the cataplasma lini but also in the cataplasma carbonis, conii, sinapis, 
and sodae chloratse. 

B.P. Cataplasma Lini. Linseed Poultice. — Mix a quarter of a pound (about 
4 tablespoonfuls) of linseed meal gradually with half a pint of boiling water, and 
add a tablespoonful of olive oil with constant stirring. 

Uses. — Linseed meal forms an excellent vehicle for applying warmth 
and moisture, and is used in the form of poultices in inflammation of 
both superficial and deep-seated parts (p. 402). 



730 VEGETABLE MATERIA MEDICA. 

Oleum Lini, U.S.P. and B.P. LlNSEED Oil. Oil OF Flax 
Seed, U.S.P. — A fixed oil expressed without heat from linseed. 

Characters. — Viscid, yellow, with a faint odor, and oleaginous 
taste. It thickens, and finally solidifies, on exposure to air. 

Uses. — It is sometimes employed as a soothing application to burns, 
scalds, and eczematous eruptions, either alone or with lime-water (p. 551). 
It is sometimes added to purgative enemata and has been recommended 
as a cure for piles in the dose of two ounces of the fresh oil morning and 
evening. 1 

GERANIACEiE. 

U.S.P. Geranium. Geranium [Cranesbill]. The rhizome of 
G-eranium maculatum. 

Characters. — Horizontal, cylindrical, two to three inches (5 to 7 
centimetres) long ; half an inch (12 millimetres) or less thick ; tubercu- 
lated, longitudinally wrinkled, dark brown ; fracture short, pale red- 
brown ; bark thin ; wood-wedges yellowish, small, forming a circle near 
the cambium line; medullary rays broad; central pith large; rootlets 
thin, fragile ; inodorous ; taste astringent. 

Officinal Peepaeation. 

dose. 
Extractum Geranii Fluidum J fl. drm. to 1 fl. drm. 

Composition. — It contains a considerable amount of tannic and 
gallic acids. 

Uses. — It is a mild and not disagreeable astringent, especially 
useful for children. It is used internally for diarrhoea, and is employed 
also as an astringent gargle in sore throat and as an injection in gonor- 
rhoea and gleet. 

POLYGALACE^E. 

Senega, U.S.P.; Senegae Radix, B.P. Senega Root. — The 
dried root of Polygala Senega. North America. 




Fig. 143. — Senega. 

Characters. — A knobby rootstock, with spreading, tortuous root- 
lets, twisted and keeled. 

Adulterations. — Ginseng and other roots, detected by absence of 
keel. 

Composition. — The active principle, which is contained in the 
cortex, is called senegin or polygalic acid. It appears to be identical 

1 United States Dispensatory, p. 1017. 



THALAMIFLOE^. 731 

with saponin obtained from Saponaria officinalis, which is a glucoside 
splitting up when boiled into grape-sugar and sapogenin. It is a white 
powder, easily soluble in hot water and alcohol, forming a soapy emulsion 
when mixed with boiling water even in small quantities. 

Peepaeations. 
u.s.p. DOSE. 

Abstractum Senegse 5-10 gr. (03-06 Gm.) 

Extractum SenegseFluidum.. 10-20 min. (0'6-l*25 c.c.) 

Syrupus Senegse 1-2 fl. dr. (375-7'5 c.c.) 

Syrupus Scillse Compositus....For children 10 min. to 1 fl. drm. (0*6-3 -75 c.c.) 
Expectorant for adults 20-30 min. (1'25-1*9 c.c.) 

B.P. 

Infusum Senegse 1-2 fl. oz. 

Tinctura Senegas J-2 fl. drm. 

Action and Use.—- It is employed as a stimulating expecto- 
rant, diuretic and diaphoretic. The indications for its administration as 
an expectorant are when the power to expectorate is small, but the quan- 
tity of expectoration is abnormally large, and it is more or less purulent 
in character, as in the second stage of acute bronchial catarrh, or pneu- 
monia in the stage of resolution. When the expectoration is tough and 
scanty, senega is of little use. 

It is also used in chronic pneumonia, and chronic bronchitis, and in 
dropsy dependent on renal disease. It is usually combined with other 
expectorants and diuretics. Its taste is to many very disagreeable, but 
spirit of chloroform both makes it more agreeable and tends to lessen 
cough. It has been recommended in palpitation due to aortic disease 
(pp. 280 and 281), and also in amenorrhoea. 

KRAMERIiE. 

Krameria, U.S.P. ; Kramerise Radix, B.P. Rhatany Root. 
— The dried root of Krameria triandra, U.S.P. and B.P., and of 
Krameria tomentosa. 

Characters. — About an inch thick, knotty above, and branched 
below, the branches are long, often broken or torn, brownish-red and 
rough externally, reddish-yellow internally, strongly astringent. 

The root of Krameria tomentosa (Savanilla Rhatany), U.S.P., is less 
knotty and more slender, and has dark purplish-brown bark. 

Composition. — The bark contains about 20 per cent, of a kind of 
tannin called Ratanhia-tannic acid; a red matter, Ratanhia-red, and a 
neutral substance, Ratanhin. 

Peepaeations. 
u.s.p. dose. 

Extractum Krameriae 5-20 grs. (0'3-l'3 Gm.) 

" " Fluidum 5 min.-l fl. drm. (0'3-375 c.c.) 

Syrupus " 1 fl. oz. (30 c.c.) 

Tinctura " J-2 fl. drm. (1 -9-7-5 c.c.) 

Trochisci " 

B.P. 

Extractum Krameriae 5-20 gr. 

Infusum Krameriae 1-2 fl. oz. 

Pulvis Catechu Compositus 

Tinctura Krameriae £-2 fl. dr. 



732 VEGETABLE MATERIA MEDICA. 

Action. — It is strongly astringent. 

Uses. — The powder is used as a dentifrice when the gums are spongy 
and bleed easily. The infusion or tincture is employed in bleeding from 
the nose, mercurial affections of the mouth, relaxed sore throat, leucor- 
rhoea, prolapsus ani. Internally it is given in diarrhoea, and haemorrhage 
from the kidneys or genito-urinary passages. 

SAPINDACE^. 

U.S. P. Guarana. Guarana. — A dried paste prepared from the 
crushed or ground seeds of Paullinia sorbilis. 

Characters. — Sub-globular, or elliptic cakes, or cylindrical sticks, 
hard, dark reddish-brown ; fracture uneven, somewhat glossy, showing 
fragments of seeds invested with a black testa ; odor slight, peculiar, 
resembling chocolate ; taste astringent, bitter ; it is partly soluble in 
water and in alcohol. 

Peepaeation. 

DOSE. 

Extraction Guaranse Fluidum 15 min. to 1 fl. oz. 

Composition. — It contains four or five per cent, of caffeine and a 
considerable amount of tannic acid, and it is upon these that its medicinal 
value depends. 

Uses. — It is chiefly used to cut short attacks of sick headache. It 
may be given in doses of one or two drachms of the powder, mixed with 
hot water, or as fluid extract, when the headache is coming on. 

ERYTHROXYLACE^E. 

U.S.P. Erythroxylon. Erythroxylon [Coca.] — The leaves of 
Erythroxylon Coca. 

Characters. — Oval or obovate-oblong, two to three inches (50 to 75 
millimetres) long, short-petiolate, entire, rather obtuse or emarginate at 
the apex, reticulate on both sides, with a prominent midrib, and, on each 
side of it, a curved line running from base to apex ; odor slight and tea- 
like; taste somewhat aromatic and bitter. 

Peepaeation. 

dose. 
Extractum Erythroxyli Fluidum 1 fl. drm. to 4 fl. drm. 

Composition. — This drug contains the alkaloids cocaine and hygrine 
and a volatile constituent which gives a pleasant fragrance to the 
fresh leaves. Different specimens of the leaves vary greatly in their 
strength. 

Action. — Cocaine is a powerful local anaesthetic. When applied 
to the tongue it destroys both taste and tactile sensibility, so that salt 
and sugar cannot be distinguished, nor the prick of a pin felt. In the 
eye it causes local anaesthesia along with dilatation of the pupil, paralysis 
of accommodation, slight lachrymation, and enlargement of the palpebral 
fissure. 1 When injected into the back of the orbit it causes protrusion 



1 Jessop, Practitioner, January, 1885. 



THALAMIFLOK^. 733 

of the eye-ball. Its effects appear to be due to stimulation of the peri- 
pheral ends of the sympathetic. Subcutaneous injection also produces 
local anaesthesia at the point of application, so that subsequent irritation 
at that spot produces no sensation in man and no reflex action in animals. 
When taken internally it appears to have, in small doses, a stimulant, 
and in large doses, a paralyzing action on the nerve centres somewhat 
like that of caffeine. It affects first the cerebral hemispheres, next the 
medulla, and afterwards the spinal cord. In small doses it is said to 
lessen fatigue, and enable the Indians in Peru to make long marches, 
and a similar result has been obtained in trials upon soldiers in Germany. 
Larger doses cause fulness in the head, weariness, slight deafness, loss 
of memory, and inability to control ideas. It appears sometimes to 
cause restlessness, singing in the ears, giddiness, headache, and delirium. 

In animals large doses appear to affect specially the semicircular 
canals, possibly by an anaesthetic action upon the nerves connected 
with them. This is shown by constant movement of the head in mam- 
mals, disturbances of equilibrium, loss of co-ordination, and rotatory 
convulsions and opisthotonos. The convulsions are of cerebral origin 
(p. 172), and cease when the spinal cord is divided. The motor columns 
of the spinal cord appear to be unaffected, but the sensory columns 
are paralyzed. In its action on respiration and circulation cocaine, to a 
certain extent, resembles atropine, and it does so also in its action on 
the pupils, intestinal movements, and salivary and sweat glands. The 
respiration is greatly increased at first, afterwards diminished, and 
death occurs from respiratory paralysis. Small doses quicken the pulse 
and raise the blood-pressure. Large doses slow the pulse and lower 
the blood-pressure. The quickness of the pulse appears to be due to 
paralysis of the vagus, and the action of cocaine on both pulse and 
blood-pressure is very like that of atropine. Small doses increase, large 
ones paralyze, the intestinal movements. The secretion of saliva and 
sweat is diminished. The urine does not appear to be affected. The 
temperature is generally raised. 

Uses. — The expectations of practical utility of cocaine, founded on 
a knowledge of physiological action which Rossbach 1 expressed, have 
been completely fulfilled, and it now bids fair to replace as a local anaes- 
thetic the use of chloroform in many minor operations. Its local 
anaesthetic action was first observed by Niemann. Its actual introduc- 
tion into practice we owe to Roller. A 4 per cent, solution dropped 
into the eye is sufficient to produce local anaesthesia, so that operations 
for cataract or squint can be readily performed, and foreign bodies 
extracted from the eye, under its influence. A 20 per cent, solution 
applied once or twice to the nasal mucous membrane at intervals of three 
or four minutes causes such complete anaesthesia that the application of 
the galvano-cautery is not felt. A similar effect is produced on the soft 
palate and larynx, and the solution may be applied to facilitate the use 
of the laryngoscope and lessen pain and spasm in operations on the 
larynx. It has been applied with benefit to the interior of the nose in 
acute coryza, nasal polypus, and hay fever. It is useful in producing 

1 Nothnagel and Rossbach, Arzneimittellehre, 5th edition. 



734 VEGETABLE MATERIA MEDICA. 

local anaesthesia of the uterus and rectum in operations on these parts ; 
in vaginismus and in pruritus of the anus and valva. Internally cocaine 
or coca is useful as a tonic, especially in debility with nervousness and 
in mental diseases accompanied by depression. It may be given in the 
form of the fluid extract either alone or with a glass of wine. A non- 
officinal wine made from the leaves is also a useful tonic. 



MALVACEAE. 

U.S.P. Gossypii Radicis Cortex. Cotton Root Bark. — The 
bark of the root of Giossypium herbaceum and of other species of gos- 
sypium. 

Characters — Thin, flexible bands or quills, brownish-yellow out- 
side, whitish and silky inside, no smell, taste faintly acrid and astringent. 

Composition. — It contains a colorless acid resin, becoming red on 
exposure. 

Peepaeatio^. dose. 

Extractum Gossypii Radicis Fluidum |-1 fl. dr. (l"9-3"75 c.c.) 

Action and Uses. — It is said to cause contraction of the uterus, 
and is used instead of ergot. It may be given either as the officinal 
fluid extract or as a decoction made by boiling 4 oz. of the bark in a 
quart of water down to a pint. Of this a wineglassful (60 c.c.) is given 
every 20 or 30 minutes. 

U.S.P. Oleum Gossypii Semiuis. Cotton Seed Oil. — A 
fixed oil, expressed from the seed of G-ossypium herbaceum^ and of other 
species of gossypium, and subsequently purified. 

Characters. — A bright, pale yellow, oily liquid, odorless, having a 
bland nut-like taste and a neutral reaction. Sp. gr. 0*920 to 0-930. It 
is only slightly soluble in alcohol, but readily so in ether. When cooled 
to near 2° C. (35*6° F.) it begins to congeal. Concentrated sulphuric 
acid instantly renders it dark reddish-brown. 

Uses. — It is a bland oil, very much like olive oil, and answers per- 
fectly well most purposes for which olive oil is generally used, except for 
making lead plaster. A great deal of the oil exported from France 
and Italy under the name of olive oil is really cotton-seed oil either 
alone or mixed with a proportion of olive oil. Eighty-eight per cent, 
of the cotton-seed oil exported from New Orleans in 1880 was sent to 
the Mediterranean. 

Officinal Peepaeations. 

U.S.P. 
Linimentum Ammonije. 
" Calcis. 

" Camphors. 

11 Plumbi Subacetatis. 

U.S.P. Gossypium. Cotton. (Purified Cotton. Absorbent 
Cotton.) — The hairs of the seed of Gossypium herbaceum and other 
species, freed from adhering impurities and deprived of fatty matter. 



THALAMIFLOR^E. 735 

B.P. Gossypium. Cotton Wool. — The hairs of the seed of 
various species of gossypium carded. 

Preparation. — It is made by boiling the raw cotton in a dilute 
alkaline solution, such as a 5 per cent, solution of caustic potash or soda. 
The alkali unites with the fatty matter of the cotton to form a soap, which 
is removed by repeated washings, in the course of which chlorinated lime 
and dilute hydrochloric acid are used as well as water. 

Test. — When thrown upon water it should immediately absorb the 
latter and sink, and the water should not acquire either an acid (no 
hydrochloric acid) or alkaline reaction. 

Peepaeations. 

u.s.p. B.P. 

Pyroxylinum (Gun Cotton). Pyroxylin (Gun Cotton). 

Uses. — Cotton-wool is employed as a local application to the skin in 
cases of burns and erysipelas, to exclude external irritation and protect 
the part from cold. Cotton-wool is also used to surround gouty or 
rheumatic joints. 

A pledget of cotton-wool placed in the ears tends to prevent sore 
throat. The explanation of this seems to be that catarrh may result 
reflexly from irritation of the auricular branch of the vagus (cf. Ross- 
bach's experiments, p. 224, where congestion of the trachea followed 
irritation of the abdomen by the application of ice). 

When subjected to heat, so as to destroy any adherent germs, it is 
used in experiments on antiseptics (p. 94) to plug the orifice of the test- 
tubes and prevent the accidental entrance of germs. With a somewhat 
similar object it has been used as a dressing to wounds, from which it 
excludes the germs which might cause pyaemia, erysipelas, etc. As a 
dressing, the absorbent cotton of the U.S. P. appears much preferable to 
the crude cotton- wool. It may be impregnated with various antiseptics 
and deodorizing substances, such as iodine, picric acid, salicylic acid, or 
benzoic acid. Some of these form useful applications to the os uteri to 
destroy foetor and induce healthy action. 

Pyroxylinum, U.S.P. ; Pyroxylin, B.P. GrUN Cotton. — Pre- 
pared by the action of sulphuric and nitric acids on cotton. 

Test. — Readily soluble in a mixture of ether and rectified spirit ; 
leaves no residue when exploded by heat. 

Use. — To prepare collodium (collodion), U.S.P. and B.P. 

Collodium, U.S.P. and B.P. Collodion. A solution of 
pyroxylin in ether and alcohol. 

Characters. — A colorless, highly inflammable liquid with ethereal 
odor, which dries rapidly upon exposure to the air, and leaves a thin, 
transparent film, insoluble in water or rectified spirit. The great inflam- 
mability of its vapor must be carefully remembered. After successfully 
completing the operation of ovariotomy, a surgeon covered the wound 
with a layer of collodion. In order to inspect it more closely he brought 
a light near, when the ethereal vapor caught fire, and the patient died 
from the effects of the burns which she received (Binz). 



736 VEGETABLE MATERIA MEDICA. 

Peepaeations. 
u.s.p. B.P. 

Collodium cum Cantharide. Collodium Flexile. 

Flexile. 
" Stypticum. 

Collodium Flexile, U.S.P. and B.P. Flexible Collodion. 
Collodion mixed with Canada balsam and castor oil. 

Uses. — Collodion applied to the skin acts both as a protective and 
also, through its contraction, exerts a gentle pressure on the part, and is 
hence applied to cut surfaces, chapped nipples, and to check haemorrhage 
from leech bites. The flexible collodion does not crack, and therefore is 
more useful as a protective, but it exerts less pressure than ordinary 
collodion. 

U.S.P. Collodium cum Cantharide. Cantharidal Collodion. 

Preparation. — By dissolving a chloroform extract of cantharides in 
flexible collodion. 

Action. — When painted on the skin it acts as a rapid and powerful 
vesicant. If covered immediately with oiled silk, so as to prevent the 
evaporation of the ether, it is said to act more rapidly. 

Uses. — Vide Cantharides. 

U.S.P. Collodium Stypticum. Styptic COLLODION. 

Preparation. — By dissolving tannin in a mixture of alcohol, ether, 
and collodion (20 parts tannin in 100). 

Uses. — To stop bleeding from leech bites, abrasions, and wounds. 
When painted over the bleeding surface the tannin coagulates the blood 
and lymph ; and this, with the collodion, forms a film over the surface 
which prevents further bleeding and protects the raw surface from 
exposure to air or from accidental irritation. 

U.S.P. Althsea. Altera. [Marshmallow.J — The root of 
Althaea officinalis. 

Characters. — In cylindrical or somewhat conical pieces, from three 
to six inches (7 to 15 centimetres) long, about half an inch (12 milli- 
metres) in diameter, deeply wrinkled ; deprived of the brown, corky layer 
and small radicles ; externally white, marked with a number of circular 
spots, and of a somewhat hairy appearance from the loosened bast-fibres ; 
internally whitish and fleshy. It breaks with a short, granular and 
mealy fracture ; has a faint, aromatic odor, and a sweetish, mucilaginous 
taste. 

Peepaeation. 

dose. 
Syrupus Althrctu 1-4 fl. dr. 

Composition. — It contains some 35 per cent, each of vegetable 
mucus and starch. 

Uses. — It is bland and unirritating, and a useful demulcent in sore 
throat, coughs, or intestinal irritation. An ointment made by boiling 
the cut fresh leaves with lard for half an hour, and then straining, has 
proved successful in palmar psoriasis after other means failed. 1 



Berry, Practitioner, vol. xxxi., p. 346. 



THALAMIFLOR^. 737 

AURANTIACE^E. 

U.S. P. Aurantii Flores. Orange Flowers. — The partially 
expanded fresh flowers of Citrus vulgaris and Citrus aurantium. They 
may be preserved by mixing them well with half their weight of chloride 
of sodium, pressing them into ajar, and keeping in a cool place. 

Characters. — Fragrant and somewhat bitter. 

% 
Preparation. 

Aqua Aurantii Florum. 

U.S.P. Oleum Aurantii Florum. Oil OF Orange Flowers, 
Oil of Neroli. — A volatile oil distilled from fresh orange flowers. 

Characters. — Yellowish or brownish ; has fragrant odor of orange 
flowers, and aromatic, somewhat bitter taste. 

'Composition. — It consists chiefly of a hydrocarbon and a little 
neroli camphor. 

Preparation. 
Spiritus Odoratus. U.S.P. 
Use. — As a flavoring- matter. 

Aqua Aurantii Florum, U.S.P. ; Aqua Aurantii Floris, 

B.P. Orange Flower Water. — The distilled water of the flowers 
of the bitter orange tree {Citrus bigaradia), and of the sweet orange tree 
{Citrus aurantium). Prepared mostly in France. 

Characters. — Nearly colorless ; has the fragrant odor of the flowers. 

Impurities. — Lead from the vessels in which it has been kept. 

Test. — It should not be colored by sulphuretted hydrogen. 

Composition. — It contains a volatile oil (Oil of Neroli). 

Preparation, 
u.s.p. dose. 

Syrupus Aurantii Florum 1-2 fl. dr. (4-8 C.C.) 

B.P. 
Syrupus Aurantii Floris 1-2 fl. dr. 

B.P. Aurantii Fructus. Bitter Orange. — The ripe fruit of 
the Citrus vulgaris (Risso), Citrus bigaradia (Duhamel). Imported 
from the South of Europe. 

Aurantii Amari Cortex, U.S.P. ; Aurantii Cortex, B.P. 

Bitter Orange Peel. — The dried outer part of the rind of the ripe 
bitter orange. 

Characters. — Thin strips of dark orange color, with a fragrant 
odor and an aromatic bitter taste. It should be nearly free from the 
white part of the rind. 

Composition. — The inner part of the rind is white, spongy, and use- 
less ; the outer part is yellow when fresh, but brownish-green when dried, 
and contains a fragrant volatile oil, a bitter neutral principle, hesperidin, 
and a small quantity of some sort of tannin. 

Preparations, 
u.s.p. DOSE. 

Extractum Aurantii Amari Fluidum. 2-4 fl. dr. (8-15 C.C.) 

Tinctura Aurantii Amari 1-2 fl. dr. (4-8 C.C.) 

47 



738 VEGETABLE MATEKIA MEDICA. 

Preparations, 
b.p. DOSE. 

Of the fresh peel — 

Tinctura Aurantii Recentis 1-2 fl. dr. 

Vinuni Aurantii 

Of the dried peel — 

Infusum Aurantii (^ oz. in £ pint) 1-2 fl. OZ. 

Compositum 1-2 fl. OZ. 

" Gentianse Compositum 1-2 fl. oz. 

Mistura Gentianae ,. 1-2 fl. oz. 

Spiritus Armoraciae Compositus 

Syrupus Aurantii (Tinct. 1, Syrup 7) 

Tinctura Aurantii 1-2 fl. dr. 

11 Cinchonas Composita 

" Gentianse Composita |-2 fl. dr. 

B.P. Infusum Aurantii Composituni. COMPOUND INFUSION OF ORANGE PEEL. 
— Bitter orange peel, \ oz. ; fresh lemon peel, 60 gr. ; cloves, bruised, 30 gr. ; boiling 
distilled water, 10 fl. oz. 

U.S. P. Aurantii Dulcis Cortex. Sweet Orange Peel. — 
The rind of the fruit of Citrus aurantium. 

Characters. — Closely resembling bitter orange peel, but having an 
orange-yellow color. It has a sweetish fragrant odor and an aromatic 
slightly bitter taste. 

Peepaeations. 
Syrupus Aurantii. Tinctura Aurantii Dulcis. 

Uses. — The preparations of oranges are used almost entirely as 
flavoring- vehicles. The rind is an aromatic stomachic, and is used with 
other bitters in the treatment of dyspepsia. 

U.S.P. Oleum Aurantii Corticis. Oil OF Orange Peel. — 
A volatile oil extracted by mechanical means from fresh orange peel. 

Preparation. — It is prepared from the outer part of the rind 
by expression ; by putting it in hot water and skimming off the oil ; or 
by rubbing it in a kind of bowl lined with short spikes in the same way 
as oil of lemons. 

Characters. — Pale yellow, has smell of oranges, an aromatic some- 
what bitter taste. By keeping it becomes thicker, and gets a turpentine- 
like taste. This may be prevented by mixing the fresh oil with 5 per 
cent, of alcohol and decanting from the sediment. 

Composition. — Contains two camphenes and a glucoside hesperidin. 

Officinal Peepaeations. 

dose. 

Elixir Aurantii 2-8 fl. dr. (4-30 c.c.) 

Spiritus Aurantii 2-4 fl. dr. (4-15 c.c.) 

Spiritus Myrciae Used as perfume. 

Action and Use. — Externally it is rubefacient. Internally, in 
large doses, an irritant poison. It is used as a flavoring- matter. 

U.S.r. Elixir Aurantii. Elixie OF Oeange (Simple Elixir). — Oil of orange, 1 ; 
cotton, 2; sugar, in coarse powder, 100 ; alcohol and water, of each a sufficient 
quantity to make 300 parts. Mix alcohol and water in the proportion of 1 part of 
alcohol to 3 parts of water. Add the oil of orange to the cotton in small portions at 



THALAMIFLORiE. 739 

a time, distributing it thoroughly by picking the cotton apart after each addition ; 
then pack tightly in a conical percolator and gradually pour on the mixture of 
alcohol and water until 200 parts of filtered liquid are obtained. In this liquid dis- 
solve the sugar by agitation, without heat, and strain. 

Use. — To cover the taste of drug-s and render them agreeable to 
the palate. By mixing tinctures and liquid extracts with simple elixir, 
preparations are obtained which are both palatable and efficient. 

U.S.P. Oleum Berg-amii. Oil OF Bergamot. — A volatile oil 
extracted by mechanical means from the rind of the fresh fruit of Citrus 
Bergamia var. vulgaris. 

Characters. — A greenish or greenish-yellow, thin liquid of a pecu- 
liar, very fragrant odor, an aromatic, bitter taste, and a slightly acid 
reaction. Sp. gr. 0*860 to 0*890. It is soluble in all proportions in 
alcohol and in glacial acetic acid. 

Use. — In flavoring. 

Peepaeation. 
Spiritus Odoratus. Peefumed Spiett (Cologne Water). — Oil of bergamot, 16 ; 
oil of lemon, 8 ; oil of rosemary, 8 ; oil of lavender flowers, 4 ; oil of orange flowers, 
4 ; acetic ether, 2 ; water, 158 ; alcohol, 800. 

Uses. — For perfuming lotions. When bathed on the temples or 
forehead and evaporated quickly by fanning the face, it is useful in head- 
aches or tendency to faintness. Eau de Cologne is not unfrequently 
taken as a stimulant by ladies, who have no idea that it contains alcohol. 

Limonis Cortex, U.S.P. and B.P. Lemon Peel. — The outer 
part of the rind of the fresh fruit of Citrus limonum. Southern Europe 
and West Indies. 

Characters. — Like those of orange peel, but the color is a deep 
lemon yellow. 

Composition. — Similar to orange peel. 

Peepaeations. 

U.S.P. DOSE. 

Oleum Iiimonis 1-5 min. 

Spiritus " 

Syrupus « 1-2 fl. dr. or more. 

Mistura Potassii Citratis 4-8 fl. dr. (15-30 c.c.) 

B.P. 

Infusum Anrantii Compositum 1-2 fl. oz. 

" * Gentianae Compositum 1-2 fl. oz. 

Oleum Iiimonis 1-5 min. 

Syrupus " 1-2 fl. dr. or more. 

Tinctura " 1-2 fl. dr. 

Oleum Limonis, U.S.P. and B.P. Oil OF Lemons. — A vola- 
tile oil extracted by mechanical means (U.S.P.), from fresh lemons, or 
expressed or distilled (B.P.). 

Characters. — A pale yellow liquid, having the fragrant odor of 
lemon ; an aromatic, somewhat bitterish taste, and a neutral reaction. 
By keeping it becomes thicker, and acquires a disagreeable terebinthi- 
nate taste. This may be prevented by mixing it while fresh with 5 per 
cent, of alcohol, and decanting the oil after it has become clear from the 



740 VEGETABLE MATERIA MEDICA. 

sediment. When wanted for use a quantity of water equal to the 
alcohol may be added, when they unite and subside, leaving the oil on 
the top. 

Preparation. — It is sometimes obtained by rasping the outside of 
the rind and expressing the oil it contains, sometimes by distillation, but 
the best is got by rubbing the lemons over the interior of a sort of cup 
lined with short points, when the oil flows into a reservoir at the bottom 
of the cup. 

Composition. — It is said to consist of two isomeric oils and a kind 
of camphor formed from them by exposure to air. 

Action. — Externally it is a strong rubefacient ; internally, in 
small doses, it is stimulating and carminative. It is chiefly used as a 
flavoring matter. 

Officinal Pkepabations. 
u.s.p. B.P. 

Spiritxis Lirnonis. Linimentum Potassii Iodidi cum Sapone. 

Spiritus Odoratus. Spiritus Ammonias Aromaticus (1 in 185). 

Linionis Succus, U.S.P. and B.P. Lemon Juice. — The 
freshly expressed juice of the ripe fruit of Citrus limonum. 

Characters. — Slightly turbid, yellowish liquid, with an acid taste, 
and usually a slight odor of lemon from a little of the oil contained in 
the rind. 

Preparation. — By squeezing the fresh fruit. 

Composition. — It contains some acid salts, especially those of 
potash, and 7 per cent, of citric acid (U.S.P.) ; 32-5 grains to the fluid 
ounce (B.P.). 

Officinal Peepaeations. 

u.s.p. dose. b.p. dose. 

Mistnra Potassii Citratis...4 fl. dr. (15 c.c.) Syrupus Limonis J-2 n. dr. 

Syrupus L,imonis Ad. lib. 

U.S.P. Mistura Potassse Citratis. MlXTUEE OF ClTEATE OF POTASSIUM. 
(Neutral Mixture). — Fresh lemon juice strained, 100; bicarbonate of potassium, 
about 10 parts, or enough to neutralize. 

Syrupus Limonis. Syeup of Lemons, U.S.P. and B.P. — Boiling lemon juice, 40 ; 
fresh lemon peel, 2; sugar, 60; water up to 100 (U.S.P.). Boiling lemon juice, 
strained, 1 pint, with fresh lemon peel, 2 oz. ; refined sugar, 2£ pounds (B.P.). 

Not officinal. Decoction of Lemon. — Cut a fresh unpeeled lemon (best when 
pulled immediately from the tree) into thin slices, put it into three teacupfuls of 
water, and boil it down to one teacupful in a clean earthenware jar. Allow it to 
stand overnight in the open air, and give it the first thing in the morning. Free it 
by compression and filtration from rind, pulp and seeds just before it is drunk. 

Uses. — It is used locally as a gargle in sore throat; to relieve itching 
in pruritus of the scrotum, in uterine haemorrhage after delivery, and 
mixed with equal parts of glycerine as an application to the face in sun- 
burn. Internally it is refrigerant, and forms a pleasant drink, allaying 
the thirst in fevers. It is used, in place of citric acid, to make efferves- 
cent mixtures and drinks. It is antiscorbutic, and is employed to 
prevent BCurvy in long voyages. 

The decoction of lemon is said to be a powerful antiperlodic, and 
to be exceedingly useful as a substitute for large doses of quinine in 
cases of ague, typho-malarial fevers, and malarious conditions generally. 



THALAMIFLOILE. 741 

It appears to be useful in reducing the temperature in typhoid fever even 
when no malarial complication exists. 

Belse Fructus, B.P. Bael Fruit. — The dried half-ripe fruit of 
JEgle marmelos. From Malabar and Coromandel. 





Fig. 144.— Bael. 

Characters. — Fruit roundish, about the size of a large orange, with 
a hard woody rind. Usually seen in fragments consisting of portions of 
the hard gray rind and dry adherent red pulp and seeds. The moistened 
pulp is mucilaginous. 

Composition. — Not well ascertained. It contains no appreciable 
amount of tannin. 

Uses. — Although it contains no tannin it is used in diarrhoea and 
dysentery. The fresh pulp is sometimes used as a laxative. Possibly 
bael fruit may owe its utility in dysentery to its possessing some action 
similar to that of cotoine (p. 337). 

Pbepaeatiox. 
u.s. p. b p. dose. 

None. Extractum Belse Liquidum 1 fl. dr. to J fl. oz. 

STERCULIACEJE, or BYTTNERIACE^E. 

Oleum Theobronise, U.S. P. and B.P. Oil or Theobroma; 
Cacao Butter. — A concrete oil obtained by expression and heat from 
the ground seeds of Theobroma cacao. 

Characters. — Of the consistency of tallow; color yellowish-white; 
odor like chocolate ; taste bland and agreeable ; reaction neutral. Does 
not become rancid from exposure to the air. Melts at 30°-35° C. (86°- 
95° F.). 

Preparation and Composition. — Consists chiefly of stearin and 
olein. 

Adulterations. — Paraffin, wax, tallow, stearin, &c. 

Tests. — If 2 parts of it be dissolved in 4 parts ether in a test-tube, 
by immersing the tube in water of 17° C. (63° F.), and if this be after- 
wards plunged into water of 0° C. (32° F.), the mixture should not 
become turbid, nor separate a granular deposit in less than 3 minutes ; 
and if the mixture, after congealing, be exposed to a temperature of 15° 
C. (59° F.), it should gradually become entirely clear (absence of 
impurities mentioned above). 



742 VEGETABLE MATERIA MEDICA. 

Peepaeations. 
u.s. p. b.p. dose. 

For suppositories of various kinds, Suppositoria Acidi Tannici 1 part in 2. 

each weighing 15 gr. or 1 Gm. Hydrargyri 1 part in 2. 

Morphise.., 1 part in 2. 

" PlumbiComposita,4 parts in 9. 

Uses. — As a basis for suppositories. Also as a non-irritant applica- 
tion to the skin. 

TERNS TROMI ACEJE . 

Not officinal. Tliea. Tea. — The dried leaves of Thea sinensis. 
China, Assam, Ceylon, &c. 

Characters. — Both green and black tea are prepared from the same 
species of thea. Green teas are obtained by drying the freshly-gathered 
leaves on a hot iron plate until they shrivel. Black teas are obtained by 
allowing the leaves to lie in heaps and undergo a kind of fermentation 
before drying them. 

Composition. — They contain caffeine, a volatile oil, and tannin. 

Action. — The action probably depends partly on the caffeine and 
partly on the volatile oil they contain. Both green and black teas are 
powerful cerebral stimulants. They render the mental faculties more 
active, and tend to prevent sleep. Green tea is much more powerful 
than black, and its admixture with black is sometimes the cause of 
sleeplessness in persons who have thus taken it unconsciously. In 
some persons it produces giddiness, restlessness, and such severe muscular 
trembling that the hand shakes violently. Both green and black teas 
are apt to cause indigestion. This is probably due, in some measure 
at least, to the tannin they contain. Tea mixed with gastric juice lessens 
its power of digesting fresh meat, but not of digesting smoked meat. 
This is probably due to the tannin hardening the soft fibre of fresh meat, 
but leaving the comparatively hard fibre of dried meat, ham, &c, un- 
changed. Tea along with fresh meat not unfrequently causes indiges- 
tion, whilst ham, dried fish, &c, may be taken along with it without 
injury. To avoid getting much tannin it is advisable not to let the tea 
stand long on the leaves, but pour it off quickly, so that the volatile oil 
which gives the aroma only is extracted. 

Use. — As a cerebral stimulant to relieve drowsiness and headache. 

U.S.P. Caffeina. Caffeine (Theine).— C 8 H 10 N 4 O 2 - h 2 O; 112. 

A proximate principle of feebly alkaloidal power, generally prepared 
from the dried leaves of Camellia Thea or from the dried seeds of Ooffea 
arabica (Nat. Ord., Rubiaceoe)', or from Guarana, and occurring also in 
other plants. 

Characters. — Colorless, soft and flexible crystals, generally quite 
long, and of a silky lustre, permanent in the air, odorless, having a bitter 
taste and a neutral reaction. Soluble in 75 parts of water and in 35 
parts of alcohol at 15° C. (59° F.); in 9*5 parts of boiling water and 
very soluble in boiling alcohol ; also soluble in about 6 parts of chloro- 
form, but very slightly soluble in ether or in disulphide of carbon. When 
heated to 100° C. (212° F.), the crystals lose 8-49 per cent, in water 
(of water of crystallization) ; and, when heated on platinum foil, they are 



THALAMIFLOR^S. 743 

completely volatilized without carbonizing. On heating caffeine with 
chlorine water, or treating it with concentrated nitric acid, it is decom- 
posed; on evaporating afterward, at a gentle heat, a yellow mass is left, 
which, when moistened with water of ammonia, assumes a purplish color. 

Sulphuric or nitric acid should dissolve it without color, and its 
aqueous solution should not be precipitated by test solution of iodide of 
mercury and potassium (absence of other alkaloids). 

Dose. — 2 to 5 grains. Caffeine is very soluble in solutions of 
benzoate, cinnamate, or salicylate of sodium. By using these as solvents 
concentrated solutions of caffeine can be made for hypodermic injection. 
Caffeine 20 grs., salicylate of soda 17J grs., water 1 fl. dr. makes a non- 
irritating solution containing 1 gr. of caffeine in 3 min., but stronger 
solutions may be made if required. 

Action. — Caffeine causes at first stimulation and subsequently 
paralysis of nerve centres in cerebrum, cord, and medulla. It has 
also a marked action on muscular fibre, both voluntary and involun- 
tary. In large doses it acts as a gastro-intestinal irritant. Its action 
on frog-s varies according to the species. In rana temporaria it pro- 
duces a rigid condition of the muscles resembling rigor mortis, especially 
when locally applied to them. In rana esculenta this action on the 
muscles is slight, and the chief symptom is tetanus, which, like that of 
strychnine, depends on the action of the drug on the spinal cord. This 
is followed by paralysis (of voluntary movement) and then of reflex action. 
In warm-blooded animals also, caffeine produces tetanic convulsions, 
which may be arrested by artificial respiration, and death frequently 
prevented even from a very large dose. Morphine lessens the convul- 
sions, but does not prevent death. 

From its stimulant action on the brain, doses of 2-8 grains some- 
times cause heaviness of the head, flashes of light before the eyes, singing 
in the ears, loss of sleep, great restlessness, and delirium. 

Its stimulant action on the medulla and cardiac centres increases 
the respiration and pulse-rate and raises the blood-pressure in 
moderate doses. Large doses depress the respiration and pulse, and 
lower the blood-pressure. In man the pulse, after somewhat large doses, 
becomes very frequent, irregular, and intermittent. This effect occurs 
in some persons even after a single cup of coffee, but it is prevented in 
such cases by adding a little brandy to the coffee, as is usually done when 
coffee is taken without milk. 

It appears sometimes to increase the salivary secretion. It has 
little action on the peristaltic movements of the intestine, but it causes 
the intestinal veins to become much dilated, and appears to cause haemor- 
rhoids. 

The temperature is not altered by small doses of caffeine, but is 
increased by large doses. 

Caffeine acts as a diuretic, though not invariably so. Its diuretic 
action may partly depend upon its stimulant action on the heart and vaso- 
motor centre, and consequent rise of blood-pressure. It may also be due 
in part to a stimulant action on the cells of the urinary tubules, as 
Brackenridge states that it increases the excretion of urinary solids as 
well as urinary water. 



744 VEGETABLE MATERIA MEDICA. 

Uses. — It is used in headache, especially migraine, and in cases where 
the headache seems to be inside the head without any external tender- 
ness. As a diuretic it is especially useful in cardiac dropsy, though it 
may be given also in cases of hepatic dropsy. It acts as a diuretic even 
when the kidneys are diseased, and is useful even in very advanced car- 
diac cases. It is best given alternately with digitalis or along with it. 

GUTTIFER^E. 

Cainbogia, U.S. P. and B.P. Gamboge. — A gum resin obtained 
from Grarcinia Hanburii (U. .S.P.); Garcinia morella, var. pedicellata 
(B.P.) Imported from Siam. 

Characters. — In cylindrical pieces, sometimes hollow in the centre, 
1 or 2 inches in diameter, breaking easily with a smooth conchoidal 
glistening fracture ; color tawny, changing to yellow when it is rubbed 
with water; taste acrid; powder, bright yellow. 

Properties and Composition. — Contains a resin, gambogic acid, 
and a soluble gum. 

Adulteration. — Starch fraudulently added. 

Test. — An emulsion made with boiling water, and cooled, does not 
become green with the solution of iodine. 

Preparation. 

U.S.P. DOSE. B.P. DOSE. 

Pilulse Catharticse Composite, 1-3 pills. Pilula Cambogise Composita 5-15 grs. 

B.P. PUula Gambogiae Composita. COMPOUND GAMBOGE PlLL. — Gamboge, 
Barbadoes aloes, and compound cinnamon powder, of each 1 oz. ; hard soap, 2 oz. ; 
syrup, 9 oz. Mix and beat to a uniform mass. 

Action and Use. — It is a drastic hydragogue purgative, and 

in large doses causes violent irritation of the alimentary canal, with vom- 
iting and griping. It is used in combination with other purgatives as a 
derivative in cerebral affections, also with cream of tartar in dropsies. 
It has been used as an anthelmintic. 



CANEIXACEJE. 

B.P. Canellae Albae Cortex. Canella Alba Bark. — The 
bark of the Canella alba. South Florida and the West Indies. 

Characters. — Large quills or flattish pieces about 1 inch in diam- 
eter; pinkish-white externally; white internally. Taste bitter, pungent, 
acrid ; odor cinnamon-like. 

Composition. — A volatile oil (about 1 per cent.) consisting of several 
oils, of which one is identical with eugenic acid, from oil of cloves ; a 
bitter principle, canellin, together with resin, starch, and mannite. 
There is no tannin. 

Preparation. 

b.p. 

It is used in Vinum Rhei. 



Dose. — Of the powdered bark, 15-30 grs. 



THALAMIFLOILE. 745 

Action and Use. — It is an aromatic bitter and tonic. Given 
sometimes in atonic dyspepsia. It has been employed in rheumatism 
and gout. 

VITACE^E. 

B.P. Uvae. Raisins. — The dried fruit of the Vitis vinifera. 
Composition. — They contain grape sugar and acid tartrate of potash. 

Peepaeations. 
Tinctura Cardamomi Composita. 
" Sennae. 

Uses. — They are used to sweeten preparations. They are a useful 
stimulant in weariness from mental work (p. 176) ; and in active physical 
exertion, such as alpine climbing, they not only tend to maintain the 
strength and prevent exhaustion, but they somewhat relieve thirst when 
water cannot be had (p. 317). 

Vinum Album, U.S.P. White Wine. Vinum Xericum, B.P. 

Sherry Wine. — A pale amber or straw-colored alcoholic liquid, made 
by fermenting the unmodified juice of the grape freed from seeds, stems, 
and skins. It should contain not less than 10 per cent, nor more than 
12 per cent, by weight of absolute alcohol. 

Preparation, 
u.s.p. 
Vinum Album Fortius, prepared by mixing 7 parts white wine with 1 of alcohol. 
This should contain not less than 20 per cent, nor more than 25 per cent, by weight 
of absolute alcohol. 

Vinum Rubrum, U.S.P. Red Wine. — A deep red alcoholic 
liquid, made by fermenting the juice of colored grapes in presence of 
their skins. 

It should not contain less than 10 per cent, nor more than 12 per 
cent, by weight of absolute alcohol. 

Action and Uses. — Vide Alcohol. 

ZYGOPHYLLACEiE. 

Guaiaci Lignum, U.S.P. and B.P. GrUAIACUM Wood. — The 
heart-wood of Gfuaiacum officinale and Cr. Sanctum. St. Domingo and 
Jamaica. Coarse powder or small chips. 

Characters. — The wood is known as Lignum vita?, occurs in logs', 
and is very hard and heavy. The alburnum, or sapwood, is yellow in 
color, the duramen, or heart-wood, is dark greenish-brown, which should 
become dark blue-green on the addition of nitric acid. 

Composition. — Contains resin, chiefly in the heart-wood. 

Peepaeatiox. 

u.s.p. DOSE. 

Decoctum Sarsaparillae Compositum 4-6 fl oz. (200-300 c.c.) 

B.P. 

Decoctum Sarsse Compositum 2-10 fl. oz. 



746 VEGETABLE MATERIA MEDICA. 

Guaiaci Resina, T7.S.P. and B.P. (xUAlACUM Resin. — The 
resin of Ghiaiacum officinale. Obtained from the stem by natural exu- 
dation, by incisions, or by heat. 

Characters. — In masses of a greenish-brown or reddish-brown 
color ; fractured surface resinous, translucent at the edges, where the 
greenish color is usually well marked, and serves to distinguish this from 
other resins. A solution in rectified spirit strikes a clear blue color when 
applied to the inner surface of a paring of raw potato (p. 78), or on the 
addition of tincture of perchloride of iron. Powder grayish, turning 
green on exposure to air. 

Composition. — It contains several resinous acids, guaiaconic, guia- 
retic, and guiacic acids ; these are soluble in alkalies and are precipitated 
on neutralization. 

Peepabatioxs. 

U.S. P. DOSE. 

Tinctura Guaiaci 1-3 fl. dr. (4-12 C.C.) 

" " Ammoniata 1-2 fl. dr. (4-8 C.C.) 

Pilnlse Antimonii Composite 

B.P. 

Mistura Guaiaci 1-1? fl. OZ. 

Tinctura Guaiaci |-1 fl. dr. 

" " Ammoniata i-1 fl. dr. 

Pilula Hydrargyri Subchloridi Composita 5-10 gr. 

(of the resin) 10-30 gr. 

B.P. Mistura Guaiaci. Guaiacum Mixtube. — Guaiacum, \oz. ; refined sugar, 
\ oz. ; gum acacia, \ oz. ; cinnamon water, 1 pint. 

Tinctura Guaiaci Ammoniata, U.S.P. and B.P. AMMOXIATED TINCTURE OF 

Guaiacum. — Guaiac, 20 ; aromatic spirit of ammonia, 100 (U.S.P.) Guaiacum resin, 
4 oz. ; aromatic spirit of ammonia, to 1 pint (B.P.). 

Action. — It causes a burning sensation in the mouth and throat 
when given in small doses. Large doses cause vomiting and purging. 
When absorbed it acts as a stimulant, an alterative, and a diuretic. 

Uses. — It is employed in the treatment of tonsillitis, Mistura G-uaiaci 
being in my experience more efficacious than the ammoniated tincture. 
Others prefer the simple powder, as it remains longer applied to the 
tonsils and pharynx. It is also used in chronic rheumatism. It has 
been used in the treatment of gout and syphilitic periosteal diseases. 

MELIACE^E. 

U.S.P. Azedarach. Azedarach. — The bark of the root of Melia 
Azedarach. 

Characters. — In curved pieces or quills, varying in size and thick- 
ness ; outer surface red-brown, with irregular, blackish, longitudinal 
ridges ; inner surface whitish or brownish, longitudinally striate ; 
fracture more or less fibrous ; upon transverse section tangentially striate, 
with yellowish bast-fibres; almost inodorous, sweetish, afterward bitter 
and nauseous. 

If collected from old roots, the bark should be freed from the thick, 
rust-brown, nearly tasteless, corky layer. 

Action. — It produces vomiting and purging and symptoms of nar- 
cotic poisoning. 



THALAMIFLOR^. 747 

Use. — It is used as an anthelmintic, to destroy the ascaris lum- 
bricoides, in the form of a decoction (2 oz. of the herb to a pint of water, 
boiled down to J- a pint). This is given in doses of a tablespoonful 
every two or three hours until the bowels are freely opened. 



RUTACEJE. 

RUTE^E. 

Oleum Rutae, XJ.S.P. and B.P. Oil of Rue. — A volatile oil 
distilled from the fresh herb of Ruta graveolens. 

Characters. — Colorless, pale yellow, or greenish-yellow ; odor, 
peculiar ; taste, bitter, acrid. 

Composition. — Consists of a hydrocarbon and an oil containing 
oxygen. 

Dose.— 2 to 5 min. (0-12-0-3 c.c). 

Uses. — Externally it is rubefacient, internally it is stimulant, 
antispasmodic, emmenagogue, and carminative ; used in amenor- 
rhoea, hysteria, convulsions, and flatulence. 

B.P. Cuspariae Cortex. Cusparia, or Angostura Bark. — 
The bark of G-alipea cusparia, the Angostura bark tree. Tropical 
America. 




Fig. 145.— Cusparia. 

Characters. — Consists of quills, gray outside, light brown inside ; 
several inches long, about an inch in breadth, and one-eighth of an inch 
thick. Generally readily recognized by one edge being cut obliquely or 
feathered, from the oblique introduction of the knife by which the bark 
has been detached. Odor, peculiar ; taste, bitter. 

Composition. — A bitter substance, cusparine, and some volatile oil. 

B.P. DOSE. 

Infusum Cusparise (1 oz. in 1 pint at 120° F.) 1-2 fl. oz. 

Adulteration. — The bark of Stryehnos nux vomica. 

Tests. — Nitric acid gives a blood-red color when applied to the inner 
surface of the false bark from the brucine present in it, but gives a bluish- 
black color with the true bark. 

Action and Use. — Cusparia is an aromatic "bitter tonic, and is 
used in cases of atonic dyspepsia and in cases of weak digestion, especially 
during convalescence from acute diseases. 

DIOSME^. 

Buchu, XJ.S.P. ; Buchu Folia, B.P. Buchu, XJ.S.P. ; Buchu 
Leaves, B.P. — The dried leaves of (1) Barosma betulina, (2) Barosma 
crenulata, (3) Barosma serratifolia. Cape of Good Hope. 



748 VEGETABLE MATERIA MEDICA. 

Characters. — Smooth, marked with pellucid dots at the indenta- 
tions and apex; having a powerful, somewhat mint-like odor, and a 
warm, camphoraceous taste. (1) Obovate, with a recurved truncated 




Fig. 146.— Barosma betulina. Fig. 147.— Barosma crenulata. Fig. 148.— Barosma serratifolia. 

apex and sharp cartilaginous spreading teeth ; (2) oval-lanceolate, obtuse, 
minutely crenated ; (3) narrow linear-lanceolate, tapering at each end, 
sharply and finely serrated. 

Composition. — The leaves contain a volatile oil in the vittse which 
appear as dots on the leaves, and a bitter substance. 

Preparations, 
u.s.p. DOSE. 

Extractum Buchu Fluidum 20-45 min. 

B.P. 

Infusum Buchu (1 oz. in 1 pint) 1-2 fl. oz. 

Tinctura Buchu 1-2 fl. dr. 

Action and Use. — Buchu is slightly tonic. It is also diuretic and 
diaphoretic. Its chief use is as a stimulant to the mucous membrane 
of the bladder in cases of vesical catarrh and irritation. It is also used 
with other drugs as an expectorant in chronic bronchitis. It is used 
in South Africa, in doses of 20 grains of the powdered leaves, in the 
treatment of diarrhoea and dysentery. 

XANTHOXYLE^E. 

U.S.P. Xanthoxylum. Xanthoxylum. Prickly Ash. — The 
bark of Xanthoxylum fraxineum, and of Xanthoxylum carolinianum. 

Characters. — Xanthoxylum fraxineum is in curved or quilled frag- 
ments, about one-twenty-fifth of an inch (1 millimetre) thick ; outer 
surface brownish-gray, with whitish patches, and minute, black dots, 
faintly furrowed, with some brown, glossy, straight, two-edged spines, 
linear at the base, and about a quarter of an inch (6 millimetres) long; 
inner surface whitish, smooth ; fracture short, non-fibrous, green in the 
outer and yellowish in the inner layer ; inodorous ; bitterish, very 
pungent. 

Xanthoxylum carolinianum resembles the preceding, but is about 
one-twelfth of an inch (2 millimetres) thick, and is marked by many 
conical, corky projections, sometimes four-fifths of an inch (2 centimetres) 
high, and by stout, brown spines, rising from a corky base. 

Xanthoxylum should not be confounded with the bark of Aralia 
spinosa, which is nearly smooth externally, and beset with slender 
prickles in transverse rows. 



THALAMIFLOR^. 749 

Preparation. 

dose. 
Extractum Xanthoxyli Fluidum 30-60 min. 

Composition. — It contains a volatile oil, resins, and possibly berberina. 

Uses. — Its action seems to be that of an aromatic and somewhat 
irritant bitter, somewhat resembling mezereum and guaiac. Like these 
drugs it is used in rheumatism. The bark is chewed to relieve toothache, 
and to aid recovery in palsy affecting the tongue. 

U.S.P. Pilocarpus. Pilocarpus. Jaborandi. — The leaflets of 
Pilocarpus pennatifolius. 

Characters. — About four inches (10 centimetres) long, short-stalked, 
oval or ovate-oblong, entire and slightly revolute at the margin, obtuse 
and emarginate, unequal at the base; coriaceous, pellucid-punctate, 
mostly smooth; when bruised, slightly aromatic; somewhat pungent 
and bitter. 

Preparation. 

dose. 
Extractum Pilocarpi Fluidum 5-60 min. 

U.S.P. Pilocarpinae Hyclrochloras. Hydrochlorate of Pilo- 
carpine. — The hydrochlorate of an alkaloid prepared from Pilocarpus. 
It should be kept in small, well-stopped vials. 

Characters. — Minute, white crystals, deliquescent, odorless, having 
a faintly bitter taste, and a neutral reaction. Very soluble in water and 
in alcohol, but almost insoluble in ether or chloroform. When heated 
on platinum foil, the crystals melt, and are finally completely dissipated. 
With concentrated sulphuric acid, the crystals yield a yellow color ; with 
nitric acid (sp. gr. 1*400), a faintly greenish- violet tint; with sulphuric 
acid and chromate of potassium, an emerald-green color. If an aqueous 
solution of the salt is slightly acidulated, the addition of water of ammonia 
produces no precipitate. Solution of soda produces a cloudiness only in 
a concentrated solution. The aqueous solution yields, with test solution 
of nitrate of silver, a white precipitate, insoluble in nitric acid, but soluble 
in ammonia. 

Dose. — ^ to J grain internally or by subcutaneous injection. 

Uses. — Its action and uses are similar to those of pilocarpus. 

Composition. — The leaves contain a volatile oil and two alkaloids, 
pilocarpine and jaborine. 

Action. — Jaborine has an action like that of atropine and antago- 
nistic to that of pilocarpine. The amount of jaborine in the leaves is 
insufficient to antagonize the pilocarpine, so that the leaves have an 
action like that of pilocarpine. It is probable that some discrep- 
ancies between the statements of different observers regarding the 
action of pilocarpine may be due to the presence of more or less jaborine 
in the pilocarpine which they supposed to be pure. 

Pilocarpine stimulates the peripheral terminations of efferent 
nerves going to glands, and first stimulates and then paralyzes the 
efferent nerves going to structures composed of involuntary muscular 
fibre. In large doses it lessens but does not quite destroy the irrita- 
bility of voluntary muscle and motor nerves. 



750 VEGETABLE MATERIA MEDICA. 

It appears to have a certain action on the nerve-centres. It pro- 
duces in rana esculenta convulsions like those of picrotoxin. In rana 
temporaria it. only produces paralysis. Frogs poisoned by it croak, when 
stroked, in the same way as when the cerebrum is removed. In mam- 
mals it causes dyspnoea, convulsive twitching and shivering, and move- 
ments of rotation (p. 195 ; cf. also Apomorphia). These may, however, 
be partly due to the action of the drug on the heart. It seems, however, 
to stimulate the centres of the salivary and sweat glands as well as the 
peripheral terminations of the secreting nerves. 

From its stimulating action on secreting nerves it produces enormous 
secretion of saliva from the submaxillary, sublingual, and parotid glands, 
and enormous secretion of sweat from the sweat glands, beginning 
either in the face or at the point of subcutaneous injection, and extending 
over the whole surface of the body. It produces, though to a less extent, 
secretion of tears from the lachrymal gland ; of wax from the ears ; of 
mucus from the nose and from the bronchial mucous membrane ; of 
gastric juice from the glands of the stomach ; probably of intestinal 
juice from the intestinal glands, and of urine from the kidney. The 
secretion of milk is sometimes but not always increased. It does not 
appear to increase the secretion of "bile. 

Its stimulating action on nerves supplying involuntary muscular 
fibre is observed in the eye, intestine, heart and vessels, bladder, uterus 
and spleen. By stimulating the terminations of the third nerve in the 
eye it causes contraction of the pupil and spasm of accommodation, and 
indistinct vision. After this passes off there may be dilatation of the 
pupil. By stimulating the intestinal ganglia it causes increased peris- 
talsis. By stimulating the vagus ends in the heart like nicotine, larg-e 
doses of it cause the pulse to become slow in frogs and in mammals, and 
the blood-pressure to fall. In small doses its effect is more complicated, 
as will be afterwards noticed. In larg-er doses it paralyzes the vag-us 
ends (A, Fig. 80, p. 276), but not the inhibitory ganglia. By acting on 
the bladder it causes contraction, and may produce strangury and some- 
times retention. It causes contractions of the uterus, which, in rabbits, 
begin at the openings of the Fallopian tubes and proceed to the os uteri. 
This depends also on a peripheral action of the drug, and is not arrested 
by destruction of the spinal cord. It causes contraction of the spleen in 
man both in its normal condition and when abnormally enlarged. 

As vomiting is a complex movement demanding the co-operation of 
the abdominal muscles and diaphragm, it is evident that it would not 
ensue merely from increased contraction of the gastric walls. Jaborandi 
appears, however, to irritate the stomach, and often causes nausea and 
vomiting ; and so does pilocarpine, though to a less extent, even when 
subcutaneously injected. 

It is probable that even when injected subcutaneously it is eliminated 
by the mucous membrane of the stomach in the same way as tartar emetic, 
morphine, atropine, quinine, and strychnine, and that it thus acts as a 
local irritant to the gastric nerves (Fig. 4, p. 56). 

Its action on the circulation is a complicated one, as the direct effect 
of the drug on the heart and vessels is probably much modified by the 
reflex action from the stomach, intestines, &c, which have been stimulated 



THALAMIFLOR.E. 751 

by it. The vessels usually become much dilated at first, the caro- 
tids pulsating violently, the pulse becoming rapid, and a feeling of heat 
being perceived over the body. When perspiration sets in there is some- 
times a feeling of cold and shivering. The blood-pressure usually falls 
a little at first with quicker pulse, then rises with slower pulse (p. 238), 
and finally falls greatly from vaso-motor paralysis. 

Respiration. — There is sometimes a feeling of slight dyspnoea just 
after the dose has been given, but this only lasts a few moments. Poison- 
ous doses cause in animals dyspnoea and convulsions, which, as already 
mentioned, probably depend in some measure on cardiac failure. In 
animals the abundant secretion into the bronchi and pulmonary oedema 
produced by large doses also lead to dyspnoea. 

The temperature rises when the patient is shivering and falls dur- 
ing sweating (p. 380). The secretion of sweat usually lasts for two or 
three hours, and is so copious that the body loses one or two pounds 
and sometimes as much as eight pounds from it and the salivation 
together. 

After the sweating is over there is usually a feeling of debility, 
languor, and thirst. 

Pilocarpine is excreted unchanged by the urine. It does not appear 
in the saliva. 

The injurious effects sometimes produced by it are, in addition to 
the dimness of vision and vomiting already mentioned, sudden collapse, 
swelling of the salivary glands and tonsils, hiccough, diminished secre- 
tion of urine, albuminuria, strangury, bleeding from the vagina, and 
anticipation of the menstrual flux. 

Atropine antagonizes pilocarpine very completely, preventing its 
action if administered before it, and removing its effects if given after 
it. Sudden collapse ought therefore to be treated by the subcutaneous 
injection of atropine. 

The nausea and vomiting generally yield easily to morphine. 

Uses. — As its action is a peripheral rather than a central one, it 
affects the eye more powerfully when applied locally than when taken 
internally. It has been employed in chronic catarrh, in intra-ocular 
haemorrhage, in separation of the retina, in albuminuric retinitis, and 
instead of physostigma in glaucoma, &c. (vide Myotics, p. 204). In some 
skin diseases it is very useful, especially in prurigo and chronic 
urticaria and in baldness. In small doses it relieves thirst (vide 
Refrigerants, p. 317) in chronic renal disease, and has been used for 
a similar purpose in fever. 

It has been used in diseases of the throat, especially tonsillitis and 
diphtheria, but its utility in the latter disease is uncertain. In bronchitis, 
asthma, and whooping-cough it sometimes gives relief, though it is not 
so useful as might be expected (p. 226). From its action on the uterus 
it has been used as an oxytocic to induce premature labor. As a 
diaphoretic it may be used in small doses to induce diaphoresis and 
prevent or relieve coryza. bronchial catarrh, or rheumatism consequent 
on a chill (p. 293). 

Its chief use is in dropsy, and especially in uraemia depending on 
disease of the kidneys. It has been employed to remove pleural and 



752 VEGETABLE MATERIA MEDICA. 

peritoneal effusions, and has been used in cardiac dropsy when digitalis 
failed, but great care is then requisite in its use. 

In renal dropsy it not only removes water from the body but it 
removes urea and possibly other products of tissue waste. Some of the 
urea is excreted in the sweat, and a considerable amount appears in the 
saliva. Probably the removal of these products from the body is the 
reason why pilocarpine cuts short uraemic convulsions. In puerperal 
eclampsia it is not so successful as in convulsions depending on kidney 
disease. Pilocarpine has also been used to eliminate other poisons from 
the body, and has been used in syphilis and chronic poisoning by lead, 
mercury and arsenic. 

Contra-indications. — Fatty heart, and impeded pulmonary circu- 
lation from valvular disease, emphysema, or pleurisy. These conditions 
do not absolutely prohibit the use of the remedy, but it must then 
be given with care and the patient watched. It may be combined with 
alcoholic stimulants, and atropine should be ready for subcutaneous 
injection if necessary. 

SIMARUBACEiE. 

Quassia, U.S.P. ; Quassiae Lignum, B.P. Quassia, U.S. P.; 
Quassia Wood, B.P. — The wood of Picrcena excelsa. Jamaica. 

Characters. — Billets varying in size, seldom thicker than the thigh. 
Wood dense, tough, yellowish- white, intensely and purely bitter. Also 
chips and raspings of the same. 

Properties and Composition. — The wood contains a small quan- 
tity of a bitter neutral principle, Quassiin. The wood contains no tannin, 
and may therefore be used with salts of iron. 

Pkeparations. 

U.S.P. DOSE. 

Extractum Quassise 3-5 gr. ('18-32 Gm.) 

" Fluidum £-1 fl. drm. (2-4 c.c.) 

Tinctura " £-2 fl. drm. (2-8 c.c.) 

B.P. 

Extractum Quassise 2-5 gr. 

Infusum " (1 drm. in £ pt. cold water for £ hr.) 1-2 fl. oz. 
Tinctura " £-2 fl. drm. 

Action and Uses. — Quassia is a pure bitter stomachic tonic, 
having no other action on man. On insects it exerts a narcotic influence, 
and, in the form of an infusion sweetened with sugar, it is often employed 
to destroy flies. 

In small doses it increases the appetite. In large doses it acts as an 
irritant and causes vomiting. The infusion is made with cold water. As 
it contains no tannin it does not form an inky mixture with iron, like 
most vegetable bitters, and so can be conveniently prescribed with it. It 
is used in atonic dyspepsia. 

Its action is not thoroughly understood, but it is not improbable that 
it lessens putrefaction in the stomach and prevents to some extent the 
formation of acid substances during digestion. 

It is often administered by using a cup made of the wood ; this, when 
filled with water, imparts its active principle to that fluid. An infusion 
is used in the form of enema to destroy ascarides. 



CALYCIFLOILE. 753 

CHAPTER XXXII. 

Class I.— EXOGENiE. Sub-Class II.— CALiYCIFLORiE. 

RHAMJSTACEiE. 

Rhamni Succus, B.P. Buckthorn Juice. — The recently ex- 
pressed juice of the ripe berries of common buckthorn, Rhamnus 
cathartieus. 

Characters. — A green liquid, with a sweetish taste and disagreeable 
odor. It has an acid reaction. 

Composition. — A yellowish, uncrystallizable substance, Rhamnoca- 
thartin, with a bitter taste and soluble in water. Also a glucoside, 
Rhamnin, and a product of its decomposition, Rhamnetin. 

Preparation, 
b.p. DOSE. 

Syrupus Rhamni £-1 fl. oz.; (for a child) £-2 fl. drm. 

Use. — Buckthorn is used as a domestic remedy for constipation, and 
is given to children in the form of syrup. It is a hydragogue purgative, 
stimulating the secretion of the mucous membrane of the intestine. It 
may cause griping. 

Frangula, TJ.S.P. Buckthorn. — The bark of Rhamnus Fran- 
gula collected at least one year before being used. 

Characters. — In quills about -^ of an inch thick; grayish or 
blackish-brown outside, with whitish corky warts ; brownish-yellow inter- 
nally. Nearly inodorous ; taste sweetish and bitter. 

Composition. — The most important constituent is a cathartic sub- 
stance, frangulin. 

Preparation, 
u.s.p. DOSE. 

Extractum Frangulae FTuidum 1 fl. drm. (4 c.c.) 

Action and Uses. — When fresh it acts as an irritant poison on 
the gastro-intestinal canal, but when dried its action becomes less violent, 
and more like that of rhubarb. It is used as a purgative in constipa- 
tion, and may be given in the form of the fluid extract or of a decoction 
(J oz. to J pint) in tablespoonful doses, or as an elixir, 1 fl. dr. of the 
fluid extract to 3 of elixir of orange. 

All the species of buckthorn appear to possess cathartic properties. 
Lately the bark of the Rhamnus Purshiana has been coming into use 
as a purgative under the name of Cascara Sagrada, or sacred bark. It is 
usually given in the form of fluid extract in doses of J- to 1 fl. oz., but 1 
fl. dr. or less given immediately after rising in the morning is often suffi- 
cient. It may also be given with advantage in chronic constipation in 
doses of 10-15 min. thrice a day before meals. 

CELASTRACEiE. 

U.S.P. Euonymus. Euonymus Wahoo. — The bark of Euony- 
mus atropurpureus. 

48 



754 VEGETABLE MATERIA MEDICA. 

Characters. — In quilled or curved pieces, about one-twelfth of an 
inch (2 millimetres) thick ; outer surface ash-gray, with blackish patches, 
detached in thin and small scales ; inner surface whitish or slightly tawny, 
smooth ; fracture smooth, whitish, the inner layers tangentially striate ; 
nearly inodorous; taste sweetish, somewhat bitter and acrid. 

Preparation. 

DOSE. 

Extractum Euonymi 2-5 gr. 

Composition. — It contains a bitter principle called euonymin, which 
is precipitated together with a resin and a fixed oil, when the strong 
tincture is poured into water. 

Action. — It acts as an hepatic stimulant (p. 351), hydragogue 
cathartic, and diuretic. In large doses it causes intestinal and hemor- 
rhoidal irritation. 

Use. — In constipation accompanied by biliousness, and in chronic 
malarial conditions. 

AQUIFOLIACEJE. 

U.S.P. Prinos. Prinos. Black Alder. — The bark of Prinos 
verticillatus, Linne (Ilex verticillata, Gray). 

Characters. — Thin, slender fragments, about one-twenty-fifth of an 
inch (1 millimetre) thick, fragile; outer surface brownish ash-colored, 
with whitish patches and blackish dots and lines, the corky layer easily 
separating from the green tissue ; inner surface pale greenish or yellowish ; 
fracture short, tangentially striate; nearly inodorous, bitter, slightly 
astringent. 

Dose. — 30 grains. 

Action. — It is an astringent bitter. It is employed in the form 
of a decoction, prepared by boiling two ounces of the bark in three pints 
of water down to two pints. This decoction is given internally, in doses 
of two or three fluid ounces, in diarrhoea and malarial disorders, and is 
used externally in indolent sores and chronic skin diseases. 

TEREBINTHACEiE. anacardmi. 

Mastiche, U.S.P. and B.P. Mastich. — A concrete resinous 
exudation from Pistacia Lentiscus. Scio. 

Characters. — Globular or elongated tears about the size of a pea, 
pale yellow, glass-like, brittle, becoming soft and plastic when chewed ; 
faint, agreeable odor and slight terebinthinate taste. 

Composition. — Consists of about 90 per cent, of an acid resin 
(mastichic acid), soluble in alcohol ; the remaining 10 per cent, is 
masticin, a tenacious resin soluble in ether, with traces of an ethereal oil. 

Preparation. — Some exudes spontaneously, but most is got by 
incision into the stem. 

Preparation. 

U.S.P. 

Pilula Aloes et Mastiches. 
Dose. — 20 to 40 gr. if administered internally. 



CALYCIFLOK.E. 755 

Uses. — It is sometimes chewed in order to give pleasant odor to the 
breath. It is chiefly employed for temporarily stopping decayed teeth, 
and for arresting hemorrhage from leech bites. When used to stop the 
teeth the cavity ought to be well cleaned and dried, and a piece of cotton 
saturated with a solution of four parts of mastiche should be gently 
pressed into it so as not to cause pain, but to fill the cavity exactly. 
Another method is to dissolve one part of mastiche with two of collodion, 
and fill the cavity with this. Either of these methods may also be em- 
ployed to stop bleeding from leech bites. It has been supposed to have 
a stimulating- action on the bronchial mucous membrane, and has been 
used in bronchorrhoea, and also in infantile cholera. It is used to cover 
mercurial pills and prevent the formation of amalgam when they are 
silvered. 

XJ.S.P. Rhus Glabra. Rhus Glabra. Sumach. — The fruit of 
Rhus glabra. 

Characters. — Sub-globular, about one-eighth of an inch (3 milli- 
metres) in diameter, drupaceous, crimson, densely hairy, containing a 
roundish-oblong, smooth putamen. It is inodorous, and its taste acidu- 
lous. 

Peepaeation. 

dose. 
Extractum Rhois Glabrae Fluidum 1-2 fl. drm. 

Composition. — It contains much tannin. 

Uses. — It may be used as an astringent in the form of decoction, 
or the fluid extract may be diluted for an effective gargle in inflammation 
of the throat or mouth. 

TJ.S.P. Rhus Toxicodendron. Rhus TOXICODENDRON. POISON 
Ivy. — The fresh leaves of Rhus Toxicodendron, Michaux ; Rhus Toxi- 
codendron and Rhus radicans, Linne'. 

Characters. — Long-petiolate, trifoliate ; the lateral leaflets sessile, 
about four inches (10 centimetres) long, obliquely ovate, pointed ; the 
terminal leaflets stalked, ovate or oval, pointed, with a wedge-shaped 
base ; the leaflets entire and glabrous (in Rhus radicans, Linne), or 
variously notched, coarsely toothed or lobed, downy beneath (in Rhus 
Toxicodendron, Linne') ; when dry, papery and brittle ; inodorous ; some- 
what astringent and acrid. 

The fresh leaves abound with an acrid juice which darkens when 
exposed to the air, and, when applied to the skin, produces inflammation 
and swelling. The leaves should, therefore, not be touched with bare 
hands. 

Rhus Toxicodendron should not be confounded with the leaves of 
Ptelea trifoliata, Linne', which are similar in appearance, but have all the 
leaflets sessile. 

Composition. — It contains a volatile acid which appears to be the 
active principle. 

Action. — In many persons contact with this plant causes an eczema- 
tous eruption of a very distressing character. It is best treated by 
solutions of lead, permanganate of potash, and ammonia. Internally it 
causes gastro-intestinal irritation, drowsiness, stupor, and delirium. 



756 VEGETABLE MATERIA MEDICA. 

Uses. — It has been recommended in incontinence of urine, paral- 
ysis, and cutaneous diseases. A fluid extract of a non-officinal plant, 
Rhus aromatica, has been used successfully in incontinence of urine, in 
doses of 5 to 30 min. 



AMYRIDACEJE, or BURSERACE^E. 

Myrrha, U.S.P. ?nd B.P. Myrrh. — A gum-resinous exudation 
from the stem of Balsamodendron Myrrha. Arabia Felix and Abys- 
sinia. 

Characters. — In irregular-shaped tears or masses varying much in 
size, somewhat translucent, of a brownish-yellow or reddish-brown color, 
fractured surface irregular and somewhat oily; odor agreeable and 
aromatic ; taste acrid and bitter. 

Composition. — Gum (50-60 per cent.) soluble in water, and of 
which arabin constitutes a portion. The remainder, insoluble in water, 
is made up principally of a resinous acid, myrrhic acid, and a volatile oil. 

Preparations. 

U.S.P. DOSE. 

Mistura Ferri Composita 1-2 fl. oz. (30-60 c.c.) 

Pilulse Aloes et Myrrhse 1 pill. 

Pilulse Ferri Composite .2-6 pills. 

" Galbani Composite 2-4 pills. 

Tinctura Aloes et Myrrhae 1-2 fl. drm. (4-8 C.C.) 

Tinctura Myrrhae 1-2 fl. drm. (4-8 C.C.) 

B.P. DOSE. 

Decoctum Aloes Compositum £-2 fl. oz. 

Mistura Ferri Composita 1-2 fl. oz. 

Pilula Aloes et Myrrhse 5-10 gr. 

" Asafoetidse Composita 5-10 gr. 

" Rhei Composita 5-10 gr. 

Tinctura Myrrhse $-1 fl. dr. 

(of myrrh, 10-30 gr.) 

Action and Uses. — Myrrh is a very useful astringent in the form 
of wash or gargle for spongy gums, aphthous stomatitis, and ulcerated 
throats. Internally it is used as an expectorant in chronic bronchitis; 
and combined with iron and aloes is used in the treatment of amenorrhcea. 
It is also useful in bronchorrhoea and leucorrhoea. 

B.P. Elemi. Elemi. — A concrete resinous exudation, the botani- 
cal source of which is undetermined, but is probably Idea Abilo. 
Manilla. 

Characters. — A soft sticky mass, yellowish-white, with fennel-like 
odor ; almost entirely soluble in rectified spirit. 

Composition. — Two resins and a volatile oil. 

Preparation, 
b.p. 
Unguentum Elemi (with simple ointment) 1 part in 5. 

Use. — Not given internally ; is used as a local stimulant in ulcer- 
ation. 



CALYCIFLOR.E. 757 

LEGUMINOS^E ; Papulionace^e. 

Glycyrrhiza, U.S.P. ; Glycyrrhizae Radix, B.P. Liquorice 
Root. — The root or underground stem, fresh and dried, of Grlycyrrhiza 
glabra. 

Characters. — In long cylindrical branched pieces, tough and 
pliable ; grayish-brown outside, yellow inside ; taste sweet and slightly 
acrid. Digested with water it yields a solution which gives a precipitate 
with diluted sulphuric acid. 

Composition. — Contains starch, sugar, and a sweet principle — 
glycyrrhizin — which is the substance precipitated by sulphuric acid. 

Peepaeations. 
u.s.p. DOSE. 

Extractum Glycyrrhizae Fluidum 1 fl. drm. (4 C.C.} 

" " Purum 1 fl. drm (4 c.c.) 

Glycyrrhizinum Ammoniatum 5-15 gr. (0'32-l Gill.) 

Pulvis Glycyrrhizae Compositus {vide p. 767) 30-60 gr. (2-4 6m.) 

B.P. DOSE. 

Confectio Terebinthinae 60-120 gr. 

Decoctum Sarsse Compositum 2-10 fl. oz. 

Extractum Glycyrrhizae 10-30 gr 

Infusum Lini 1-2 fl. oz. 

Pilula Hydrargyri 3-8 gr. 

" Ferri Iodidi 3-8 gr. 

Extractum Glycyrrhizae Laquidum 1 fl. drm. 

Pulvis Glycyrrhizae Compositus (vide -p. 767) 30-60 gr. 

OF EXTEACT OF LIQTJOEICE — 

Confectio Sennse (1 part in 94, nearly) 

Decoctnm Aloes Compositum (1 oz. in 30 fl. oz.)... 

Mistura Sennse Composita (J oz in 1 pint) 

Tinctura Aloes (1J oz. to 1 pint) 

Trochisci Opii . 

U.S.P. Glycyrrhizinum Ammoniatum. AMMONIATED GLYCYEEHIZIN. — Pre- 
pared by exhausting powdered liquorice with ammonia, precipitating by sulphuric 
acid, redissolving in ammonia, and drying. It forms dark brown or reddish scales, 
very sweet. It is used for flavoring. 

Action and Uses. — Taken into the mouth, liquorice has a sweet 
taste ; it increases the flow of saliva, and being mucilaginous acts as a 
demulcent. It is used to allay cough by lessening the irritation of the 
mucous membrane. It is particularly useful when there is violent cough 
due to irritation of the pharynx and upper part of the respiratory pas- 
sages (p. 222). It is used as a vehicle to cover the taste of other medi- 
cines, and has been used instead of sugar in diabetes. The Pulv. 
Glycyrrhizae Co., which is really a preparation of senna, q.v., is a gentle 
laxative. 

Scoparius, U.S.P. ; Scoparii Cacumina, B.P. Broom, U.S.P. ; 
Broom Tops, B.P. — The fresh and dried tops of Sarothamnus Scopa- 
rius (Cytisus Scoparius). From indigenous plants. 

Characters. — Thin, flexible, tough twigs, dark green, angular, of a 
bitter nauseous taste, and of a peculiar odor when bruised. 

Composition. — It was found by Stenhouse to contain two principles 
— a neutral body, scoparin, and a volatile poisonous alkaloid, sparteine. 



758 VEGETABLE MATERIA MEDICA. 

Preparations. 

B.P. DOSE. 

Decoctuni Scoparii (1 oz. in 1 pint for 10 minutes and strain)... 1-3 n. oz. 

Succus Scoparii 1-2 n. dr. or more. 

None in r.s.P. 

Physiological Action. — Broom tops have a diuretic action. 

The action of sparteine is identical with that of coni'rne. It para- 
lyzes the endings of the motor nerves and vasri, diminishes reflex 
excitability of the cord, and causes death by paralysis of the respiratory 
centre in the medulla oblongata. According to J. Fick it has a diuretic 
action. 

Scoparin has been supposed to be the diuretic principle. It has 
little physiological action, and in a number of unpublished experiments 
which I made in 1865 with a specimen given to me by my friend Dr. 
Stenhouse, I found that in the healthy subject it does not produce 
diuresis. Similar results have been obtained by Paton. It is quite 
possible, however, that it may act as a diuretic in cases of dropsy. 

Therapeutical Uses. — Broom tops are most useful in dropsy 
dependent on chronic renal disease. They are also useful in cardiac 
dropsy, but digitalis is generally more certain. In comparative experi- 
ments I have found the decoction of the dried broom tops quite as effica- 
cious as the juice expressed from the fresh tops. 

Tragacantha, U.S.P. and B.P. TRAGACANTH. — A gummy exu- 
dation from the stems of Astragalus gummifer and from other species 
of Astragalus. Asia Minor. 




Fig. 149— Tragacanth. 

Characters. — Shell-like bands, slightly curved, white or yellowish, 
tough and elastic ; very sparingly soluble in cold water ; but swelling 
into a gelatinous mass, which is tinged violet by tincture of iodine. 

Composition. — Consists of a mixture of arabin, or common gum- 
arabic ; and bassorin, a gum which does not dissolve in water, but swells 
up in it. 

Preparations, 
u.s.p. dose. 

Mucilago Tragacanthae 

B.P. 

Confectio Opii 5-20 gr. 

Mucilago Tragacantha- 1 A. OZ. Or more. 

Pulvis Opii Compositus 2-5 gr. 

Pulvis Tragacantha} Compositus 20 gr. upwards. 

Mucilago Tragacantha'. Mucilage of Trag acanth. — Tragacanth, 6 ; glycerine, 
18 ; water up to 100 (U.S.P.). Tragacanth, 60 gr.; water, 10 fl. oz. (B.P.). 

B.P. Pulvis Tragacantha? Compositus. COMPOUND POWDER OF TRAGACANTH. 

— Tragacanth, 1 ; gum acacia, 1 ; starch,! ; refined sugar, 3. 



CALYCIFLORiE. 759 

Uses. — It is used to suspend heavy powders, such as subnitrate 
of bismuth, and is more efficacious than gum-arabic, owing to the insoluble 
gum bassorin, which swells up when water is added. Also used in 
making lozenges, and emulsions of cod-liver oil. 

Santalum Rubruin, U.S.P. Red Saunders. — The wood of 
Pterocarpus santalinus. 

Pterocarpi Lignum, B.P. Red Sandal- Wood. — The wood of 
Pterocarpus santalinus. Ceylon. 

Characters. — The wood is in billets, chips, or powder. It resem- 
bles logwood in appearance, but is denser, and the cut surface is more 
glistening and of a deeper red color. 

Composition. — It contains a fine ruby coloring-matter named santalin, 
which may be dissolved out by spirit, ether, acetic acid, &c; insoluble in 
water. 

Preparation. 

u.s.p. b.p. dose. 

Not given. Tinctnra Lavandulae Composita §-2 n. dr. 

Use. — It is used to give color to the compound tincture of lavender, 
and through this to Liquor arsenicalis. 

Kino, U.S.P. and B.P. Kino. — The inspissated juice obtained 
from incisions made in the trunk of Pterocarpus marsupium. Malabar. 

Characters. — Small, angular, brittle, glistening, reddish-black frag- 
ments, translucent and ruby-red on the edges, inodorous, very astringent. 
When chewed it tinges the saliva blood-red. 

Composition. — Kino-tannic acid and pyrocatechin, which differs very 
slightly from catechin, obtained from catechu. Through the action of 
kino-tannic acid, kino strikes a violet color with ferrous salts, turning to 
green by exposure. 

Preparations. 

U.S.P. DOSE. 

Tinctura Kino 2 -2 fl. dmi. (2-8 C.C.) 

B.P. 

Pulvis Catechu Compositns 20-40 gr. 

Pulvis Kino Compositns (p. 710) 5-20 gr. 

Tinctura Kino j-2 fl. dr. 

(of powdered kino, 10-30 gr.) 

Action and Uses. — Kino has an astringent action both externally 
and internally. It is useful in relaxed sore throat as a gargle. It is 
given internally in diarrhoea and in pyrosis. From its insolubility it is 
most useful when we desire an astringent action on the lower part of the 
intestinal canal, but when the astringency is required in the upper part 
it is not so useful as the more soluble astringents. 

Balsanmm Peruvianuni, U.S.P. and B.P. Balsam or Peru. 
— A balsam obtained from Myroxylon Pereirce. It exudes from the 
trunk of the tree after the bark has been scorched and removed. Salva- 
dor, in Central America. 

Characters. — A nearly black liquid, reddish-brown and translucent 
in thin films ; syrupy consistence, balsamic odor, and an acrid, slightly 
bitter taste. 



760 VEGETABLE MATERIA MEDICA. 

Composition. — Contains resin, volatile oil, and both benzoic and 
cinnamic acids. 

Dose. — 10 min. to J fl. drm. and upwards, made into an emulsion 
with mucilage or yolk of egg. 

Action and Uses. — It is employed locally as a parasiticide in 
scabies and in cases of skin diseases depending on vegetable fungi. It 
destroys both the itch acarus and its eggs. It is much more agreeable 
than sulphur ointment. Before applying it, it is advantageous to take 
a warm bath, and wash the affected parts thoroughly with soft soap, and 
then to rub it well in all over the body, especially into the armpits, 
between the fingers, and on the inside of the thighs. It should be 
repeated every two or three days, during which time the same linen 
should be worn; this when cast off should be well disinfected, or the 
disease may return. It is also useful in prurigo, in pruritus, and in the 
later stages of an acute eczema. It is a useful stimulant to bed-sores 
and ulcers. It is given internally to lessen discharge from mucous mem- 
branes, as in bronchorrhoea, gleet, and leucorrhoea ; also as a stimulating 
expectorant in chronic bronchitis. 

Balsamum Tolutanum, U.S. P. and B.P. Balsam of Tolu. — 
A balsam obtained from Myroxylon toluifera. It exudes from the trunk 
of the tree after incisions have been made into the bark. New Granada. 

Characters. — A soft and tenacious solid with a fragrant balsamic 
odor; soluble in rectified spirit. The solution shows an acid reaction 
with test paper. 

Composition. — Contains a resin, volatile oil, and free cinnamic and 
benzoic acids. 

Peepakations. 

U.S. p. DOSE. 

Syrupus Tolutanus 1-3 fl. drm. (4-12 c.c.) 

Tinctura Tolutana 1-2 fl. drm. (4-8 c.c.) 

B.P. DOSE. 

Syrupus Tolutanus 1-3 fl. drm. 

Tinctura Benzoini Composita £-1 fl. drm. 

" Tolutana 1-1 fl. drm. 

(of the balsam, 10-30 gr. ) 

Uses. — As a stimulating expectorant in chronic coughs. It should 
not be used while acute inflammation is present. The syrup covers well 
the taste of chloral or croton chloral. 

Abrus. Jequirity Seeds, Prayer Beads, Jumble Beads, 
Gumchi, Indian Liquorice. — The seeds of Abrus precatorius. Not 
officinal. 

Characters. — Small, hard seeds of a brilliant scarlet color, with a 
black spot round the hilum. They contain a ferment, and the infusion 
when left for a short time swarms with bacteria. 

Action. — When applied to the eye the infusion causes inflamma- 
tion of the conjunctiva. The seeds are sometimes used to kill cattle 
illegitimately. The seeds are moistened with water and rolled into small 
cylinders or needles with which the animal is stabbed, the point being 
left in the wound. The animal dies in a few hours. The seeds contain 



CALYCIFLOILE. 761 

no alkaloid, and death is probably due to the ferment of the seeds caus- 
ing micrococci and bacilli to develop in the blood in the same way as 
papain (p. 92). 

Use. — An infusion is used to produce purulent ophthalmia in order 
to cure granular lids. The infusion is made by mixing the powdered 
seeds (3) with cold water (500), and adding hot water (500). This is 
filtered when cold. It is applied three times the first day, and repeated 
on the second or third day if necessary. An emulsion made by tritu- 
rating the seeds with water and painted on with a brush is useful in 
unhealthy ulcers and lupus. 

Physostigma, U.S. P. ; Physostigmatis Faba, B.P. Calabar 
Bean. — The seed of Physostigma venenosum. Western Africa. 



Q 



Fig. 150.— Calabar Bean (}/ 2 natural size). 

Characters. — A kidney-shaped bean about an inch long, chocolate- 
colored, shining, and with a broad black groove along the whole length 
of the convex edge. Internally the bean is white, and tastes like an 
edible bean. 

Composition. — Contains two alkaloids — physostigmine or eserine, 
and calabarine. 

Dose. — Of the powdered bean 1 gr. gradually increased. 

Pbepabations. 

U.S. p. DOSE. 

Extractum Physostigmatis -^-\ gr. (0 '004-0 *01 Gm.) 

Tinctura Physostigmatis 12 min. 

B.P. DOSE. 

Extractum Physostigmatis T V? gr. 

U.S.P. Physostigminse Salicylas. SALICYLATE OF PhySOSTIG- 
mine. C 15 H 21 N 3 2 C 7 H 6 3 ; 413. — The salicylate of an alkaloid prepared 
from physostigma. 

Characters. — Colorless, shining, acicular, or short, columnar crys- 
tals, gradually turning reddish when long exposed to air and light, odor- 
less, having a bitter taste, and a neutral reaction. Soluble in 130 parts 
of water, and in 12 parts of alcohol at 15° C. (59° F.); in 30 parts of 
boiling water, and very soluble in boiling alcohol. When heated on 
platinum foil, the salt is completely dissipated. The aqueous or alcoholic 
solution of the salt, when exposed to light for a short time, turns reddish. 
On adding bicarbonate of sodium to the aqueous solution, shaking with 
ether, and evaporating the ethereal solution, an amorphous residue is 
obtained, having an alkaline reaction, and assuming, when dissolved for 
some time in water, a reddish color, which disappears on the addition of 
sulphurous acid, but returns again as the latter evaporates. On concen- 
trating the aqueous solution, which has been shaken with ether, to a small 



762 VEGETABLE MATERIA MEDICA. 

bulk, and supersaturating with sulphuric acid, a bulky, white precipitate 
is obtained which responds to the reactions of salicylic acid (see Acidum 
Salicylicum). 

Dose.— ^ to ^ gr. 

Physiological Actiox. — It stimulates muscular fibre, both 
voluntary and involuntary, throughout the body, and paralyzes the 
nerve -centres. 

The alkaloids of Calabar bean have different actions, and dif- 
ferent or even contradictory results may be obtained according to the 
amount of each present in the preparation of the bean employed. 
Pliysostigmine or eserine paralyzes the nervous centres and stimu- 
lates muscular fibre, but calabarine causes convulsions like strych- 
nine. 

General Action. — A small dose of physostigma, from its action on 
the muscular fibres of the intestine, causes pain in the abdomen, with 
nausea and vomiting. From its action on the vagus and motor centres 
it causes a sense of oppression in the chest and weakness. With larger 
doses these symptoms become worse ; and, in addition, contraction of the 
pupil, salivation, slowness of the pulse, and spasmodic respiration occur. 
Death is due to paralysis of respiration. 

The excitability of the muscles is increased, so that they contract 
on the application of a slighter stimulus than usual, but their actual 
working power is not increased. In the first stage of poisoning in frogs 
muscular tremors are often apparent, and are also seen on the local 
application of the drug to the muscle of frogs. They are due to the local 
action of the drug on the intra-muscular end-plates, for they occur when 
the sciatic nerve has been divided before poisoning, but cease after ihe 
injection of curare. 

The spinal cord is paralyzed ; the posterior columns first and then 
the anterior columns. This action on the cord is the cause of the general 
paralysis induced by the drug. Convulsions like those of strychnine 
poisoning may occur. They are due to calabarine. 

The medulla is paralyzed, and respiratory movements cease before 
the reflex action of the spinal cord is destroyed. 

The motor nerves in warm-blooded animals are not usually affected 
until very late, but in frogs they are paralyzed gradually. 

The sensory nerves are partially paralyzed by the local application 
of physostigma in a concentrated form, but not when it is injected into 
the blood. 

The brain in man seems not to be paralyzed, for in a number of 
cases of poisoning, which occurred among children in consequence of 
eating the beans, consciousness was not impaired at all, and there were 
neither convulsions nor anaesthesia. Notwithstanding the absence of 
convulsions in these cases, however, physostigma appears to have an 
irritant action upon the brain, for when it is administered to epileptic 
patients, or to animals rendered epileptic by section of the sciatic nerve, 
it increases the number of fits (p. 172). Cats and guinea-pigs poisoned 
by it also show symptoms of great cerebral excitement, becoming very 
timid and running wildly about. This maybe partly due to interference 
with the respiration, but can hardly be the only cause, as this condition 



CALYCIFLOR^E. 763 

is not observed in the case of other drugs which paralyze the respiration. 
In frogs the brain appears to be paralyzed before the spinal cord, so that 
voluntary motion ceases before reflex action. 

Action on the Eye. — When locally applied, physostigma causes 
contraction of the pupil, diminishes intra-ocular tension, and causes spasm 
of accommodation, preceded by increased power of accommodation for 
near objects; often twitching of the eyelids and slight supra-orbital pain 
are observed. These effects are due either to stimulation of the fibres of 
the third nerve or of the circular muscular fibres of the iris ; but are 
certainly not due to paralysis of the sympathetic, since stimulation of the 
sympathetic will, during the influence of the poison, cause dilatation of 
the pupil (p. 201). 

Respiration is first quickened and then retarded. The acceleration 
is due to spasm of the bronchial tubes, according to some observers ; but 
others consider it to be caused by stimulation of the ends of the vagi in 
the lungs (p. 219) ; and it is certain that if the vagi are first divided, 
physostigma no longer causes acceleration of respirations, but slows them 
from the first. The slowing of respiration is due to paralysis of the 
respiratory centre in the medulla. Death is the result of this failure of 
respiration. 

Action on the Circulation. — Small doses sometimes cause a slight 
fall in blood-pressure, larger ones always cause a rise. This rise is chiefly 
due to the increased contractile power of the heart, but it is not improb- 
able that it is aided by a contraction of the arterioles, the muscular fibres 
of which, like all other involuntary muscles in the body, are stimulated 
by the action of the physostigma upon them. According to von Bezold 
and Goetz, the rise is also partly due to tetanic contraction of the intes- 
tinal walls, which drives the blood out of them. The irritability of the 
vagus appears to be increased, as a slighter stimulus applied to its trunk 
will stop the heart after its administration. We should therefore expect 
the normal stimuli passing to the vagus centre along sensory nerves from 
various parts of the body to have a greater effect upon the heart than 
usual, and thus render its beats slower. This seems to be the case, for 
physostigma causes slowness of the pulse, which does not appear to 
depend upon direct stimulation of the vagus roots, as it is absent in 
animals which have been deeply chloralized before the administration of 
physostigma. In such animals physostigma, on the contrary, quickens 
the pulse and raises the blood-pressure. 

Muscle. — When applied to the frog's heart it renders the pulsations 
slower and more powerful. Its stimulant action on the cardiac mus- 
cular fibre is so great that neither irritation of the vagus nor of the 
venous sinus can stop the heart. That the vagus is not paralyzed is 
shown by the fact that when the stimulant action of the physostigma on 
the muscular fibre is counteracted by a poison having a paralyzing action 
on the muscle, such as a double salt of copper, stimulation of the vagus 
will again produce the stillstand in diastole. 1 In larger doses physo- 
stigma produces the staircase phenomenon (p. 275, and Fig. 16, p. 110), 
and finally imperfect stillstand in systole. The contracted ventricle still 

1 Harnack, Buchlieiin's Arzneimittellehre, 3te Aufl., p. 712. 



764 VEGETABLE MATERIA MEDICA. 

continues to pulsate slightly, and when it is distended by increasing the 
pressure of the fluid within it the pulsations become vigorous, and there 
is no tendency, as in the case of digitalis, to rapid paralysis of the car- 
diac muscle. 

The action of the physostigma on the heart is counteracted by atro- 
pine, and, though to a less extent, the action of atropine is counteracted 
by physostigma (p. 423). 

From its action on involuntary ninscle it causes contraction of the 
stomach, retching, and vomiting. It causes also diarrhoea and increased 
peristaltic movements of the intestines, which finally end in tetanic 
contraction, so that the lumen of the intestine is almost obliterated, and 
it appears like a hard cord. It causes contraction of the spleen, 
"bladder, and nterns : these contractions are not prevented by a dose 
of atropine sufficient to paralyze the nerves. The difference between the 
action of muscarine, which causes tetanic contraction of the intestine 
by acting on the nerves, and of physostigma, which produces a similar 
effect by acting on the muscular fibre, is seen when muscarine, atropine, 
and physostigmine are administered successively to an animal. 1 The 
muscarine first causes tetanic contraction. Atropine causes this to dis- 
appear, and produces complete relaxation, which is succeeded by a 
second tetanic contraction after the administration of physostigma. In 
consequence of its action on the bladder it causes nrination. 

Secretion is increased by physostigma not only in the salivary but 
in the sweat, lachrymal, and mucous glands. It seems probable that the 
secretion is not due, like that produced by muscarine, nicotine, or pilo- 
carpine, to an action on the ends of the secreting nerves, but rather to 
the action of physostigma on the secreting cells themselves, because, 
unlike the secretion produced by the three drugs already mentioned, it 
still persists after the administration of atropine. Physostigmine restores 
its excitability to the chorda tympani after its secretory fibres have been 
paralyzed by atropine. When the dose of physostigma is large, the 
secretion of saliva which it occasions lasts only for a short time, because 
the vessels of the gland become so much contracted through the action 
of the physostigma that the circulation is insufficient to maintain the 
secretion (p. 315). 

Therapeutics. — It is used in certain diseases of the eye, e.g. y 
wounds and ulcers of the cornea, and from its lessening intra-ocular ten- 
sion it is used in glaucoma and staphyloma (p. 203). It removes 
dilatation of the pupil and paralysis of accommodation after the use of 
atropia, and, used alternately with atropia, breaks down adhesions after 
iritis (p. 203). 

It is used in tetanus, strychnia poisoning, general paralysis of the 
insane, and mania, in paraplegia and in locomotor ataxy. 

It is also useful in constipation due to atony of the intestinal walls. 

It has been recommended in bronchitis, catarrh and dyspnoea when 
due to weakness of bronchial muscles (Ringer). 

It is used as an antidote to atropine and also to strychnine. 



1 Schmiedeberg, Arzndmiltellchre, p. 70. 



calycifloile. 765 

Treatment in Poisoning by Physostigma. — Evacuate the 
stomach by an emetic, and inject atropine (4 mins. of the liquor every J 
hour) until the pulse quickens or the symptoms pass off. If the dose 
of atropine be too great, it seems to intensify the lethal action of the 
physostigma. 

Haematoxylon, U.S. P. ; Hsematoxyli Lignum, B.P. LOG- 
WOOD. — The heart-wood of Hcematoxylum campechianum. Imported 
from Campeachy, Honduras, and Jamaica. 

Characters. — The logs are heavy, hard ; purplish-black externally ; 
reddish-brown internally. The chips have often a greenish lustre, they 
have a feeble agreeable odor, and sweetish taste ; a small portion chewed 
imparts to the saliva a dark pink color. 

Composition. — The coloring principle of logwood is a crystalline 
substance, hsematoxylin. It is soluble in hot water or in alcohol. Log- 
wood also contains tannic acid, which imparts to it its astringent 
properties. 

Preparations, 
u.s. p. dose. b.p. dose. 

Extractum Haematoxyli 10-30 gr. Decoctum Hsematoxyli 1-2 fl. oz. 

(0-65-1-95 Gm.) Extractum " 10-30 gr. 

B.P. Decoctum HajmatoxyU. DECOCTION OF LOGWOOD. — Logwood in chips, 
1 oz. ; cinnamon bark, in coarse powder, 60 gr. ; distilled water, 1 pint. 

Boil the logwood in the water for ten minutes in a covered, vessel, adding the 
cinnamon towards the end. Strain the decoction, and pour as much distilled water 
over the contents of the strainer as will make the strained product measure a pint. 

Uses. — It is a useful astringent in diarrhoea, especially in children. 
Its great disadvantage is the stain which it imparts to clothing. For 
the diarrhoea of phthisis, decoctum haematoxyli with acidum sul- 
phuricum aromaticum, is a good prescription. It is also used in dysen- 
tery and in atonic dyspepsia. 

U.S. P. Chrysarobinuni. Chrysarobin. — A mixture of proxi- 
mate principles (commonly misnamed chrysophanic acid), extracted from 
goa powder, a substance found deposited in the wood of the trunk of 
Andira Araroba. 

Characters. — A pale orange-yellow crystalline powder, permanent 
in the air, odorless and tasteless, almost insoluble in water, only slightly 
soluble in alcohol, readily soluble in ether and in boiling benzol. When 
heated to about 162° C. (323° -6 F.), it melts, and may be partially sub- 
limed. On ignition it is wholly dissipated. In solutions of alkalis it is 
soluble with a yellowish-red or reddish-yellow color, which is changed to 
red by passing air through the liquid. Sulphuric acid dissolves it with a 
deep blood-red color ; on pouring the solution into water, the substance 
separates again unchanged. 

Dose. — -J- to J grain (•Ol-'OS Gm.) per diem in water. 

Peepaeation. 
Unguentum Chrysarobini. Chrysarobin Ointment (Chrysarobin 10, benzoated lard 90) . 

Uses. — It is used in psoriasis and parasitic affections of the skin. 
It may be simply applied to the skin moistened with vinegar or saliva, 



766 VEGETABLE MATEEIA MEDICA. 

or used in the form of ointment. It should never be applied to the head, 
as it may cause oedema of the face. It colors both the skin and cloth- 
ing, and it is better not to use it over too large a surface at a time, as it 
may cause much irritation. It may also be given internally in eczema, 
impetigo, acne, psoriasis, urticaria, and other skin diseases. 

LEGUMINOSJE; ciESAXPiNiiE. 

Senna, U.S. P. Senna. — The leaflets of Cassia acutifolia (Alex- 
andrian senna), and of Cassia elongata (Indian senna). 

Senna Alexandrina, B.P. Alexandrian Senna. — The leaflets 
of Cassia lanceolata and C. obovata. Imported from Alexandria ; care- 
fully freed from the flowers, pods, and leaf-stalks of the same, and from 
the leaves, flowers, and fruit of Solenosternma Argel. 

Characters. — Lanceolate or obovate leaflets, about an inch long, 
unequally oblique at the base, brittle, grayish-green, of a faint peculiar 
odor, and mucilaginous sweetish taste. 

Senna Indica, B.P. Tinnevelly Senna. — The leaflets of Cas- 
sia elongata {Cassia angustifolia). Southern India. 

Characters. — About two inches long, lanceolate, acute, unequally 
oblique at the base, flexible, entire, green, without any admixture ; odor 
and taste those of Alexandrian senna, in place of which it may be used. 

Composition. — The properties of senna are due principally to a glu- 
coside, cathartic acid, which, when isolated, is powerfully purgative. 

Adulteration. — Solenosternma Argel. 




Fig. 151.— Alexandrian Senna. Fig. 152.— Indian Senna. 

Test. — Senna leaves have always an unequally oblique base, and are 
free from bitterness. Other leaves are equally oblique at the base. 

Prepaeations. 
u.s.p. DOSE. 

Confectio Sennae 60-120 gr. 

Extractum Sennae Fluidum 1 fl. dr. (4 c.c.) 

Infusum Sennae Compositum 2£ fl. oz. (75 c.c.) 

Pulvis Glycyrrhizae Compositus 30-60 gr. (2-4 Gm.) 

Syrupus Sarsaparillae Compositus 1-4 fl. dr. (4-16 c.c.) 

Syrupus Sennae 1-4 fl. dr. (4-16c.c.) 

B.P. DOSE. 

Confectio Sennae 60-120 gr. 

Infusum " 1-2 fl. oz. 

Mistura " Composita 1-1£ fl. oz. 

Syrupus " 1 fl. dr. upwards. 

Tinctura " 1 fl. dr. to \ fl. oz. 

Pulvis Glycyrrhizae Compositus 30-60 gr. 

Confectio Sennee. Confection of Senna. — Senna, 10 ; coriander, 6 ; cassia fis- 
tula, 16; tamarind, 10; prunes, 7; figs, 12; sugar, 50; water, 60 (U.S.P.). Senna, 
in fine powder, 7; coriander, 3; figs, 12 ; tamarind, 9; cassia pulp, 9; prunes, 6; 
extract of liquorice, '■{ ; refined sugar, 30 ; distilled water, 90 (B.P.). 



CALYCIFLOR.E. 767 

B.P. infusum Senna?. Infusion of Senna. — Senna, 1 oz. ; ginger, sliced, 30 
gr. ; boiled distilled water, 10 fl. oz. 

U.S.P. Infusum Senna? Compositum. COMPOUND INFUSION OF SENNA. BLACK 
Draught. — Senna, 6 ; manna, 12 ; sulphate of magnesium, 12 ; fennel, 2 ; boiling 
water, 100. Macerate, strain and make up to 100 with water. 

B.P. Mistura Sennse Composita. COMPOUND MIXTURE OF SENNA. — Sulphate of 
magnesia, 4 oz. ; extract of liquorice, J oz. ; tincture of senna, 2£ fl. oz. ; compound 
tincture of cardamoms, 10 fi. dr. ; infusion of senna, up to 1 pint. 

Pulvis Glycyrrhizse Compositus. COMPOUND LIQUORICE POWDER, U.S.P. and 
B.P. — Senna, 18; liquorice, 16; fennel, 8 ; washed sulphur, 8; sugar, 50 (U.S.P.). 
Senna, 2 ; liquorice root, 2 ; sugar, 6 (B.P.) The powder of the U.S.P. resembles that 
of the German Pharmacopoeia, and. is much better than that of the B.P. 

Syrupus Senna?, U.S.P. and B.P. SYRUP OF SENNA. — Senna, 33 ; sugar, 60 ; alco- 
hol, 4; oil of coriander, 1; water up to 100 (U.S.P.). Senna, 16 oz. ; oil of corian- 
der, 3 min. ; refined sugar, 24 oz. ; distilled water, 5 pints, or a sufficiency ; rectified 
spirit, 2 fi. oz. ; distilled water, up to 2 lb. 10 oz. (B.P.). 

B.P. Tinctura Sennse. Tincture of Senna. — Senna, 2| oz. ; raisins, 2 oz. ; 
caraway fruit, \ oz. ; coriander fruit, \ oz. ; proof spirit, 1 pint. 

Action and Uses. — Senna acts as a laxative or brisk purgative, 
according to the dose. It acts chiefly on the small intestines, and increases 
both peristalsis and the secretion. It is frequently combined with other 
purgatives. A useful remedy in constipation is Mistura Sennae Co., 
where we have senna combined with sulphate of magnesia. In habitual 
constipation, the most convenient preparation, perhaps, is Pulvis Glycyr- 
rhizae Co., U.S.P., which contains sulphur and fennel seeds in addition 
to the constituents of the B.P. powder. One drachm taken regularly at 
bedtime will generally keep the bowels regularly open without acting too 
violently. The sulphur in this preparation is in such small quantity that 
it might seem useless ; but in a number of experiments which I made on 
small quantities (about \ grain) of sulphur many years ago, I found that 
they caused an increase of flatus in the intestine which appeared to facili- 
tate the expulsion of its contents. 

Cassia Fistula. Purging Cassia, U.S.P. — The fruit of Cassia 
fistula. 

Cassise Pulpa, B.P. Cassia Pulp, B.P. — The pulp obtained from 
the pods of the purging cassia, Cassia fistula. 

Characters. — Blackish-brown, viscid, sweet in taste, and somewhat 
sickly in odor ; usually containing the seeds and dissepiments. 

Composition. — Sugar, with albuminoid matter. 

Preparations. 

U.S.P. DOSE. 

Confectio Sennae 1-2 dr. (4-8 Gm.) 

B.P. 

Confectio Sennas 60-120 gr. (of cassia pulp, 120 gr. or more). 

Use. — A simple laxative in doses of 120 gr. upwards. Seldom 
given alone. 

Tamarindus, U.S.P. and B.P. Tamarind. — The preserved pulp 
of the fruit of Tamarindus indiea. West Indies. 

Characters. — A reddish-brown, sweetish, subacid pulp, preserved 
in sugar, containing strong fibres, and brown shining seeds, each inclosed 
in a membranous coat. 



768 VEGETABLE MATERIA MEDICA. 

Composition. — The pulp contains citric, tartaric, and acetic acids, 
chiefly in combination with potash. Grape sugar is also present. 

Impurity. — Traces of copper. 

Test. — A piece of bright iron left in contact with the pulp for an 
hour does not exhibit any deposit of copper. 

Peepaeations. 
u.s.p. DOSE. 

Confectio Sennae 1-2 drm. (4-8 Gm.) 

B.P. 

Confectio Sennse 60-120 gr. (of tamarind, I oz. upwards). 

Uses. — Tamarind, in doses of J oz. upwards, is both a laxative and 
refrigerant. The pulp is said to weaken the action of resinous cathartics 
in general, but it is frequently prescribed with them, and is used in the 
form of compressed tablets, called "Tamar Indien," as a vehicle for the 
administration of some purgative, probably jalap. A cooling and agree- 
able drink (tamarind whey) may be made by adding 4 parts of the pulp 
to 100 of boiling milk, straining and filtering. 

Copaiba, U.S.P. and B.P. Balsam of Copaiba, U.S. P.; Co- 
paiva, B.P. — The oleo-resin obtained from incisions made in the trunk 
of Copaifera Langsdorjii, U.S.P. {Copaifera multijuga, B.P.), and other 
species of Copaifera. Valley of the Amazon. 

Characters. — A more or less viscid liquid, about the consistence of 
olive oil, light yellow, transparent, with a peculiar odor and a persistently 
bitter and acrid taste. 

Composition. — Copaiva consists of a solution of several resins in a 
volatile oil. The resins consist chiefly of crystallizable copaivic acid. 

Impurities. — Wood oil, or gurjun balsam, and fixed oils, especially 
castor oil, fraudulently added. 

Tests. — Perfectly soluble in an equal volume of benzol. Does not 
become gelatinous after having been heated to 270°. Is not fluorescent 
(wood oil). After heating on paper it does not leave a greasy ring round 
the stain (fixed oil). 

The absence of turpentine is shown by the smell of it not being given 
off on heating, and, after distilling off the volatile oil, the residue, when 
cool, should be hard and friable (absence of fixed oils). The essential 
oil distilled off from the oleo-resin, when rectified, should not begin to 
boil below 200° C. (392° F.). On adding 1 drop of copaiba to 19 drops 
of disulphide of carbon, and shaking the mixture with 1 drop of a cold 
mixture of equal parts of sulphuric and nitric acids, it should not acquire 
a purplish-red or violet color (absence of gurjun balsam). 

Peepaeations. 
u.s.p. dose. b.p. dose. 

Massa Copaibae 10-30 gr. Oleum Copaiba) 5-20 min. 

U.S.P. Masna Copaibue. Mass of Copaib a.— Copaiba, 94; magnesia recently 
prepared, 6 ; mix and set aside till it concretes into a pilular mass. If it does not 
concrete in eight or ten hours, there is deficiency of water in the copaiba. This may 
be remedied in subsequent operations by shaking the copaiba with one-twentieth of 
its weight of water and decanting after the uncombined water has subsided. The 
mass is divided, while fresh, into pills weighing 5 gr. (033 Gm.) each. 



CALYCIFLOR^. 769 

Oleum Copaibae, U.S.P. and B.P. Oil of Copaiva. — A volatile 
oil distilled from copaiva. 

Characters. — Colorless or pale yellow, with the odor and taste of 
copaiva. 

Dose. — Of copaiva, 15 min. to 1 fl. drm. ; of oil of copaiba, 5 min. 
to 20 min. ; of the resin (as a diuretic), 15 to 20 gr. in almond emulsion. 

Copaiva may be taken mixed with yolk of egg, or floating upon water 
or some other liquid, or made into pills with burnt magnesia ; or, lastly, 
dissolved in water by the aid of liquor potassse, with which it forms a 
soap. Sometimes, to hide its disagreeable taste, it is put into mem- 
branous or gelatinous capsules. 

Action. — Copaiva has a stimulating action on mucous membranes, 
especially that of the lungs and genito-urinary tract. It is diuretic. 
Large doses have an irritant action, causing vomiting and purging. It 
is excreted by the kidneys and lungs, and may be recognized by its 
characteristic odor. It is very apt to produce an eruption of the skin, 
generally in the form of rose-colored spots resembling a syphilitic erup- 
tion, but distinguished from it by its affecting chiefly the backs of the 
arms and legs, by coming on suddenly, and by the intense itching with 
which it is accompanied. Sometimes it resembles urticaria more in its 
appearance, but rarely it is eczematous. Copaiba forms a conjugate 
glycuronic acid in the system, and is eliminated in the urine, which, with 
nitric acid, gives a precipitate of copaibic acid, easily mistaken for albu- 
men, but distinguished by disappearing on the application of heat. The 
conjugate acid renders the urine antiseptic, as it is secreted by the kid- 
neys, so that it does not readily decompose, and bacteria either do not 
appear in it at all or only in very small numbers, even after the surface 
has become covered with mould. It is probable that the utility of the 
drug in diseases of the bladder and urethra is due to the washing out of 
the urinary passages by the antiseptic urine (p. 385). 

Uses.— Copaiba is employed in diseases of the mucous membranes, 
and especially of the genito-urinary passages, the lungs, and, along with 
digitalis, in cardiac dropsy. It is also useful in chronic bronchitis and 
bronchorrhoea. Its great disadvantage is its nauseous smell and taste. 
It is chiefly used in gonorrhoea. It is inadvisable to use it when the 
inflammation is acute and severe, but it is exceedingly useful after the 
acuteness of the inflammation has subsided. It is not so useful in gleet. 
It appears to be of service in chronic cystitis. The resin is a good 
diuretic, especially in cases of dropsy depending on disease of the liver, 
where the kidneys are healthy. 

Piscidia Erythrina. Jamaica Dogwood. — The part used is the 
bark. Not officinal. 

Prepakation. 

dose. 
Extractum Piscidise Erythrinse Fluidum 20 min.-2 fl. dr. 

Action. — It has been employed for stupefying and catching fish. It 

is a narcotic not only to fish but to frogs, rabbits and man. It lessens 

reflex action at first, by stimulation of Setschenow's centres (p. 153), and 

after wards produces tetanus by stimulation of the spinal cord. It 

49 



770 VEGETABLE MATERIA MEDICA. 

stimulates the vaso-motor centre, raises blood-pressure, and slows the 
pulse. It dilates the pupil. It increases the secretion of the skiu and 
saliva. 

Use. — It is employed as a narcotic instead of opium. 

MIMOSILE. 

Acacia, U.S. P.; Acaciae Gunmii, B.P. Gum Arabic, U.S. P.; 
Gum Acacia, B.P. — A gummy exudation from Acacia Verek, and from 
other species of Acacia. 

Characters. — In roundish tears usually from half an inch to an inch 
in length, nearly colorless, brittle, and opaque from numerous minute 
cracks, or in angular fragments, with shining surfaces. Bland and 
mucilaginous in taste ; insoluble in alcohol, but soluble in water. The 
aqueous solution forms with subacetate of lead an opaque white jelly. 

Composition. — Arabin or arabic acid (gummic acid) combined with 
calcium, and, in smaller quantities, with potassium and magnesium. 

Impurity. — Starch fraudulently added. 

Test. — Should not give a blue color with iodine. 

Preparations containing Gu3i Acacia. 

U.S. P. DOSE. B.P. DOSE. 

Mucilago Acaciae ad lib. Mistura Creta 1-2 fl. oz. 

Syrupus Acaciae " " Guaiaci £-2 fl. oz. 

Mucilage- Acaciae ad lib. 

Purvis Amygdalae Compositus 60-120 gr. 

" Tragacanthae " 20-60 gr. 

Trochisci, in all. 

Uses. — Is a useful demulcent in coughs or sore throat, also in 
irritation of the stomach and intestines due to catarrhal inflammation. 
It is also serviceable in cases of irritant poisoning, and it has been 
employed as a masticatory. The mucilage is used to suspend pow- 
ders. 

U.S. P. Catechu. Catechu. — An extract prepared from the 
wood of Acacia Catechu. Pegu. 

Characters. — In dark brown, irregular masses, containing frag- 
ments of leaves, brittle, somewhat porous and glossy when freshly 
broken ; soluble in alcohol and partly soluble in water. It is nearly 
inodorous, and has a strongly astringent and sweetish taste. 

It was formerly officinal in the B.P. It is sometimes called black 
catechu, to distinguish it from the pale catechu got from Uncaria Gambler. 

COMPOSITION. — It contains a form of tannic acid called catechu- 
tannic acid. This differs from other forms of tannic acid in not being a 
glucoside. It gives a greenish-black with iron, and precipitates gela- 
tine, but not tartar emetic. 

Preparations. 

U.S. p. DOSE. 

Tinctnra Catechu Composita 15 min.-2 fl. drm. (2-8 c.c.) 

Trochisci Catechu (1 grain in each) ad lib. 

Tinctnra Catechu Composita. COMPOUND TINCTURE OF CATECHU. — Catechu, 
12; cinnamon, 8; diluted alcohol to 100. 



CALYCIFLORiE. 771 

Uses. — It is a powerful astringent. It may be employed as an 
injection in gonorrhoea and gleet. The lozenges are useful in sore throat, 
hoarseness, relaxed uvula, and the tickling cough consequent on it 
(p. 222). Internally it is useful in diarrhoea, and in internal haemor- 
rhages, especially from the uterus. 

Erythrophloeum. Casca Bark, Sassy Bark. Not officinal. — 
The bark of ErythropJiloeum Gru'inense, a large tree growing on the 
coast of Africa. 

Composition. — It contains an alkaloid, erythrophlceine. 

(Not officinal.) Peepaeation. 

dose. 
Tinctura Erythrophloei...(l in 10) 5-10 min. 

Action. — The powder when inhaled causes violent sneezing. Inter- 
nally the infusion or tincture causes vomiting and purging. Erythro- 
phleum has an action on the circulation (p. 239) and kidneys like that of 
digitalis (p. 372). The alkaloid appears to combine the actions 
of di gitalin and picrotoxin, producing convulsions like the latter 
(Harnack). 

Uses. — I have found it useful in dilated heart without valvular 
disease. It is also useful in mitral disease and dropsy. It has the 
disadvantage of disturbing the digestion still more readily than digitalis. 

Indigo, B.P. C 8 H 5 NO. — A blue pigment prepared from various 
species of Indigofera. 

Preparation. — Solution of sulphate of indigo. 

Use. — As a test for chlorine. 

ROSACEA. 

POMEJS. 

U.S.P. Cydonium. Cydonium. Quince Seed. — The seed of 
Cydonia vulgaris. 

Characters. — About a quarter of an inch (6 millimetres) long, 
oval or oblong, triangularly compressed, brown, covered with a whitish 
mucilaginous epithelium, causing the seeds of each cell to adhere. 
With water the seeds swell up, and form a mucilaginous mass. The 
unbroken seeds have an insipid taste. 

Composition. — It contains a large amount of mucilage. 

Peepaeation. 

dose. 
Mucilago Cydonii (cydonium, 2 ; water, 100 ; macerate for half an 

hour, and strain through muslin) ad lib. 

Use. — It is useful as a bland demulcent preparation to relieve 
irritation of mucous surfaces. 

DRYADE^!. 

U.S.P. Rubus. Rubus. Blackberry. — The bark of the root 
of Rubus villosus, Rubus canadensis, and Rubus trivialis. 



772 VEGETABLE MATERIA MEDICA. 

Characters. — In thin, tough, flexible bands, outer surface blackish 
or blackish-gray, inner surface pale brownish, sometimes with strips 
of whitish, tasteless wood adhering; inodorous; strongly astringent, 
somewhat bitter. 

Preparation, 
u.s.p. DOSE. 

Extractum Rubi Fluidum 30-60 gr. 

Uses. — It is a pleasant astringent, its efficacy being due to tannin. 
It is useful in the diarrhoea of children, and also in adults. 

U.S.P. Rubus Idseus. Raspberry. — The fruit of Rubus idceus. 
Characters. — Deprived of the conical receptacle and therefore 
hollow at the base ; hemispherical, red, finely hairy, composed of from 
twenty to thirty coalesced small drupes, each one crowned with the 
withered style ; juice red ; of an agreeable odor and pleasant acidulous 
taste. 

The closely allied, light red fruit of Rubus strigosus, and the 
purplish-black fruit of Rubus occidentalism may be employed in place of 
the above. 

Preparation. 

dose. 
Syrupus Rubi Idsei ad lib. 

Use. — To give mixtures an agreeable color and flavor. 

rose^:. 

Oleum Rosse, U.S.P. Oil of Rose. — A volatile oil distilled 
from the fresh flowers of Rosa damascena. 

Characters. — Pale yellowish, strong odor of rose, sweetish taste. 

Adulterations. — Sandal wood oil, geranium oil, and other volatile 
oils ; fixed oils ; spermaceti. 

Test. — When slowly cooled to near 10° C. (50° F.) the oil becomes 
a transparent solid, interspersed with numerous slender shining iridescent 
scale-like crystals. When rapidly cooled to 12°*5 C. (54°*5 F.) it con- 
geals to a solid mass of light feathery shining scales or plates. 

Rosa Centifolia, U.S.P. ; iRosse Centifoliae Petala, B.P. 
Pale Rose, U.S.P. ; Cabbage-Rose Petals, B.P. — The fresh petals, 
fully expanded, of Rosa centifolia. 

Characters. — Pink, fragrant roseate odor ; taste sweetish-bitter, 
and faintly astringent ; both readily imparted to water. 

Composition. — A minute quantity of volatile oil, a red coloring mat- 
ter, a little gallo-tannic acid, fat, sugar, acids, &c. 

Preparations, 
u.s.p. DOSE. 

Aqua Rosae ad lib. 

Syrupus Sarsaparillae Conipositus 1-4 fl. drm. (30-118*4 c.c.) 

B.P. 
Aqua Rosae ad lib. 

U.S.P. Unguentum Aqure Rosae. OINTMENT OF ROSE WATER (COLD CREAM.)— 
Expressed oil of almond, 50 ; spermaceti, 10 ; white wax, 10 ; rose water, 30. 

Uses. — Rose water is much used as a vehicle for gargles and lotions, 
and sometimes it is used for internal administration. 



CALYCIFLOK.E. 773 

Rosa Gallica, U.S.P. ; Rosae Gallicae Petala, B.P. Red Rose, 

U.S.P. ; Red Rose Petals, B.P. — The fresh and dried petals of Rosa 
gallica, collected before expanding. 

Characters. — Small cones consisting of numerous imbricated, deep, 
purple petals, roseate odor, bitterish, astringent taste. 

Composition. — Similar to cabbage rose petals. 

Preparations. 

U.S.P. DOSE. 

Pilulse Aloes et Mastiches 1 pill. 

Confectio Kosae ad lib. 

Extractum Kosae Fluidum ad lib. 

Mel Kosae ad lib. 

Syrupus Kosae ad lib. 

B.P. 

Confectio Kosae GaUicae 60 gr. Or more. 

Infusum Koste Aciduria 1-2 fl. OZ. 

Syrupus GaLlicse 1 fl. dr. or more. 

B.P. Infusum Kosae Acidum. Acid Infusion of Roses. — Dried red-rose petals, 
broken up, \ oz. ; diluted sulphuric acid, 1 fl. drm. ; boiling distilled water, 10 fl. oz. 

B.P. Rosae Caninae Fructus. Fruit op the Dog-Rose. Hips. 
— The ripe fruit of the dog-rose, Rosa eanina, and other indigenous 
allied species. 

Characters. — An inch or more in length, ovate, scarlet, smooth, 
shining ; taste sweet, subacid. 

Composition. — Crystallizable sugar, gum, citric and malic acids free 
and combined. 

Preparation. 

B.P. DOSE. 

Confectio Rosse Caninae 60 gr. or more 

Uses. — The preparations of roses are used chiefly as vehicles. The 
Confectio Rosae Grallicaa and Confectio Rosae Caninae are used as a basis 
for pills, and also for linctus. The acid infusion of roses is used as a gar- 
gle, and is slightly astringent. Aqua Rosae is used as a vehicle. 

Brayera, U.S.P.; Cusso, B.P. Kooso, U.S.P.; KOUSSO, B.P. 
— The female inflorescence of Brayera anthelmintica (Hagenia abys- 
sinicd). Abyssinia. 

Characters. — In bundles, rolls, or compressed clusters consisting of 
panicles about 10 inches (25 centimetres) long. Flowers small, reddish- 
brown, on hairy stalks. Odor slight, tea-like, taste bitter and nauseous. 

Composition. — Tannic acid ; a bitter, acrid resin and some volatile 
oil and kosin or koussem. Kosin is the active principle of the drug. It 
is a crystalline substance with an acid reaction. Koussem is a resinoid 
substance, and consists of impure kosin. 

Preparations, 
u.s.p. dose. 

Infusum Brayerae 8 fl. oz. (236 c.c.) 

Extractum Brayerse Fluidum %. 20-40 min. (1 '25-2*50 c.c.) 

B.P. 

Infusum Cusso 4-8 fl. oz. 



774 VEGETABLE MATERIA MEDICA. 

U.S.P. Infusum Brayerre. INFUSION OF BSAYEKA. — Bray era in No. 20 powder, 
6 ; boiling water, 100. Pour trie boiling water on the brayera and let it macerate 
in a covered vessel until cool. This infusion should be dispensed without straining. 

B.P. Infusum Cusso. Infusion OF Kousso. — Kousso in coarse powder, £ oz. ; 
boiling distilled water, 8 fl. oz. Infuse in a covered vessel for fifteen minutes with- 
out straining. 

Action and Use. — Cusso is used as an anthelmintic for tape- 
worm. Kosin or coussine, which is the active principle, administered in 
20 gr. doses, acts quite as well as the infusion, and has not the disadvan- 
tage of producing nausea and vomiting, which are sometimes caused by the 
infusion of the pharmacopoeias. 

U.S.P. Quillaia. Quillaia. Soap Bark. — The bark of Quil- 
laia saponaria. Chili. 

Characters. — Flat, large pieces, about one-fifth of an inch (5 milli- 
metres) thick ; outer surface brownish- white, often with small patches of 
brown cork attached, otherwise smooth ; inner surface whitish, smooth ; 
fracture splintery, checkered with pale brownish bast-fibres embedded with 
white tissue ; inodorous, very acrid and sternutatory. 

Composition. — It contains a glucoside, saponin. Saponin is also 
contained in senega and sarsaparilla. It appears to be identical with 
cyclamin from Cyclamen europceum and with primulin from Primula 
officinalis. Digitonin from digitalis appears to be a kind of saponin 
differing somewhat from the others. 

Action and Uses. — The bark has little or no application in medi- 
cine. The powder when snuffed provokes sneezing. Its infusion and 
extract are used for cleaning cloth and taking out stains. On account of 
the saponin it contains, the infusion froths easily and the froth remains 
long. A little of it is sometimes added to syrups, lemonade, or other 
drinks, to give them a head. It also retains fine powders in suspension 
and forms emulsions. It is used to form an emulsion with coal-tar. 

Saponin when applied locally acts as a powerful irritant, local anaes- 
thetic, and muscular poison. On account of its local irritant action, it 
produces most intense pain when injected subcutaneously ; sneezing 
when applied to the nose ; vomiting, diarrhoea, and gastro-enteritis when 
taken internally in large doses. Locally applied it paralyzes nerves both 
sensory and motor, and muscular fibre both voluntary and involuntary. 
It therefore produces local paralysis and local anaesthesia when 
injected under the skin in a frog's leg. The muscles and motor nerves 
being paralyzed, no irritation to either will cause contraction ; and the 
sensory nerves being also paralyzed, local irritation does not produce 
reflex action. In the voluntary muscles it produces a condition of rigor 
mortis, and the muscular substance becomes brittle and structureless as 
after myositis. 

When locally applied to the intestine, either by internal adminis- 
tration or injection into the peritoneal cavity, it paralyzes the involuntary 
muscular fibre of the intestinal wall. When applied to the heart it 
causes rapid stoppage in diastole. It counteracts the effect of digitalis 
on the heart, and vice versd, digitalis counteracts the effect of saponin on 
the heart, so that when the ventricle of the frog's heart has been brought 



CALYCIFLOR^E. 775 

to a standstill by one of these drugs, its pulsations may be restored by 
the other. 

When absorbed into the circulation, saponin paralyzes the nerve 
centres in addition to the nerves and muscular structures. The symp- 
toms it produces depend on the mode in which it is introduced into the 
body and the structures which it first reaches in consequence. If injected 
into the jugular vein so as to reach the heart first, it usually kills by 
producing cardiac paralysis, with slow pulse, and rapid fall of blood- 
pressure, and convulsions which are probably asphyxial and due to the 
failure of circulation (p. 213), respiratory movements still continuing. 
Saponin also paralyzes the respiratory and vaso-motor centres, so that 
the blood-pressure falls much and the respirations become feeble and slow. 
In large doses saponin may paralyze the respiratory centre before the 
heart, so that death ensues from failure of the respiration while the heart 
continues to beat. 

It is possible that quillaia might be used instead of sarsaparilla, and 
it might perhaps be useful in cases of aortic disease with hypertrophy 
(p. 300). 

AMYGDALE^C. 

Amygdala Dulcis, XJ.S.P. and B.P. Sweet Almond. — The 
seed of the sweet almond tree, Amygdalus communis, var. dulcis (Pru- 
nus amygdalus). Malaga. 

Characters. — Above an inch in length, lanceolate, acute, with a 
clear cinnamon-brown seed-coat, with a bland sweetish kernel. Does not 
evolve the odor of bitter almonds when bruised with water. 

Composition. — Contains upwards of 50 per cent, of a fixed oil which 
consists principally of oleic acid. It contains also an albuminous sub- 
stance — emulsin, which is supposed to be produced from a vegetable 
casein and asparagin. 

Prepakations. 

U.S. P. DOSE. 

Mistura Amygdalae 2 fl. dr.-l fl. oz. (4-16 c.c.) 

Syrupus Amygdalae 2 fl. dr.-l fl. oz. (4-16 c.c.) 

B.P. DOSE. 

Oleum Amygdalae 1 fl. dr. to ? fl. oz. 

Pulvis Amygdalae Compositus (almonds 8, sugar 4, gum acacia 1)..60 gr. to 120 gr. 
Mistura Amygdalae (2£ oz. of Pulv. Amygd. Co. to 1 pint) 1-2 fl. oz. 

Amygdala Amara, U.S.P. and B.P. Bitter Almond. — The 
seed of the bitter almond tree, Amygdalus communis (Prunus amygdalus), 
var. amara. Mogadore. 

Characters. — Resembles the sweet almond in appearance, but is 
rather broader and shorter ; has a bitter taste, and when rubbed with a 
little water, emits the odor of hydrocyanic acid. 

Composition. — Bitter almonds contain all the constituents of sweet 
almonds, the fixed oil, however, being in less proportion, and in addition 
a glucoside, amygdalin, upon which emulsin (either of sweet or bitter 
almonds) acts as a ferment, producing hydrocyanic acid and volatile oil 
of bitter almonds, thus : — 

Amygdalin. Bitter almond oil. Glucose. 

O.HsNOu + 2H 2 = HON + C 7 H 6 + C u H*O a 



776 VEGETABLE MATERIA MEDICA. 

Ammonia and formic acid are also produced in the decomposition. 
Amygdalin may be extracted by alcohol, and is not poisonous. Emulsin 
by boiling loses its property of decomposing amygdalin. 

Peepaeations. 
u.s. p. k DOSE. 

Syrupus Amygdalae 2 fl. drm.-2 fl. oz. (4-60 c.c.) 

B.P. DOSE. 

Oleum Amygdalae. 1 fl. drm.-£ fl. oz. 

Oleum Amygdalae Expressum, U.S.P. ; Oleum Amygdalae, 

B.P. Expressed Oil of Almond, U.S.P. ; Almond Oil, B.P. — A 
fixed oil expressed from bitter and sweet almonds. 

Characters. — Pale yellow, nearly inodorous or having a nutty odor, 
with a bland oleaginous taste. 

Peepaeations. 

U.S.P. B.P. 

Unguentum Aquae Rosse. Unguentum Cetacei. 

" Hydrargyri Oxidi Rubri. 

Plumbi Subacetatis Compositum. 
Simplex, and the preparations containing it. 

U.S.P. Oleum Amygdalae Amarse. Oil of Bitter Almond. 
— A volatile oil obtained from bitter almonds by maceration with water, 
and subsequent distillation. 

Characters. — A colorless or yellowish, thin liquid of a peculiar 
aromatic odor, a bitter and burning taste and a neutral reaction. 

Peepaeation. 

dose. 
Aqua Amygdalae Amarse (oil of bitter almond 1, water 999)... 2 fl. drm. (7*5 c.c.) 

Uses. — The fixed oil is demulcent. It is applied externally to 
chapped hands and slight excoriations, also to the ear in earache. Inter- 
nally, in doses of 1 drachm to 2 drachms, it is a mild laxative. The 
cake left after expression of the bland oil from sweet almonds contains no 
starch, and is therefore employed instead of bread in diabetes. The oil 
of bitter almonds is used as a flavoring agent. The crude oil of the 
U.S.P. contains hydrocyanic acid and may be used instead of it as 
a local application in pruritus, and also for external administration. It 
retains its strength better than pure hydrocyanic acid, but its disad- 
vantage is that the proportion of the acid is not constant. It may be 
given in doses of J to 1 minim cautiously increased. 

Prunum, U.S.P. and B.P. Prune. — The dried drupe of the 
plum, Prunus domestica. Southern Europe. 

Characters. — Oblong, shrivelled, blackish-blue. 

Composition. — Malic acid, with saccharine and albuminoid matter. 

Peepaeations. 
u.s.p. dose. b.p. dose. 

Confectio Senme 1-2 dr. Confectio Sennse 1-2 dr. 

(of prunes, 2 oz. or more.) 



CALYCIFLORiE. 777 

Use.— Stewed prunes form a useful and pleasant laxative for children 
or adults. If they do not move the bowels when simply stewed, they 
may be stewed along with senna, which does not impart to the 
prunes any unpleasant taste, and children will still take them readily. 

XJ.S.P. Primus Virginiana. Wild Cherry. — The bark of 
Prunus serotina (Cerasus serotina) collected in autumn. 

Characters. — In curved pieces or irregular fragments, one twelfth 
of an inch (2 millimetres) or more thick, outer surface greenish-brown, 
or yellowish-brown, smooth and somewhat glossy, marked with transverse 
scars ; if collected from old wood and deprived of corky layer, the outer 
surface is nut-brown and uneven ; inner surface somewhat striate or 
fissured. Upon maceration in water it develops a distinct bitter-almond 
odor ; its taste is astringent, aromatic, and bitter. 

The bark of the small branches is to be rejected. 

Preparations. 

dose. 

Extractum Pruni Virginianae Fluidum 30-60 min. (2-4 c.c.) 

Infusum " " " 2-3 fl. oz. (60-180 c.c.) 

Syrupus " " " 1-4 fl. drm. (4-16 c.c.) 

Uses. — A nervous sedative and tonic, used in atonic dyspepsia and 
general debility, associated with general or local irritation. In large 
doses it renders the action of the heart slow. It has been employed in 
hectic fever and consumption. 

B.P. L.aurocerasi Folia. Cherry-Laurel Leaves. — The fresh 
leaves of Prunus laurocerasus. The common or cherry laurel. 

Characters. — Ovate-lanceolate or elliptical, distantly toothed, fur- 
nished with glands at the base, smooth and shining, deep green, on strong 
short footstalks ; emitting a ratafia odor when bruised. 

Composition. — By distillation the leaves yield bitter almond oil and 
hydrocyanic acid. 

Preparation. 

dose. 
Aqua Laurocerasi 5-30 min. 

Action. — Similar to hydrocyanic acid, but less certain, owing to 
its variable strength. 

Use. — Cherry-laurel water is supposed to be an elegant mode of 
giving prussic acid. The advantage which it possesses, viz., a more 
agreeable taste, is more than counterbalanced by its uncertain strength. 

PAPAYACE^E (PASSIFLOR^). 

Not oflicinal. Papayotin. The dried juice of the papaw tree, 
Qarica papaya. Papain. A ferment obtained from the juice of Qarica 
papaya. The term papain is frequently applied to the dried juice. 

Preparation. — When scratches are made on the half ripe fruit of the 
Carica papaya a milky juice exudes in abundance. When dried it forms 
a powder somewhat like gum-arabic, and to this the name of papayotin is 
sometimes given. Papain is the pure ferment obtained by precipitation 
with alcohol and removal of albuminous matters by acetate of lead. 

Dose. — 5 to 10 grains. 



778 VEGETABLE MATERIA MEDICA. 

Action. — The fruit of the papaw tree has long been used in the 
West Indies to render beef tender. The unripe fruit is split open and 
rubbed over the surface of the meat previous to cooking. Its action 
probably depends upon the fact that papain has a dige stive action not 
only upon muscular fibre, but also upon connective tissue. It digests 
fibrine and albumen more readily than pepsin. It also rapidly dissolves 
the false membrane of croup. When injected into the circulation in 
large doses it paralyzes the heart. In smaller quantities it appears to 
favor the multiplication of micrococci in the blood (p. 92). 

Uses. — It has been recommended to dissolve the fibrinous membrane 
in croup and diphtheria, a solution being painted over the pharynx every 
five minutes. It has also been recommended to destroy epithelioma. 
Internally it appears to be useful in dyspepsia and catarrhal conditions 
of the stomach. 

MYRTACEJE. 

Caryophyllus, U.S.P. ; Caryophyllum, B.P. Cloves. — The 
dried, unexpanded flower-buds of Eugenia caryophyllata, U.S.P. 
{Caryophyllus aromaticus, B.P.). East Indies. 

Characters. — About \ an inch long, dark reddish-brown, plump 
and heavy, consisting of a nearly cylindrical body, surmounted by four 
teeth and a globular head, with a strong fragrant odor, and a bitter, 
spicy, pungent taste. It emits oil when indented with the nail. 

Composition. — Cloves contain a large quantity of volatile oil, resin, 
gum and tannin. 

Preparations, 
u.s.p. dose. 

Oleum CaryophyUl 

Tinctura Lavandulae Composita 2-2 fl. drm. (2-8 c.c.) 

" Rhei Aromatica 2-4 fl. drm. (8-15 c.c.) 

Syrupus " Aromaticus 1 fl. drm. (4 c.c.) 

Vinum Opii 6 min. (0*4 c.c.) 

B.P. DOSE. 

Infusum Aurantii Compositum 1-2 fl. oz. 

" CaryophyUl 1-2 fl. OZ. 

Mistura Ferri Aromatica 1-2 fl. oz. 

Oleum CaryophyUl 1-5 min. or more. 

Vinum Opii 10-40 min. 

Action and Use. — Stimulant carminative, used in flatulence, 
nausea, and atonic dyspepsia, chiefly given along with other medicines 
to afford an agreeable flavor and prevent griping. 

Oleum Caryopliylli, U.S.P. and B.P. Oil OF Cloves. — A 
volatile oil distilled from cloves. 

Characters. — Colorless when recent, but gradually becoming red- 
brown, having the odor of cloves and a pungent, spicy taste. 

Composition. — It consists chiefly of a phenol-like substance, euge- 
nol or eugenic acid, which forms permanent salts with alkalis. With its 
own bulk of strong solution of potash, the oil forms a semi-solid mass. 

Dose. — Of the oil, 2 to 6 drops. 



CALYCIFLOILE. 779 

Pkepaeations. 

B.P. DOSE. 

Confectio Scammonii , 10-30 gr. or more. 

Pilula Colocynthidis Composita 

" " et Hyoscyanii 5-10 gr. 

Action and Use. — Same as those of cloves. It has a local anal- 
gesic action, and is frequently used to relieve toothache by putting a 
drop on a piece of cotton-wool, and introducing it into the cavity of the 
tooth. 

Pimenta, TJ.S.P. and B.P. Pimenta, U.S. P.; Pimento, B.P. 
Allspice. — The nearly ripe fruit of the allspice tree, Eugenia Pimenta 
{Pimenta officinalis). West Indies. 



Fig. 153.— Pimenta. 

Characters. — Of the size of a small pea, brown, rough looking, 
somewhat like black pepper, but distinguished from it by being crowned 
with the teeth of the calyx. Odor and taste aromatic, hot and peculiar. 
Composition. — From 3 to 4 per cent, of a volatile oil having the 
same composition as oil of cloves ; also a considerable quantity of tannin 
and some starch. 

Pkepaeations. 
u.s. p. dose. b.p. dose. 

Oleum Pimentae A few drops. Aqua Pirnentse 1-2 fl. oz. 

Oleum " 1-5 niin. 

Syrupus Rhamni 1 fl. dr. 

Oleum Pimentae, TJ.S.P. and B.P. Oil of Pimenta, Oil of 
Allspice, U.S. P.; Oil of Pimento, B.P. — A volatile oil distilled 
from pimenta. 

Characters. — Colorless or slightly reddish when recent, but becom- 
ing brown by age, having the odor and taste of pimenta. 

Composition. — Nearly the same as oil of cloves. 

Use. — Same as cloves. The oil may be given in a dose of 2 or 3 
drops on a piece of sugar in flatulence. 

Peepaeations. 
u.s.p. B.P. 

Spiritus Myrciae. None. 

Clieken. — Not officinal. The leaves and shoots of Myrtus chehan 
{Eugenia cheJcan). Chili. 

Appearance. — They resemble some buchu leaves {Barosma 
betnlina), but have the margin entire and a different smell. 

Composition. — They contain a volatile oil resembling that of euca- 
lyptus, a volatile alkaloid, chekanine, and tannin. 

Action and Uses. — It is antiseptic, tonic, expectorant, and 
diuretic. The expressed juice diluted with water has been used as a 
lotion in inflammation of the eye, and a decoction of the bark as an 
astringent in dysentery. It is chiefly used in catarrh of the mucous 



780 VEGETABLE MATERIA MEDICA. 

membranes, especially those of the bronchi and bladder. It appears to 
be very useful in cases of bronchitis with thick purulent expectoration, 
also in cases of phthisis. The oil of myrtle appears to have a similar 
action. 

Preparations, not Officinal. 

dose. 

Infusum Cheken (1 part leaves to 10 of boiling water) 

Extractum Cheken Fluidum (prepared like Ext. Cinchonse Fluid., U.S.P.)....l-3 fl. dr. 
Syrupus Cheken (1 part leaves to 2 of syrup) 

Oleum Myrti. Oil OF Myrtle. — Not officinal. A volatile oil 
obtained from the leaves of Myrtus communis. 

Dose. — 0-15 Gm., in capsules. 

Action and Uses. — It has an antiseptic action, and may be used 
in cases of foul ulcers and foetid discharges from mucous passages, as in 
otorrhcea. It is not a sufficiently powerful irritant to affect the unbroken 
skin, but does so when the epidermis is removed. It has been used 
externally as a rubefacient in rheumatism. It causes warmth and 
increased flow of saliva in the mouth ; and in small doses (0-6-0*9 Gm.) 
appears to aid digestion. In larger doses it acts as an irritant, causing 
nausea, flatulent distention, headache, and languor. It is excreted in 
the urine, to which it gives a smell like violets, and like copaiba gives a 
precipitate when nitric acid is added to the urine. Like copaiba it may 
be used as an expectorant in chronic bronchitis with profuse expectora- 
tion, in phthisis, and in chronic inflammation of the bladder or urethra 
(cf. p. 385). 

Oleum Cajuputi, U.S.P. and B.P. Oil of Cajuput. — A volatile 
oil distilled from the leaves of Melaleuca cajuputi, U.S.P. ; M. minor, 
B.P. (M. Leucodendron). East Indies. 

Characters. — Pale bluish-green, transparent. Odor strong and 
agreeable; taste, warm and aromatic, leaving a sensation of coldness in 
the mouth. 

Impurity. — Copper, added to preserve the fine green color which 
the oil possesses when newly distilled or accidentally present. 

Test. — See Copper. 

Dose. — 1 to 5 min. or more. 

Preparations. 

B.P. DOSE. 

No Prep, in u.s.P. Linimentum Crotonis i fl. dr. 

Spiritus Cajuputi 1 fl. dr. 

Uses. — It is a powerful stimulant and antispasmodic. Locally 
it acts as a stimulant and rubefacient. It is used externally in skin dis- 
eases — pityriasis, psoriasis, and acne rosacea. In this last disease it is 
said to be particularly useful, and also in eczema. 1 It has also been used 
externally, alone, or with olive oil, in cases of muscular and articular 
rheumatism, and gout. Applied to a carious tooth it relieves pain in the 
same way as oil of cloves. Internally it is used to relieve flatulence. A 



1 Claiborne, GaillariVs Med. Journ., Virginia, U.S.A. 



CALYCIFLOR.E. 781 

few drops on a piece of sugar are useful in neuralgia and hysteria, and 
its internal use is said to be also useful in chronic rheumatism. 

U.S.P. Eucalyptus. Eucalyptus. — The leaves of Eucalyptus 
globulus, collected from rather old trees. 

Characters. — Petiolate, lanceolately scythe-shaped, from six to 
twelve inches (fifteen to thirty centimetres) long, rounded below, tapering 
above, entire, leathery, gray-green, glandular, feather-veined between the 
midrib and marginal veins ; odor strongly camphoraceous, taste pungently 
aromatic, somewhat bitter and astringent. 

Composition. — Eucalyptol, resin, tannin, &c. 

Prepaeations. 

DOSE. 

Extractum Eucalypti Fluidum 5-15 min. 

Oleum Eucalypti 2-5 drops. 

U.S.P. Oleum Eucalypti. Oil of Eucalyptus. — A volatile oil 
distilled from the fresh leaves of Eucalyptus globulus, or Eucalyptus 
amygdalina, and some other species of Eucalyptus. 

Characters. — A colorless or very pale yellowish liquid, having a 
characteristic aromatic odor, a pungent, spicy, and cooling taste, and a 
neutral reaction. It is soluble in an equal weight of alcohol. 

Action. — Eucalyptus oil, or eucalyptol, as it is often termed, is a 
powerful antiseptic, even more powerful than quinine (p. 100). The 
antiseptic action of the oil is greater when it is old and charged with 
oxygen than when it is freshly distilled. Like quinine (p. 72) it arrests 
the movements of white "blood-corpuscles, and its vapor prevents 
inflammation in the exposed mesentery of the frog. The red corpuscles 
of frog's blood have their nucleus rendered more distinct, and their surface 
wrinkled by it. Like quinine it causes contraction of the spleen. It is 
a local irritant. When applied to the skin and its evaporation pre- 
vented, it acts as a rubefacient, vesicant, or pustulant. When applied to 
a mucous membrane or injected hypodermically it causes pain. When 
swallowed it causes burning in the throat, stomach, and intestine. It 
may produce nausea, loss of appetite, and slight looseness of the bowels, 
but is not an active emetic, nor purgative. After absorption in large 
doses it appears to act chiefly on the nerve-centres, producing paralysis 
and death. In invertebrata killed by exposure to its vapor the paralysis 
is preceded by excitement, but in vertebrate animals the paralysis is not 
preceded by excitement. Its depressing action on the spinal cord is 
so great as to abolish reflex action even when it has been previously 
increased by brucine ; and from depression of the brain, medulla, and 
heart, there is drowsiness, feeble respiration, lowered blood-pressure, 
and fall of temperature. Death occurs from paralysis of the respira- 
tion. It is excreted by the lungs and kidneys. Like turpentine, it 
imparts a smell of violets to the urine of persons taking it. 

Uses. — It has been employed as an antiseptic in surgical dressing in 
the form of eucalyptus gauze, but is apt to cause local irritation. It has 
proved useful as a lotion to wash out suppurating cavities. As an inhala- 
tion it has been employed to check secretion, and remove foetor in ozgena, 



782 VEGETABLE MATERIA MEDICA. 

in bronchitis with profuse or foetid expectoration, in phthisis, and in 
diphtheria. It has been used in the form of injections or pessaries in 
uterine catarrh, and after parturition. It has been recommended as a 
hypodermic injection in pygemia. 

In three cases of septicaemia I treated by it recovery occurred during 
its use, and in one of these quinine had proved useless. It has been used 
as an antiperiodic in ague and an antipyretic in fever, but it has not 
proved so useful as one would have expected from the resemblance 
between its action and that of quinine. 

Eucalyptus trees, when freely planted in malarious districts, appear 
to render them more healthy. 

Granatuin, U.S. P.; Granati Radicis Cortex, B.P. Pome- 
granate, U.S. P.; Pomegranate Root Bark, B.P. — The dried bark 
of the root of Punica G-ranatum. South of Europe. 




Fig. 154.— Pomegranate. 

Characters. — In quills or fragments of a grayish-yellow color 
externally, yellow internally, having a short fracture, little odor, and an 
astringent, slightly bitter taste. 

Composition. — The most important constituents on which its anthel- 
mintic action depends are two liquid alkaloids, pelletierine and isopelle- 
tierine. It contains two other alkaloids which are inactive, tannin, 
mannite, &c. 

Pkepakation. 

r.s.p. B.P. DOSE. 

None. Decoctum Granati Radicis 2 ounces to 1 pint 1-3 fl. oz. 

Uses. — Pomegranate is chiefly used as an anthelmintic for tape- 
worm. As it is not purgative, but rather astringent, its use must be 
followed by that of a cathartic. Often, several doses are required. The 
dose of the tannate of pelletierine is J-f gr. (0-03-0-05 gr.), taken 
fasting, and followed in fifteen minutes by a brisk purgative. 

CUCURBITACEiE. 

U.S. P. Coloeynthis. Colocynth. — The fruit of the Citrullus 
Coloeynthis, deprived of its rind. 

Characters. — Globular, from two to four inches (five to ten centi- 
metres) in diameter, white, or yellowish-white ; light, spongy, readily 
breaking into three wedge-shaped pieces, each containing near the 
rounded surface many flat, ovate, brown seeds, inodorous, taste intensely 
bitter. 

Colocynthidis Pulpa, B.P. Colocynth Pulp. — The dried 
decorticated fruit, freed from seeds, of Citrullus Coloeynthis. Imported 
chiefly from Smyrna, Trieste, France, and Spain. 



CALYCIFLOE.E. 783 

Characters. — Light, spongy, white or yellowish-white in color, 
intensely bitter in taste. 




Fig. 155.— Colocynth (peeled). 



Composition. — The active principle is a glucoside, colocynthin, which 
is soluble in water and alcohol, not in ether. The remaining part of the 
pulp consists principally of resinous matter. 

Peepaeations. 

U.S.P. DOSE. 

Extractum Colocynthidis Seldom used alone. 

" Compositum 5-20 gr. 

Pilulae Catharticae Composite 1-3 pills. 

B.P. DOSE. 

Extractum Colocynthidis Compositum 3-10 gr. 

Pilula Colocynthidis Composita 5-10 gr. 

Pilula Colocynthidis et Hyoscyami 5-10 gr. 

(of the powdered pulp, 2-8 gr.) 

Extractum ColocyntMdis Compositum. COMPOUND EXTEACT OF COLOCYNTH, 
B.P. — Colocynth pulp, 6 oz. ; extract of Socotrine aloes, 12 oz. ; resin of scammony, 
4 oz. ; hard soap, in powder, 3 oz. ; cardamom seeds, in fine powder, 1 oz. ; proof spirit, 
1 gallon. An extract of the colocynth is first made, and then mixed with the other 
ingredients. 

In the U.S.P. a simple extract is already officinal, and the proportions are — 
extract of colocynth, 16 parts ; aloes, 50 ; cardamom, 6 ; resin of scammony, 14 ; soap, 
14 ; alcohol, 10. 

B.P. Pilula ColocyntMdis Composita. COMPOUND PlLL OF COLOCYNTH. — Colo- 
cynth pulp, 1 ; Barbadoes aloes, 2 ; scammony, 2 ; sulphate of potash, J ; oil of cloves, 
£ ; distilled water, q.s. 

B.P. Pilula Colocynthidis et Hyoscyami. PlLL OF COLOCYNTH AND HYOS- 
cyamus. — Compound pill of colocynth, 2 ; extract of hyoscyamus, 1. 

U.S.P. Pilulse Catkarticee Composita?. COMPOUND CATHAETIC PlLL. — Compound 
extract of colocynth, 130; abstract of jalap, 100; mild chloride of mercury, 100; 
gamboge, 25 ; = 355 grains ; water, q.s. To make 100 pills. 

Physiological Action. — The active principle, colocynthin, acts as 
a powerful cathartic on the intestines, whether swallowed, administered 
hypodermically, or injected into the circulation. In small doses it 
increases peristalsis, and the secretion from the intestines and liver. It 
thus produces watery and mucous motions, frequently accompanied by 
griping. In large doses it causes gastro- enteritis with mucous and 
bloody stools. It appears to act also on the urinary system, as Tidy 
found inflammation of the kidneys and bladder, as well as of the rectum 
in dogs, poisoned by it, and it is said to act as a diuretic. 

Therapeutics. — It is used in obstinate chronic constipation, 
especially if there is a tendency to congestion of the brain, as in plethoric 



784 VEGETABLE MATERIA MEDICA. 

people. It is also used in amenorrhoea. It is apt to gripe if given 
alone : hence it is well to combine it with other purgatives and with 
sedatives such as hyoscyamus. It may sometimes be advantageously 
combined with mercurial pill. 

B.P. Ecbalii Fructus. Squirting Cucumber Fruit. — The 
fruit, very nearly ripe, of the squirting cucumber, Ecbalium officinarum. 

Preparation. 

B.P. DOSE. 

Elaterium ^-J gr. 

Characters. — Oval, about . 1J in. long, covered with soft prickles 
terminating in white points. When ripe the fruits are suddenly detached 
from the stalk and the juice and seeds expelled. 

Composition. — The juice deposits elaterium. 

B.P. Elaterium. Elaterium. — A sediment from the juice of 
the squirting cucumber fruit. 

Preparation. — Expressing the juice, separating the deposit by 
straining, and drying by a gentle heat. 




Fig. 156.— Elaterium. 

Characters. — In cakes, about one line thick, light, friable, slightly 
incurved, greenish-gray, acrid and bitter. 

Composition. — Elaterium is composed of Elaterin, with starch and 
fibrous and coloring matters. 

Impurities. — Chalk and earthy matter fraudulently added. 

Tests. — Does not effervesce with acids (absence of chalk), yields 
half its weight to boiling rectified spirit. This solution concentrated 
and added to warm solution of potash yields on cooling not less than 
twenty per cent, of elaterin in colorless crystals. 

Dose. — jig-th to J gr. 

Preparations. 

B.P. DOSE. 

Pulvis Elaterii Compositus £-5 gr. 

(1 gr. elaterium mixed with 9 of sugar of milk.) 

U.S. P. Elaterinum. Elaterin. — A neutral principle extracted 
from elaterium, a substance deposited by the juice of the fruit of Ecba- 
lium elaterium. 

Characters. — Small, colorless, shining, hexagonal scales or prisms, 
permanent in the air, odorless, having a bitter, somewhat acrid taste, and 
a neutral reaction. A solution of elaterin in cold concentrated sulphuric 
acid assumes a yellow color, gradually changing to red. 

The alcoholic solution should not be precipitated by tannic acid, nor 
by salts of mercury or of platinum (absence of, and difference from, 
alkaloids). 

Dose.— ^ gr . 






CALYCIFLOR.E. 785 

Preparation. 

DOSE. 

Trituratio Elaterini (1 gr. elaterin, 9*grs. sugar of milk.) |-| gr. 

Action and Uses. — Elaterin is the most powerful hydragogue 
cathartic we possess, increasing the peristaltic action and flow of fluid 
from the intestines. It only acts as a purgative when taken internally, 
and appears to require bile in order to act. When injected subcutane- 
ously it acts on the nervous system, causing salivation, insensibility, 
tetanus, and dyspnoea. It is used in dropsies, especially those affecting 
the abdominal cavity and due to cirrhosis of the liver. It is also used as 
a depletory in cerebral affections. It is usually combined with henbane 
and volatile oils, as it is apt to gripe. In large doses it may cause 
gastro-enteritis and fatal collapse, and should be given with care to old 
or feeble persons. 

U.S. P. Pepo. Pumpkin Seed. — The seed of Qucurbita Pepo. 

Characters. — About three-quarters of an inch (2 centimetres) long, 
broadly ovate, flat, white or whitish, nearly smooth, with a shallow 
groove parallel to the edge ; containing a short, conical radicle, and two 
flat cotyledons ; inodorous, bland, and oily. 

Composition. — It is probable that the active principle is a resin 
contained in the endopleuron or greenish envelope immediately surround- 
ing the embryo. This resin is dissolved and rendered more active by 
castor oil, which should be given before and after the anthelmintic. The 
decorticated seeds, as well as the oil derived from them, are bland and 
unirritating. 

Dose. — An ounce or an ounce and a half. The seeds may be 
crushed, and flavored with some aromatic oil. 

Uses. — It is an excellent anthelmintic for the removal of tape- 
worm. It should be given the first thing in the morning after a very 
light supper, and should be followed in two or three hours by an active 
purgative. No solid food should be taken until two hours after the pur- 
gative. 

U.S. P. Bryonia. Bryonia. Bryony. — The root of Bryonia 
alba, and of Bryonia dioica. 

Characters. — In transverse sections about two inches (5 centimetres) 
in diameter, the bark gray-brown, rough, thin, the central portion whitish 
or grayish, with numerous small wood-bundles arranged in circles and pro- 
jecting, radiating lines; inodorous, taste disagreeably bitter. 

Preparation. 

dose. 
Tinctura Bryonise 2-10 fl. dr. 

Composition — It contains a bitter principle, bryonin. 
Use. — Its chief use was that of a hydragogue cathartic, but it is 
now superseded by jalap. 

UMBELLIFERiE. 

CAMPTLOSPEKM^!. 

B.P. Conii Folia. Hemlock Leaves. — The fresh leaves and 
young branches of spotted hemlock, Conium maculatum ; also the leaves 
50 



786 VEGETABLE MATERIA MEDICA. 

separated from the branches and carefully dried; gathered from wild 
British plants when the fruit begins to form. 

Characters. — Fresh leaves, smooth, arising from a smooth stem with 
dark purple spots ; dried leaves of a full green color and characteristic 
mousey odor. The leaf rubbed with solution of potash gives out strongly 
the odor of coniine. 

Composition. — The fresh leaves and branches contain the same alka- 
loids as the fruits (which see) although in smaller proportion, while the 
coniine is sometimes accompanied by a third alkaloid, conhydrine. These 
principles are lost when the leaves are dried or heated, both being highly 
volatile. 

Peepaeations. 
u.s.p. b.p. dose. 

None. Cataplasma Conii For external use. 

Extractum Conii (green extract) 2-6 gr or more. 

Succus Conii 30 min. to 2 fl. dr. or more. 

Vapor Conise Vide infra. 

Pilula Conii Composita 5-10 gr. 

(Of the powdered leaf, 2-8 gr.) 

B.P. Cataplasma Conii. Hemlock Poultice. — Hemlock leaf, in powder, 1 oz.; 
linseed meal, 3 oz.; boiling water, J pint. 

B.P. Pilula Conii Composita. COMPOUND PlLL OF HEMLOCK. — Extract of hem- 
lock, 2 J ; ipecacuanha, in powder, £ ; treacle, q.s. 

B.P. Vapor Conife. Inhalation of Conia. — Extract of hemlock, 60 gr. ; 
solution of potash, 60 min.; distilled water, 10 n. drm. Put 20 min. of the mixture 
on a sponge in an inhaler containing hot water. 

Conii Fructus, B.P. Hemlock Fruit. — The dried ripe fruit of 
Conium maculatum (spotted hemlock). 

% 

A 

Fig. 157.— Conium. 

Characters. — About one-eighth of an inch long, broadly ovate, com- 
pressed laterally ; half-fruit with five waved or crenated ridges. Reduced 
to powder and rubbed with solution of potash they give out strongly the 
odor of con'ine. 

Conium, U.S.P, Hemlock. — The full grown fruit of Conium 
maculatum, gathered while yet green. 

Characters. — Similar to those of hemlock fruit, B.P. 

Composition. — Conine, a poisonous alkaloid, occurs in hemlock as a 
yellow, oily liquid, and is separated by distilling the fruits with slightly 
alkaline water. The fruit contains methyl-conine in varying proportion, 
and a small quantity of volatile oil which does not appear to be poisonous. 

Peepaeations. 

U.S.P. DOSE. 

Abstractum Conii 7-8 gr. 

Extractum Conii Alcoholicum 2 gr. 

Extractum Conii Fluidum 15 min. 

Tinctura Conii..' 60 min. 

B.P. DOSE. 

Tinctura Conii 20-60 min. 



CALYCIFLOK.E. 787 

Physiological Action. — The action of conium depends on the alka- 
loids, conine and methyl-conine, which it contains, and as their action 
differs considerably and the relative quantity of each varies, contradictory 
results have been obtained by different observers. The symptoms of conium 
poisoning are weakness of the legs and staggering gait, passing on to 
paralysis, which gradually progresses upwards and finally causes death by 
failure of respiration. The mind remains clear to the last. Conine 
paralyzes the ends of the motor nerves and of the vagus like curare, and 
afterwards paralyzes the motor centres in the brain and spinal cord. It 
causes death by paralyzing the respiratory muscles. Death is usually 
accompanied by convulsions in warm, but not in cold-blooded animals. 
There is dilatation of the pupil, and ptosis from paralysis of the endings of 
the third nerve. Locally applied, it appears to paralyze the ends of sen- 
sory nerves. 

Methyl-conine acts on the spinal cord,causing paralysis of reflex 
action. 

Dimethyl-conine and conhydrine have an action similar to that of 
conine, but less active. 

Therapeutics. — It is used locally as a poultice to soothe pain in can- 
cer and ulcers, and as a vapor to relieve cough in bronchitis and pertussis. 
It is used to allay muscular spasm in chorea, mercurial tremor, and paraly- 
sis agitans, but is useless in tetanus and strychnia poisoning. The best 
preparation to use is the succus in doses of 5i, gradually increased as the 
patient becomes tolerant of the drug. 

ORTHOSPERMJE. 

Assafoetida, U.S.P. and B.P. Asafetida, U.S. P.; Assafcet- 
ida, B.P. A gum-resin obtained from the root of Ferula Narthex and 
F. tScorodosma, U.S.P. {Narthex Assafoetida, B.P.). In Afghanistan 
and the Punjaub. 

Characters. — In irregular masses, composed of whitish tears, which 
are embedded in a yellowish-gray or brownish-gray sticky mass. The 
tears, when hard, break with a conchoidal fracture, showing a milky 
white color, which changes gradually on exposure to pink, and finally 
to brown. Taste bitter, acrid ; odor foetid, alliaceous. 

Composition. — Volatile oil, resin and gum. The oil contains a very 
large proportion of sulphur. 

Test. — It dissolves almost entirely in rectified spirit, B.P. ; 60 per 
cent, soluble in alcohol, U.S.P. 

u.s.p. Preparations. dose. 

Emplastrum Asafoetidse for external use. 

Mistura Asafcetidae 4-8 fl. dr. 

Magnesiae et Asafoetidse 4 fl. dr. 

Pilulae Asafcetidae (3, soap 1) 1-3 pills. 

" Aloes et Asafoetidae 2-5 pills. 

" Galbani Composites 2-4 pills. 

Tinctura Asafoetidse 30 min.to 1 fl. dr. 

B.P. DOSE. 

Enema Assafoetidae vide infra. 

Pilula Aloes et Assafoetidae 4-10 gr. 

Pihila Assafoetidae Composita 5-15 gr. 

Spiritus Ammoniae Foetidus ^-1 fl. dr. 

Tinctura Assafoetidae ^-1 fl. dr. or more. 

(of the gum resin, 5-30 gr. or more.) 



7 00 VEGETABLE MATERIA MEDICA. 

B.P. Enema Assafoetida?. EXEMA OF ASSAFGETIDA (EXEMA FCETIDUM).— 
Assafcetida, 30 gr. ; distilled water, 4 fl. oz. Rub the assafoetida in a mortar with 
the water added gradually, so as to form an emulsion. 

U.S. P. Mistura Asafoetidae. ASAFETIDA MlXTTJEE. — Rub asafetida, 4, with 
water, 100. 

U.S.P. Mistura Magnesiae et Asafoetida?. MIXTURE OF MAGNESIA AXD ASA- 
fetida (Dewees' Carminative). — Carbonate of magnesium, 5: tincture of asafetida, 
7 



tincture of opium, 1 ; sugar, 10 ; distilled water up to 100. 



B.P. Spiritus Ammonia Foetidus. FETID SPIEIT OF AMMONIA. — Assafoetida, 1? 
oz. ; strong solution of ammonia, 2 fl. oz. ; rectified spirit up to 1 pint. 

B.P. Pilula Assafoetidae Composita. C03IPOT7XD PlLL OF ASSAFOETIDA (PlLULA 

Galbaxi Composita). — Assafoetida, 2 ; galbauum, 2 ; myrrh, 2 ; treacle, by weight, 1. 

Uses. — It is used as a stimulant, antispasmodic, and carmina- 
tive. It is useful in hysteria, especially that occurring about the 
menopause. 

It is an exceedingly useful remedy in the form of enema for tympa- 
nites, but on account of its disagreeable odor is not much used for 
flatulent distention of the stomach. It is given as a stimulating 
expectorant in cases of chronic bronchitis and pertussis. 

Galbanum, XJ.S.P. and B.P. Galbanum. — A gum-resin, derived 
from Ferula galbaniflua, and probably from other allied plants. 

Characters. — In tears about the size of a pea, or more commonly 
in masses formed by their agglutination ; greenish-yellow or pale brown 
externally, milky white internally, translucent, having a strong dis- 
agreeable odor, and an acrid, bitter taste. 

Composition. — Gum-resin and volatile oil. 

Peepaeatioxs. 
u.s.p. DOSE. 

Emplastrnm ^a^id*........ = esternal uge 

Pilulse Galbani Compositse 2-4 pills. 

B.P. DOSE. 

Emplastrum Galbani for external use. 

Pilula Assafcetidse Composita 5-15 gr. 

(of the gum-resin, 10-30 grs. or more.) 

U.S.P. Pilula? Galbani Composite. COMPOUND PlLLS OF GALBANUM.— Gal- 
banum, 150 ; myrrh, 150 ; asafetida, 50 ; syrup, q.s. up to 350 grains. To make 100 
pills. This pill is much like the compound assafoetida pill, B.P., but contains less 
assafoetida, and is made up with syrup instead of treacle. 

Uses. — It has little antispasmodic power, but is a stimulant expec- 
torant, used in chronic bronchitis with much wheezing and abundant 
discharge, as it lessens secretion. It is also used locally as a stimulant 
to inflamed joints. 

Ammoniacum, U.S.P. and B.P. AMMONIAC, U.S.P. ; Ammo- 
niacum. B.P. — A gum-resin from Dorema Ammoniacum. Persia and 
the Punjaub. 

Characters. — In roundish tears or irregular masses formed by 
their agglomeration without any intervening dark-colored substance. 
The tears are roundish, pale yellowish-brown externally, milky white 
internally, brittle. Peculiar odor, bitter, acrid, nauseous taste. 

COMPOSITION. — Gum-resin and volatile oil. 

Dose.— 10 to 30 grains. 



CALYCIFLOILE. 789 

Peepabatioxs. 

U.S.P. DOSE. 

Emplastrum Ammoniaci \ f px+prrml nRe 

Ammoniaci cum Hydrargyro / t0r extemai llse ' 

Mistura Ammoniaci (4, water 100) 2 fl. dr. or more. 

B.P. DOSE. 

Emplastrum Ammoniaci cum Hydrargyro for external use. 

Mistura Ammoniaci (J oz., water 8 fl. oz.) J-l fl. oz. 

Use. — It is used for the same purposes as galbanum, chiefly as a 
stimulant to the mucous membrane in bronchorrhcea. 

Foeniculum, U.S.P. ; Foeniculi Fructus, B.P. Fennel, 

U.S.P. ; Fennel Fruit, B.P. — The fruit of Foeniculum vulgare, U.S.P. 
(F. dulce, B.P.). Malta. 






Fig. 158.— Fennel. 

Characters. — Longer than common fruit, being about one-quarter 
of an inch long. Slightly curved, elliptical, longitudinal ribs, the two 
lateral being double; taste and odor aromatic. The footstalk is often 
attached. 

Composition. — A volatile oil, having the same composition as oil of 
anise. 

Pbepaeation. 
u.s.p. b.p. dose. 

None. Aqua Foeniculi (1 lb. to 1 gallon).. 1-2 fl. oz. 

Use. — It is stimulant and carminative, used to relieve flatulence, 
and lessen griping of purgatives. 1 

U.S.P. Anisum. Anise. — The fruit of Pimpinella anisum. 

Characters. — About -J of an inch (4 millimetres) long, ovate. It 
has an agreeable aromatic odor and a sweet, spicy taste. It may be dis- 
tinguished irom conium fruit, which it somewhat resembles, and which 
has been mistaken for it, by the conium fruit consisting usually of single 
mericarps, which are smooth grooved upon the face and have crenate 
ridges and no oil-tubes. 

Oleum Anisi, U.S.P. and B.P. Oil of Anise. — A volatile oil 
distilled in Europe from the fruit of Pimpinella anisum, or from Illicium 
(U.S.P.), and the oil distilled in China from the fruit of Illicium anisatum 
(p. 705). 

Characters oe Oil of Anise. — Colorless or pale yellow ; with the 
odor of anise, and a warm, sweetish taste. Concretes at 10° to 15° C. 



1 I am informed that the wild fennel growing in South Africa will completely 
drive away fleas from kennels and stables. 



790 VEGETABLE MATERIA MEDICA. 

(50°-59° F.). Oil of illicium has nearly the same properties, except 
that it congeals at 2° C. (35-6° F.). 

Composition. — The same as that of oil of fennel. 

Peepaeations. 

U.S.P. DOSE. 

Aqua Anisi Indefinite. 

Spiritus Anisi 1-2 fl. dr. 

Tinctura Opii Camphorata 1-2 fl. dr. 

Trochisci G-lycyrrhizae et Opii 1-3 troches. 

B.P. DOSE. 

Essentia Anisi 10-20 min. 

Tinctura Camphorae Composita 15 min. to 1 fl. dr. 

Tinctura Opii Ammoniata £-1 fl. dr. 

(of the oil, 2-5 min.) 

Use. — It is an aromatic stimulant carminative, and is used as an 
adjunct to purgatives, to lessen griping. 

B.P. Anethi Fructus. Dill Fruit. The fruit of Anethum 
graveolens. England, or middle and southern Europe. 




Fig. 159.— Dill. 

Characters. — Oval, flat, about a line and a half in length, and 
easily distinguished by its membranous wings. Aromatic taste and odor. 
Composition. — Contains a volatile oil. 

Peepabations. 
u.s.p. b.p. dose. 

None. Aqua Anethi 1-2 fl. oz. 

(for infants, 1-2 fl. dr.) 
Oleum Anethi 2-5 min. 

B.P. Oleum Anethi. Oil of Dill. — A volatile oil distilled from 
the fruit. 

Characters. — Pale yellow color, aromatic odor, sweetish taste. 

Use. — The chief use of dill water is in the flatulence of children, in 
5i doses. It is stimulant and carminative. 

Carum, U.S.P.; Carui Fructus, B.P. Caraway, U.S.P.; 
Caraway Fruit, B.P. — The dried fruit of Carum Carvi, U.S.P. (Carum 
Carui, B.P.). 




FlG. 160.— Caraway. 



CALYCIFLOKiE. 791 

Characters. — Fruit usually separating into two mericarps about 
one-sixth inch long, curved, tapering at each end, brown, with five paler 
longitudinal ridges ; having an agreeable aromatic odor and spicy taste. 

Composition. — A volatile oil, which consists of a hydrocarbon, 
carvene, and an oxygenated oil identical with that obtained from oil of 

dill. 

Peepaeations. 

U.S. P. DOSE. 

Oleum Cari 2-5 min. 

Spiritus Juniperi Compositus 2-4 fl. dr. 

B.P. DOSE. 

Aqua Carui 1-2 fl. OZ. 

Oleum Carui 2-5 min. 

Confectio Opii 5-20 grs. 

Confectio Piperis 60-120 grs.' 

Pulvis Opii Compositus 2-5 grs. 

Tinctura Cardamomi Composita £-2 fl. dr. 

Tinctura Sennse 1-4 fl. dr. 

Oleum Cari, U.S. P. ; Oleum Carui, B.P. Oil OF CARAWAY. 
— A volatile oil distilled from caraway, U.S. P. The oil distilled in 
Britain from caraway fruit, B.P. 

Characters. — Colorless or pale yellow, odor aromatic, taste spicy, 
and neutral reaction. It is soluble in an equal weight of alcohol. 

Peepaeations. 

u.s.p. 

Spiritus Juniperi Compositus. 

B.P. 

Confectio Scammonii, 1 fl. drm. in 10 oz. 
Pilula Aloes Barbadensis, 1 fl. drm. in 4 oz. 

Use. — Carminative and stimulant. Used with purgatives to lessen 
griping and to relieve flatulence. 

Sumbul, U.S.P. ; Sumbul Radix, B.P. Sumbul, U.S.P. ; 
Sumbul Root, B.P. — The dried transverse sections of the root of 
Ferula Sumbul, U.S.P. (Ewryangium Sumbul, B.P.) Imported from 
Russia and India. 

Characters. — Cylindrical pieces varying considerably in diameter 
and thickness. They are covered on the outer edge with a dusky brown 
rough bark, frequently beset with short, bristly fibres. The cut surface 
looks like felt from the interior of the root, consisting of easily separated 
fibres. It has a stong odor, resembling that of musk. The taste is at 
first sweetish, becoming after a time bitterish. 

Composition. — A resin soluble in ether, and a small quantity of an 
essential oil. 

Peepaeations. 

u.s.p. dose. 

Tinctura Sumbul (10 per cent.) 1-4 fl. drm. 

B.P. dose. 

Tinctura Sumbul (2joz. in 1 pint) 10-60 min. 

Use. — Sumbul is said by some to be of little service ; however it 
seems useful in the malady for which it is usually prescribed, viz., hys- 
teria and nervous conditions occurring in females in feeble health or 
recovering from an acute disease. 



792 VEGETABLE MATERIA MEDICA. 



CCELO SPERM JE. 



Coriandrum, U.S. P. ; Coriandri Fructus ; B.P. Coriander, 
U.S. P. ; Coriander Fruit, B.P. — The fruit of Coriandrum sativum. 




Fig. 161.— Coriander. 

Characters. — Globular, nearly as large as white pepper, beaked, 
finely ribbed, yellowish-brown ; has an agreeable aromatic odor and 
flavor. 

Composition. — Contains volatile and fixed oils. 

Pbepabatioxs. 

U.S. P. DOSE. 

Oleum Coriandri 2-5 mm. 

B.P. DOSE. 

Confectio Sennse 60-120 grs. 

Mistura Gentianee £-1 fl. oz. 

Oleum Coriandri 2-5 mill. 

Syrupus Rhei 1-4 fl. drm. 

Tinctura Rhei 1-8 fl. drm. 

Tinctura Sennse 1-4 fl. drm. 

Syrupus Sennse 1-4 fl. drm. 

(of the oil, 2-5 min.) 

Oleum Coriandri, U.S.P. and B.P. Oil of Coriander. — A 
volatile oil distilled from coriander. 

Characters. — A colorless, or yellowish liquid, having the charac- 
teristic aromatic odor of coriander, a warm, spicy taste, and a neutral 
reaction. 

Pbepaeation. 

b.p. 
Syrupus Sennae. 

Use. — Carminative and stimulant. Used as an adjunct to pur- 
gatives. 



COROLLIFLOR^E. 793 

CHAPTER XXXIII. 
Sub-Class III.— COROLLIFLOR^E. 

CAPRIFOLIACE^E. 

B.P. Sainbuci Flores. Elder Flowers. — The fresh flowers of 
Sambucus nigra. From indigenous plants. 

Characters. — Flowers small, white, fragrant, crowded in large 
cymes. 

U.S.P. Sambucus. Elder. — The flowers of Sambucus cana- 
densis. 

Characters. — In level tipped cymes, cream-colored, odor peculiar, 
taste sweetish, aromatic, slightly bitter. 

Composition. — A small amount of a light essential oil. 

Peepaeatton. 
u.s.p. b.p. dose. 

None. Aqua Sambuci 1-2 fl. oz. 

Use. — Elder-flower water is used as a vehicle in collyria and lotions. 

CORNACE^E. 

U.S.P. Cornus. Cornus. Dogwood. — The bark of the root of 
Cornus florida. 

Characters. — In curved pieces of various sizes, about one-eighth of 
an inch (3 millimetres) thick; deprived of the furrowed, brown-gray, 
corky layer ; outer and inner surface pale-reddish, or light reddish-brown, 
striate ; transverse and longitudinal fracture short, whitish, with brown, 
yellow striae ; inodorous ; astringent and bitter. 

Peepaeations. 

DOSE. 

Extractum Cornus Fluidum 1 fl. drm. 

Cornus 20-60 gr. 

Composition. — It contains a bitter neutral principle. 

Action. — It acts as an astringent tonic and feeble stimulant to 
the stomach. It was formerly used in ague and malarious conditions, 
and a resinoid substance obtained from it by alcohol is popularly called 
dogwood-quinine. 

KUBIACE^E; (CINCHONACEiE). 

cinchone^:. 

U.S.P. Cinchona. Cinchona. — The bark of any species of cin- 
chona containing at least 3 per cent, of its peculiar alkaloids. 

Peepaeation. 
u.s.p. dose. 

Infusum Cinchonae, (cinchona in powder 6, aromatic sulphuric acid 1 1 o a n 
1, water q.s. to make 100 parts by percolation) J " ' z " 



794 VEGETABLE MATERIA MEDICA. 

B.P. Cinchona Pallidae Cortex. Pale Cinchona Bark. — 

The bark of Cinchona officinalis, and several allied species. Loxa in 
Ecuador. 



Fig. 162.— Pale Cinchona Bark. 

Characters. — In single or double quills, brittle, easily splitting 
longitudinally, and breaking with a short transverse fracture ; outer sur- 
face brown and wrinkled, or gray and speckled with adherent lichens, 
with or without numerous transverse cracks ; inner surface bright orange 
or cinnamon brown ; powder pale brown, slightly bitter, very astringent. 

Adulteration. — Inferior barks are sometimes added. 

Test. — 200 grains of the bark, assayed in the same manner as yellow 
cinchona bark, with the substitution of chloroform for ether, should yield 
not less than one grain of alkaloids. 

Peepaeations. 

B.P. DOSE. 

Mistura Ferri Aromatica 1-2 fl. oz. 

Tiactura Cinclionae Composita J-2 fl. drm. 

B.P. Tinctura Cinclionae Composita. COMPOUND TlNCTUEE OF CINCHONA. — 
Pale cinchona bark, 2 oz.; bitter orange peel, 1 oz.; serpentary, § oz.; saffron, 60 grs. ; 
cochineal, 30 gr.; proof spirit, 1 pint. 

|F' S Cinchona Flava, U.S. P. ; Cinchonae Flavae Cortex, B.P. 

Yellow Cinchona Calisaya Bark, U.S. P.; Yellow Cinchona 
Bark, B.P. — The bark of the trunk of Cinchona Calisaya, containing 
at least 2 per cent, of quinine. Collected in Bolivia and Southern Peru. 




Fig. 163.— Yellow Cinchona. 



Characters. — In flat pieces, or quills. The flat pieces are recog- 
nized by their tawny yellow color, and by the long channelled depres- 
sions left on the outer side of the bark by the gouge with which the 
epidermis has been removed. Transverse fracture shows numerous very 
rigid glistening fibres, short and very fibrous. Powder cinnamon-brown, 
somewhat aromatic, persistently bitter. The quills are J to 2 inches in 
diameter, and have a gray, corky, fissured epidermis. Internally, cinna- 
mon-brown, and finely striate from the bark fibres. 

Adulteration. — Spurious cinchona bark is rarely found, but infe- 
rior varieties of cinchona barks are frequently added. 

Test. — 100 grains of the bark, when assayed, should yield at least 
two grains of pure quinine. 



COROLLIFLOR^E. 795 

Peepaeations. 

U.S. P. DOSE. 

Extractum Cinchona? 8-15 grs. 

" " Fluidum 30-60 min. 

Tinctura Cinchona? 1-2 fl. drm. 

B.P." DOSE. 

Decoctum Cinchona? Flavae 1-2 fl. oz. 

Extractum Cinchona? Flava? Liquidum 10-30 min. 

Infusum Cinchona? Flava? 1-2 fl. oz. 

Quinia? Sulphas 1-10 grs. 

Tinctura Cinchona? Flava? ^-2fl. drm. 

Cinchona Rubra, U.S.P. ; Cinchonae Rubra? Cortex, B.P. 

Red Cinchona. Red Cinchona Bark. — The bark of Cinchona 
succirubra. From Chimborazo. 




Fig. 164.— Ked Cinchona. 

Characters. — In flat or incurved pieces, less frequently in quills, 
coated with the periderm, outer surface brown or reddish-brown, fre- 
quently warty ; inner surface redder ; fractured surface often approach- 
ing to brick-red; transverse fracture finely fibrous; powder red-brown ; 
taste bitter and astringent. 

Adulteration. — Some of the brown and red inferior barks are 
occasionally substituted. 

Test. — 100 grains of the bark, assayed in the same manner as 

yellow cinchona bark, with the substitution of chloroform for ether, 

should not yield less than 2 grains of quinine, U.S. P., 1*5 grains of 

alkaloids, B.P. 

Peepaeatton. 
u.s.p. dose. b.p. 

Tinctura Cinchona? Composita 1-4 fl. dr. None. 

U.S.P. Tinctura Cinchona? Composita. COMPOUND TlNCTUEE OF CINCHONA. — 
Eed cinchona, 10; bitter orange peel, 8; serpentaria, 2; glycerin, 10; alcohol and 
water, (in the proportion of 8 of the former to 1 of the latter) q.s. to make 100. 

Properties and Composition of the Cinchona Barks. — The 
cinchona barks contain varying quantities of the following alkaloids : — 
Cinchonine (C 29 H 22 N 2 0), cinchonidine (C 19 H 22 N 2 0), quinine (C 20 H 24 N 2 O 2 ), 
quinidine (C 20 H 24 lSr 2 O 2 ), quinamine (C 19 H 24 N 2 2 ), conquinamine (C 19 H 24 
N 2 2 ). Quinine, quinidine, and quinamine are abundantly soluble in 
ether ; cinchonidine only sparingly soluble, and cinchonine is almost 
entirely insoluble. The solutions of quinine and cinchonidine are lsevo- 
gyrate ; those of cinchonine, quinidine, quinamine and conquinamine 
are dextrogyrate. If chlorine water and a drop of ammonia be added 
to a dilute solution of quinine a brilliant green color appears, and in 



796 VEGETABLE MATERIA MEDICA. 

concentrated solutions of quinine a green precipitate of thalleioquin is 
produced. Quinidine also gives this reaction, but cinchonine, cinchoni- 
dine, and quinamine do not. Solutions of quinine and quinidine are 
fluorescent, but those of cinchonine, cinchonidine and quinamine, if pure, 
exhibit no fluorescence. 

Both the total quantity of alkaloids and the relative proportions of 
each vary considerably in the barks of the different species of cinchona. 
The yellow bark is usually richest in quinine ; it yields from 2 to 6 per 
cent, of the alkaloid. The pale bark contains only about 1 per cent, of 
alkaloids and these are chiefly cinchonine and cinchonidine. The flat 
kind of the red bark contains about 3 to 4 per cent, of alkaloids, but the 
quill red bark is richer, yielding 5 to 10 per cent., of which about one- 
third is quinine, one-fourth cinchonidine, and the rest cinchonine with 
traces of quinidine. 

By heating solutions of the cinchona alkaloids with excess of a mineral 
acid they may be converted into amorphous isomeric alkaloids. Quinine 
yields quinicine, and cinchonine is converted into cinchonicine. 

In addition to the alkaloids, the cinchona bark contains certain acid 
principles. These are : — (1) Quinic or chinic acid, soluble in water and 
alcohol, but sparingly so in ether. On oxidation it yields quinone or 
chinone. (2) Cincho-tannic acid. (3) Quinovic acid. 

Cinchona bark also contains quinovin, which by means of hydrochloric 
acid is resolved into quinovic acid and an uncrystallizable sugar. It also 
contains cinchona-red, which is a coloring matter abundantly found in 
the red bark. 

U.S.P. Quinina. Quinine, C^H^KjO^ELjO (crystallized) 378. 
— An alkaloid prepared from different species of cinchona. 

Preparation. — By adding to the solution of the sulphate a quantity 
of water of ammonia or solution of soda, just sufficient to precipitate the 
alkaloid. 

Although it is not separately mentioned in the B.P., it is used in the preparation 
of citrate of iron and quinine. 

Preparations, 
u.s.p. DOSE. 

Ferri et Quininse Citras 3-5 gr. 

Liquor Ferri et Quininse Citratis 8-45 min. 

Syrupus Ferri Quininse et Strychninse Phosphatum 1-2. fl dr. 

Quininse Sulphas. Sulphate of Quinine. U.S.P. Quiniae 
Sulphas. Sulphate of Quinia. B.P. (C 20 H a4 N 2 O 2 ) 2 H 2 SO 4 . 7H 2 0; 

872. — The sulphate of an alkaloid prepared from yellow cinchona bark, 
and from the bark of Cinchona laneifolia, and several other species. 

Preparation. — Macerate powdered yellow cinchona bark with hydro- 
chloric acid, precipitate the liquid thus obtained with solution of soda, 
dissolve and neutralize the precipitate by sulphuric acid, concentrate and 
crystallize. 

Characters and Tests. — Filiform, silky, snow-white crystals, of a 
pure, intensely bitter taste, sparingly soluble in water, yet imparting to 
it a peculiar bluish tint. The solution gives, with chloride of barium, a 
white precipitate, insoluble in nitric acid, and when treated first with 



COROLLIFLOR.E. 797 

solution of chlorine and afterwards with ammonia, it becomes of a splendid 
emerald-green color. Dissolves in pure sulphuric acid with a feeble 
yellowish tint, and undergoes no further change of color when gently 
warmed. Ten grains with ten minims of diluted sulphuric acid and half 
a fluid ounce of water form a perfect solution, from which ammonia 
throws down a white precipitate. This redissolves on agitating the whole 
with half a fluid ounce of ether, without the production of any crystalline 
matter floating on the lower of the two strata into which the agitated 
fluid separates on rest. 25 grains of the salt should lose 3*6 grains of 
water by drying at 212°. 

Peeparations. 

B.P. DOSE. 

Ferri et Quinise Citras 5-10 gr. 

Pilulse Quinise 2-10 gr. 

Tinctura Quhme £-2 fl. dr. 

Vinum Quiniae £-1 fl. oz. 

Tinctura Quiniae Ammoniata f-2 fl. dr. 

XJ.S.P. Quininse Bisulplias. BlSULPHATE OF QUININE, O 20 H 24 
N 2 2 H 2 S0 4 . 7H 2 ; 548. 

Characters. — Colorless, clear, orthorhombic crystals or small needles, 
efflorescing and becoming opaque on exposure to air ; no smell, very bitter 
taste, strongly acid reaction. It resembles the sulphate in its reactions, 
but is much more readily soluble. It dissolves with vivid blue fluorescence 
in 10 parts, while the sulphate requires 740 parts, of water at 59° F. 

U.S.P. Quininse Hydrobromas. Hydrobromate of Quinine, 
C 20 H 24 N 2 O 2 HBr.2H 2 O; 440-8. 

Characters. — Colorless, lustrous needles, no smell, very bitter taste, 
and a neutral or slightly alkaline reaction. It is soluble in about 16 parts 
of water at 59° F. The solution gives the reaction of quinine, and with 
test solution of nitrate of silver yields a white precipitate, insoluble in 
diluted nitric acid, and in solution of carbonate of ammonium. 

Action. — Useful for hypodermic injection. It is supposed to 
produce fewer unpleasant head symptoms than other preparations of 
quinine. 

U.S.P. Quininse Hydrochloras. Hydrochlorate of Quinine, 
C 20 H 24 N 2 O 2 HC1.2H 2 O; 396-4. 

Characters. — White needles forming tufts, no smell, bitter taste, 
neutral or faintly alkaline reaction.! It gives the reaction of quinine, and 
with test solution of nitrate of silver produces a white precipitate insoluble 
in nitric acid, but soluble in ammonia. 

Uses. — Like those of the bisulphate. 

U.S.P. QuininseValerianas. Valerianate of Quinine, C 20 H 24 
N 2 O 2 C 5 H 10 O 2 .H 2 O; 444. 

Characters. — White, pearly crystals, with a slight odor of valerianic 
acid, a bitter taste, and a neutral reaction. The solution, when acidulated 
with sulphuric acid, emits the odor of valerianic acid, and gives the 
reactions of quinine. 

Use. — As a tonic in hysteria and nervous irritability. It is said to 
be particularly useful in some forms of intermittent and spasmodic nervous 
affections. 



798 VEGETABLE MATERIA MEDICA. 

U.S. P. Quiiiidiuse Sulphas. Sulphate of Quixidixe, (C^H^ 
N 2 2 ) 2 H 2 S0 4 . 2H 2 ; 782. — It is chiefly obtained from Cinchona Pitay- 
ensis. 

Characters. — White, silky needles, no smell, very bitter taste, with 
a neutral or faintly alkaline reaction. It is soluble in 100 parts of water 
at 59° F. Its solution, when acidulated with sulphuric acid, has a blue 
fluorescence, and gives an emerald-green reaction like quinine. It is 
distinguished from quinine by adding water of ammonia to the solution, 
when a white precipitate is thrown down ; and this precipitate of quini- 
dine is only sparingly soluble, while quinine is readily soluble in excess 
of ammonia or ether. 

U.S. P. Cinchonina. Cixchoxixe, C-JEL^O; 308. 

Characters. — White, somewhat lustrous prisms or needles, no smell, 
at first nearly tasteless, but developing a bitter after-taste, and having an 
alkaline reaction. Almost insoluble in hot or cold water, readily soluble 
in diluted acids. Forming salts of a very bitter taste. Its solution in 
diluted sulphuric acid does not fluoresce if quinine or quinidine be 
absent. The alkaloid precipitated by ammonia is distinguished from 
the other cinchona alkaloids by requiring at least 300 parts of ether to 
dissolve it. 

U.S. P. Ciuchoumse Sulphas. Sulphate OF ClXCHOXIXE, 
(C 20 H 24 N 2 O 2 H 2 SO,) 2 H 2 O; 750. 

' Characters. — Hard, white, shining prisms, no smell, very bitter 
taste, soluble in about 70 parts of water at 59° F., in 60 of chloroform 
and readily in diluted acids. Ammonia precipitates cinchonine from its 
solution, which gives the reactions already mentioned. The salt dried 
and macerated for half an hour with 70 times its weight of chloroform 
at 59° F. is dissolved (the sulphates of quinine or cinchonidine are not 
dissolved). 

U.S. P. Cmchonidiiise Sulphas. Sulphate of Cixchoxidixe 

(aoH^O^H.SO^HO; 768. 

Characters. — White, silky, lustrous needles, no smell, very bitter 
taste, and a neutral or faintly alkaline reaction, soluble in 100 parts 
water at 59° F. Its solutions, like those of cinchonine, do not fluoresce 
when pure ; when precipitated fron^ its solutions by ammonia cinchoni- 
dine dissolves in about 75 times its weight of ether, while cinchonine 
requires four times as much. 

U.S. P. Chiuoidinum. Chixoidix. (Quixoidix.) A mixture 
of alkaloids, mostly amorphous, obtained as a by-product, in the manu- 
facture of the crystallizable alkaloids from cinchona. 

Characters. — A brownish-black or almost black solid, breaking 
when cold with a resinous shining fracture, becoming plastic when 
warmed, odorless, having a bitter taste and an alkaline reaction. Almost 
insoluble in water, freely soluble in alcohol, chloroform and diluted 
acids. 

Use. — It is of uncertain composition, and liable to adulteration, and 
is employed instead of quinine on account of its cheapness. 



COKOLLIFLOK.E. 799 

u.s. p. Cinchona Alkaloids and their Salts. 

DOSE. 

. . f^-2 grs. as tonic; 2-5 grs. repeated every 2-4. 

yumma ^ hours as antipyretic. 15-20 grs. a large dose. 

Quininse Sulphas The same. 

" Bisulphas A little larger. 

" Hydrobromas..The same as for quinia. 

" Valerianas 1-2 grs. 

Quinidinas Sulphas... Same as quinia. 

Chinoidinum Somewhat larger than of the crystalline alkaloids. 

Chinonidinae Sulphas..l-15 grs. 

Cinchonina About one half more than of quinia. 

Cinchoninaj Sulphas... " " " " 

Physiological Action. 

General Action. — A solution of quinine when added to albumen 
loses its fluorescence and seems to enter into combination with it, for the 
albumen is rendered less soluble and more coagulable (p. 69). 

It lessens protoplasmic and amoeboid movements, (pp. 72 and 
75), and destroys low animal and vegetable organisms, but salt water 
amoebae seem to withstand the action of quinine to a great extent. 

Quinine diminishes oxidation (p. 82) and diminishes and prevents 
the development of a blue color on the addition of a few drops of blood 
to a solution of tincture of guiac and ozonic ether (p. 79). A similar 
but less marked effect is seen if blood be taken from an animal into 
which quinine has been previously injected, instead of mixing the qui- 
nine directly with the blood. 

Quinine diminishes and in large doses arrests fermentation, espe- 
cially when it depends on organized ferments (as alcoholic, lactic, or 
butyric fermentations), but does not prevent the change of starch into 
sugar by ptyalin, or of amygdalin into oil of bitter almonds by emulsin. 
It has, however, an action on some enzmes (p. 85) and diminishes the 
action of pepsin on albumen. It is a powerful antiseptic (p. 100), and 
a dilute solution will preserve meat, milk, butter or urine for a length 
of time. It is absorbed from all mucous membranes, and is better 
given in solution, as some of the powder passes out in the foeces. It 
forms with the bile a salt which is sparingly soluble, except in excess of 
bile, hence before giving quinine in malaria, clear out the liver by admin- 
istering an emetic and a cholagogue purgative. 

Special Action. — On the Alimentary Canal. — When taken into 
the mouth, quinine causes a persistent bitter taste if the solution be 
neutral or only slightly acid, for then the alkalinity of the saliva precipi- 
tates the alkaloid ; but if given with an excess of acid, and a little water, 
the bitter taste soon disappears, leaving a sweetish one behind. The 
bitter taste produces increased flow of saliva by reflexly influencing the 
centre in the medulla. When quinine is injected into the duct of the 
submaxillary gland it prevents the secretion of watery saliva by paralyz- 
ing the ends of the chorda tympani, or by acting directly on the secre- 
tory cells themselves (p. 312). The secretion of the thick ropy saliva is 
not prevented, for the sympathetic is not paralyzed except by large doses 
(p. 313). The vaso-dilator nerve fibres are not paralyzed, for if they be 
stimulated the blood vessels dilate, the lymph spaces become full and the 
gland oedematous, but no secretion takes place. 



800 VEGETABLE MATERIA MEDICA. 

When taken into the stomach, small doses increase the appetite, 
especially in atonic dyspepsia, but if the stomach is irritable quinine 
causes loss of appetite, and may produce nausea and vomiting (p. 319). 
If the stomach be congested the flow of mucous secretion will be increased 
by quinine. Large doses diminish the appetite, and may cause nausea 
and vomiting. When it causes vomiting the addition of hydrobromic 
acid will often enable it to be borne. 

The action of quinine on the secretions and peristalsis of the intes- 
tines is unknown, as also is its action on the secretion of bile, though it 
is certain that it does not increase it. 

When absorbed into the "blood, quinine causes contraction of the 
spleen, and in large doses lessens the contractile power and amoeboid 
movements of the white blood corpuscles. It thus checks the diapedesis 
of the white blood corpuscles (p. 72). 

The size of the red corpuscles is increased, (p. 73) but their power 
of giving up oxygen seems to be diminished, as is shown by the guaiacum 
test (p. 79.) 

On the Circulation. — Small and moderate doses increase the 
strength of the circulation, but how they act has not been ascertained. 

Large doses diminish the blood-pressure, chiefly by weakening the 
heart but partly by paralyzing the vaso-motor centre, thus causing dila- 
tation of the vessels. This paralysis occurs from very large doses. It is 
evidenced by the fact that irritation of a sensory nerve or asphyxia no 
longer produces contraction of the vessels and rise of blood-pressure. 

The heart's action is weakened by quinine, from its action on the 
motor ganglia and probably also on the muscular fibres of the heart itself. 

The vagus nerve is little affected by moderate doses, but is finally 
paralyzed by very large doses. In poisoning by quinine death gener- 
ally occurs from failure of the respiration, and only occurs through car- 
diac paralysis if the drug be injected directly into the circulation in large 
doses ; the animal then dies in convulsions consequent on stimulation of 
the nerve centres by thcvenous condition of blood thus produced. 

On the Respiration. — Small doses have no effect on it. Moder- 
ate doses quicken the respiratory movements, but large doses first slow, 
and then stop them, by paralyzing the respiratory centre. The amount 
of oxygen taken in and of carbon dioxide exhaled is diminished. This is 
due to the action of the drug on tissue change and on the red blood cor- 
puscles (p. 82). 

On Tissue Change. — Moderate doses diminish tissue change (p. 
360) and lessen the nitrogen and sulphates in the urine, but increase 
its total quantity. In fever, especially when due to septic poisoning, the 
temperature of a patient is lowered by quinine. It is also lowered in 
an animal even after section of the cord and wrapping up in cotton-wool, 
showing that the fall is due to the lessened tissue change and oxidation 
in the body. When given in fever, quinine increases the amount of nitro- 
gen in the urine. 

On the Nervous System. — In man small doses give tone to the 
system generally. 

Large doses cause symptoms to which the term cinchonism (or 
quinism) has been applied ; these consist in a feeling of tightness across 



COROLLIFLOR^E. 801 

the forehead, ringing in the ears, deafness, diminution of the power of 
sight and accuracy of feeling (p. 205). These symptoms may generally 
be relieved by giving 30 minims of hydrobromic acid with each dose. 
Ergot also tends to prevent or remove them. 

By still larger closes the powers of hearing and sight are more 
affected, sometimes complete deafness being produced. Giddiness, head- 
ache, staggering gait, and muscular weakness succeed, and the circula- 
tion becomes feeble. 

With very large closes delirium occurs and occasionally death, 
sometimes in convulsions. 

Small doses stimulate, large doses depress, the functions of the 'brain, 
lessening the powers of thought, but may stimulate the motor centres and 
cause epileptic fits (p. 174). 

Spinal Cord. — Reflex action is diminished, especially in the frog. 
Immediately after the injection of quinine into the lymph-sac of a frog a 
great depression of reflex action occurs. This was attributed by Chaperon 
to stimulation of Setschenow's centres by the quinine. It is probably, 
however, only reflex depression, due to the local irritation of the injec- 
tion. At a later stage of poisoning considerable depression of the reflex 
action is also observed, which has been attributed to gradual paralysis of 
the cord from feebleness of the heart and consequent failure of the circu- 
lation. Sensory and motor nerves are only affected by the drug 
when locally applied. The muscles retain their irritability till near 
death, but their capacity for work as well as their irritability is dimin- 
ished. The muscular curve is somewhat prolonged (p. 125). During its 
excretion quinine stimulates the genito-urinary tract, and occasionally 
produces irritability of the bladder and urethrea. It is said to produce 
contraction of the gravid uterus, and is therefore to be given with care 
in pregnancy. 

Uses. — From its power of destroying germs and preventing putrefac- 
tion, quinine is used as a local antiseptic. As a lotion it is useful in con- 
junctivitis, and in the diphtheritic form of this disease quinine destroys 
the power of the secretion to cause inflammation when inoculated into 
another eye. 

Hay fever, which probably is caused by the presence of the pollen of 
grasses is often relieved by washing the nose with a saturated aqueous 
solution of sulphate of quinine (about J grain to 1 fl. oz.), (p. 410). Some- 
times it is quite useless. 

Sore throat is often relieved by a gargle of quinine (cf. p. 684). 

Whooping-cough is often relieved by quinine, which may be inhaled 
in the form of spray. 

After the evacuation of an empyema or pleural effusion, a solution of 
quinine may be injected as an antiseptic into the pleural cavity. 

As a tonic it is useful in general debility ; it increases the appetite 
and muscular strength ; may be advantageously combined with iron. 

As an antiperiodic it is used in ague, malarial fever, and all mala- 
rial remittent affections, with great efficiency, being almost a specific. 
It should be given in doses of 3 or 4 grains, three times a day, or in a 
single dose of 10 grains, just before a fit comes on; it will often cut short 
a fit of moderate intensity. An emetic or chologoyne purgative should 
51 



802 VEGETABLE MATERIA MEDICA. 

be given before it (p. 352). In malarial cachexia without distinct fits it 
is much less serviceable. 

In neuralgia of the intestine, when due to malaria, 5 grains should 
be administered in one dose, followed by 5 more in a quarter of an hour 
if no relief is obtained. It will also cure other forms of neuralgia not 
apparently due to malaria, and even when not of a periodic character. 
It is especially useful in supraorbital neuralgia. 

Intermittent headache is often greatly relieved by 5 grains of quinine, 
especially if calomel, or gray powder, or podophyllin be also given along 
with it (cf. pp. 327, 353) to act on the liver. 

As an antipyretic, large doses (5-20 grs.) lessen the temperature 
in typhus, enteric, and other fevers. It is better to give a single large 
dose once a day, or two doses of 5 grains given in the same hour, between 
five and six in the evening. 

In symptomatic fevers quinine has been used to reduce the tempera- 
ture, as in pneumonia. 

In rheumatism and exanthemata it is not much used. 

In the treatment of worms quinine is useful to prevent the accumula- 
tion of mucus which forms a nidus for the worm. 

As a prophylactic agent against ague and all intermittent affections 
quinine is invaluable. 

Warburg-'s tincture, containing quinine and a number of aromatics, 
is very useful in cases of collapse from various causes. 

The other alkaloids of cinchona seem to have very much the same 
action as quinine. 

Sometimes people who work with cinchona barks are attacked with 
great irritation of the skin ; this is probably due to the mechanical action 
of minute spicules of the bark. 

COFFEES. 

Ipecacuanha. Ipecacuanha. Ipecac. U.S. P. — The dried root 
of Cephaelis Ipecacuanha. Brazil. 




Fig. 165.— Ipecacuanha. 

Characters. — In pieces about the size of a small quill, contorted 
and irregularly annulated. Color brown, of various shades. It consists 
of two parts, the cortical or active portion, which is brittle, and a slender, 
tough, white, woody centre. This hard centre and the annulated appear- 
ance of the cortex give to the root the appearance of a number of brown 
beads strung on a white thread. 

Composition. — The woody centre is inert. The cortical part con- 
tains an alkaloid, emetine, and an acid, ipecacuanic acid, which is a 
glucoside allied to tannic acid. 






COROLLIFLORiE. 803 

Pbepaeations. 

U.S.P. DOSE. 

Extractum Ipecacuanhse Fluidum (as expectorant) 5 min. 

" " " (as emetic) 25 min. 

Pulvis Ipecacuanhas et Opii 5-15 gr. 

Trochisci Ipecacuanhas (i gr. in each) 1-4. 

Trochisci Morphinae et Ipecacuanhas (^ gr. of morphine, T V gr. ipecac.) 

Tinctura Ipecacuanhse et Opii 4-15 min. 

Syrupus Ipecacuanhas (as expectorant) 2-30 min. 

" " (as emetic) HA- oz. 

Yinum Ipecacuanhas (as expectorant) 3-5 min. 

" " (to relieve vomiting) half a drop. 

B.P. DOSE. 

Pilula Conii Composita 5-10 gr. 

Pilula Ipecacuanhas cum Scilla 5-10 gr. 

Pulvis Ipecacuanhas Compositus 5-14 gr. 

Trochisci Ipecacuanhas (J gr. in each) ..1-3 

Trochisci Morphias et Ipecacuanhas 1-6 

Vinum Ipecacuanhas (as an emetic) 3-6 fl. dr. 

" " (as an expectorant) 5-40 min. 

(of the powdered root, as emetic, 15-30 gr. ; in dysentery, 20-30 gr., in a bolus.) 

Pulvis Ipecacuanha? et Opii. POWDEE OF IPECAC AND OPIUM, U.S.P. Pulvis 
Ipecacuanha? Compositus. COMPOUND POWDEE OF IPECACUANHA, B.P. (DOVEE'S 

Powdee). — Ipecac, 10 ; powdered opium, 10; sugar of milk, 80, U.S.P. Ipecacuanha, 
| ; opium, J; sulphate of potash, 4, B.P. 

B.P. Pilule Ipecacuanha? cum Scilla. PlLL OF IPECACUANHA WITH SQUILL. 
— Compound powder of ipecacuanha, 3 ; squill, 1 ; ammoniacum, 1 ; treacle, q.s. 

Physiological Action. — In frogs small doses of emetine cause 
irregularity of the heart, with final stoppage in diastole and loss of irrita- 
bility of the cardiac muscle. Larger doses paralyze the central nervous 
system and diminish the contractile power of the muscles (p. 125). 

Locally applied to the skin or mucous membranes, it acts as an 
irritant, and may produce a pustular eruption. In some persons it has a 
peculiarly irritating action on the respiratory tract, so that almost infini- 
tesimal quantities of the powder cause running at the nose, and sometimes 
asthma. When taken internally, it is an irritant to the mucous mem- 
brane of the stomach, and acts as a prompt emetic. This is partly due 
to the local action of the drug on the ends of the vagus in the stomach, 
and, when absorbed into the blood, to its action on the vomiting centre 
in the medulla. 

Emetine produces, in dogs, both when injected under the skin and 
when administered internally, diarrhoea, which is sometimes bloody. 
The intestinal mucous membrane is swollen, red, and ecchymosed as in 
poisoning by arsenic, antimony, platinum, iron, or sepsine. 

When injected either subcutaneously or into the veins, it produces 
death by cardiac paralysis. It paralyzes the vessels first, and then the 
heart, so that the blood-pressure sinks nearly to zero, while each cardiac 
pulsation is still powerful and produces a considerable wave in the blood- 
pressure tracing. 

The lungs are often congested, oedematous, or in a state of red 
hepatization, especially in rabbits. 

In medicinal doses it increases the secretion from mucous membranes 
often very markedly, and is hence used to increase the expectoration 



804 VEGETABLE MATERIA MEDICA. 

and render it more fluid in bronchitis. It is slightly diaphoretic 
independently of the effect produced by its nauseating qualities. 

Therapeutics. — Ipecacuanha is used as an emetic in cases of 
poisoning and in overloaded conditions of the stomach ; to clear out the 
trachea and larynx in croup and diphtheria (1 teaspoonful of vin. ipec. 
every \ hour till vomiting takes place) ; to empty the bronchial tubes in 
chronic bronchitis when choked up with mucus. 

In jaundice depending on catarrhal conditions of the bile-ducts it is 
useful to lessen the viscidity of the mucus ; also in jaundice depending 
on the presence of a small calculus. 

As a diaphoretic it is given in suddenly suppressed menstruation 
and acute and muscular rheumatism in the form of Dover's Powder ; 
also in catarrhs. In small doses it is often useful in vomiting from 
various causes, as vomiting of pregnancy, suckling, and in children. 

As an expectorant (p. 226) it is very useful when the bronchial 
secretion is scanty, tough, and difficult to expectorate. Ringer strongly 
recommends the spray of vin. ipec. in winter cough and bronchial 
asthma. 

Ipecacuanha is very useful as an antidys enteric, especially in the 
acute dysentery of the tropics ; large doses (xxx grs.) must be given on 
an empty stomach, preceded by a dose of laudanum half an hour before, 
to still the stomach and prevent vomiting. No water must be taken with 
it and the patient must lie down with his head low. 

Precautions. — Large doses must not be given to pregnant women, 
or to old people with atheromatous arteries. The wine is apt to lose 
its power by keeping, and hence it is best to preserve it in small sealed 
bottles. 

Caffea. Coffee. Not officinal. — The seed of Ooffea arabica. 

Composition. — Unroasted coffee contains caffeine and a kind of 
tannin called caffeotannic acid. During roasting a part of the caffeine 
is volatilized and an empyreumatic substance called caffeon is developed. 

Action. — The action of coffee is somewhat like that of caffeine 
but differs from it in some respects, inasmuch as the caffeon increases 
the peristaltic movements of the intestine, and causes, indeed, 
tetanic contraction of it, while caffeine does not alter peristaltic move- 
ments. Caffeon quickens the pulse, dilates the vessels, and lowers the 
blood-pressure and produces a sensation of warmth on the surface. In 
some persons coffee produces feeling of weight in the abdomen and a 
tendency to haemorrhoids. As tea has not this action, or has it only to 
a comparatively slight extent, it is probably due to the combined action 
of the caffeine and caffeon. 

Use. — Coffee is used chiefly as a remedy in headache and in doses of 
opium poisoning. 

B.P. Catechu Pallidum. Pale Catechu. — An extract of the 
leaves and young shoots of Uncaria Gambier, and U. Acida. Eastern 
Archipelago. 

Characters. — In cubes about an inch square, or masses formed of 
coherent cubes, externally brown, internally ochrey -yellow or pale brick- 
red, breaking easily with a dull earthy fracture. Taste bitter, very 
astringent, and mucilaginous, succeeded by slight sweetness. 



COROLLIFLOR^E. 805 

The catechu of the U.S. P. is an extract prepared from the wood of 
Acacia Catechu, Leguminosae (p. 770). 

Composition. — Contains catechu-tannic acid and catechuic acid, or 
catechin which is related to catechu-tannic acid in the same way as gallic 
to tannic acid. There is also a yellow coloring matter, quercitin. 

Adulteration. — Starch. 

Tests. — The decoction when cool is not rendered blue by iodine. 

Peepaeations. 

B.P. DOSE. 

Infusum Catechu (catechu, 160 gr. ; cinnamon, 

30 gr. ; water, £ pint) 1-1J fl. oz. 

Pulvis Catechu Compositus 20-40 gr. 

Tinctura Catechu 1-2 fl. drm. 

Trochisci Catechu 1-3 or more. 

Uses. — Catechu is employed as a local remedy in relaxed sore throat. 
It may sometimes be chewed with advantage before taking food by persons 
suffering from pyrosis. Its use in such cases is probably to diminish the 
coating of mucus on the gastric mucous membrane. It is also employed 
in diarrhoea as an astringent. 

VALERIANACE^. 

TJ.S.P. Valeriana. Valerian. — The rhizome and rootlets of 
Valeriana officinalis. 




Fig. 166.— Transverse section of rhizome of Valerian. 

B.P. Valerianae Radix. Valerian Root. — The dried root of 
Valeriana officinalis. From plants indigenous to and also cultivated in 
Britain. 

Characters. — A short, yellowish-white rhizome, with numerous 
fibrous roots about two or three inches long; of a bitter taste and pene- 
trating odor, agreeable in the recent root, becoming fetid by keeping ; 
yielding volatile oil and valerianic acid when distilled with water. 

Composition. — Contains a volatile oil and valerianic acid. 

Peepaeations. 

U.S. p. DOSE. 

Abstractum Valerianae , 15-45 gr. 

Extractum Valerianae Fluidum 15-30 min. 

Tinctura Valerianae (20 per cent.) 1-2 fl. drm. 

Tinctura Valerianae Ammoniata (20 in aromatic spirit of ammonia 

up to 100) 1-2 fl. drm. 

Oleum Valerianae One or more drops. 

Quinina Valerianas 



806 VEGETABLE MATERIA MEDICA. 

Preparations — (continued). 

B.P. DOSE. 

Infusum Valerianae (2 drm. in £ pint) 1-2 fl. oz. 

Tinctura Valerianae (2J oz. in 1 pint spirit) 1-2 fl. drm. 

Tinctura Valerianae Ammoniata (2£ oz. in 1 pint aromatic spirit 

of ammonia) £-lJ fl. drm. 

U.S.P. Oleum Valerianae. Oil of Valerian. — A volatile oil 
distilled from Valerian. 

Characters. — A greenish or yellowish, thin liquid, becoming darker 
and thicker by age and exposure to air, having the characteristic odor 
of valerian, an aromatic, somewhat camphoraceous taste, and a slightly 
acid reaction, sp. gr. about 0*950. It is readily soluble in alcohol. 

Action and Uses. — The activity of valerian is chiefly due to the 
volatile oil it contains and not to the valerianic acid. The oil in large 
doses paralyzes both the brain and spinal cord, and lessens the con- 
vulsions due to strychnia poisoning, lowers the blood-pressure and 
slows the pulse. It is employed as an antispasmodic and stimulant 
in cases of hysteria and is most useful in those occurring in delicate and 
young women. 

Valerianate of zinc has been supposed to combine the nervine tonic 
action of zinc with the antispasmodic effect of valerian, but it is much 
better to use valerian itself or its oil along with a salt of zinc, as the acid 
has no important physiological action. It is used in chorea, especially 
when occurring in hysterical persons, and should not be discontinued 
until symptoms of nausea begin to make their appearance. It is also 
employed in epilepsy and neuralgia. 

Valerianate of iron and valerianate of ammonia have also been used 
in medicine, and may be given in the same doses as the corresponding 
salt of zinc. For the action of valerianate of quinine vide p. 799. 

CAPRIFOLIACE^E. 

U.S.P. Viburnum. Viburnum. Black Haw. — The bark of 

Viburnum prunifoliurn. 

Characters. — In thin pieces or quills, glossy, purplish-brown, with 
scattered warts, and minute black dots ; when collected from old wood, 
grayish-brown; the thin, corky layer easily removed from the green 
layer; inner surface whitish, smooth; fracture short; inodorous, some- 
what astringent and bitter. 

Preparation. 

dose. 
Extractum Viburni Fluidum 30-60 min. 

Uses. — It is said to be useful in preventing threatened abortion, and 
in dysmenorrhoea. Its action is not well understood. 

COMPOSITE. 

Pyrethrum, U.S.P.; Pyrethri Radix, B.P. PYRETHRUM, 
U.S.P.; Pellitory Root, B.P. — The root of Anacyelus pyrethrum. 
The Levant. 



COROLLIFLOE^]. 807 

Characters. — In pieces about the length and thickness of the little 
finger, covered with a thick brown bark studded with black shining 
points. Breaks with a resinous fracture and presents internally a 
radiated structure. When chewed it excites a prickling sensation in the 
lips and tongue, and a glowing heat. 

Composition. — A resin, the properties of which are not yet fully 
known ; also a volatile oil and sugar. 

Pkepaeation. 
u.s. p. dose. b.p. 

Tinctura Pyrethri 10-20 m. The same. 

Action and Uses. — Pellitory is a local irritant, increasing the flow 
of saliva when taken into the mouth. It is used as a masticatory in dry- 
ness of the mouth, relaxed conditions of the throat, aphonia, and paralysis 
of the tongue or throat. It is also employed as a masticatory in headache 
and neuralgia of the head or face. The tincture diluted with water may 
be used as a gargle in similar conditions. The tincture may be applied 
on cotton-wool to carious teeth to lessen the pain, but that of the pharma- 
copoeia is hardly strong enough. It has been given internally with 
success in globus hystericus in doses of 10 to 20 drops four times a day. 

U.S. P. Absinthium. Wormwood. — The leaves and tops of 
Artemisia absinthium. Leaves about two inches (5 centimetres) long, 
hoary, silky-pubescent, petiolate, roundish-triangular in outline, pinnately 
two or three-cleft, with the segments lanceolate, the terminal one spatu- 
late, tracts three-cleft or entire ; heads numerous, subglobose with numer- 
ous small, pale yellow florets, all tubular and without pappus; odor 
aromatic ; taste persistently bitter. 

Preparation. — Vinum aromaticum. 

Dose. — Of the powder, 20-40 gr. It may be infused with advantage 
(1 oz. to 2 fl. oz.), of which 1-2 fl. oz. may be given. It strikes blue 
with iron salts. 

Action. — It contains a volatile oil and a bitter principle, absinthin. 
To the bitter principle it owes its action in stimulating the digestive 
organs. The volatile oil is a narcotic poison. In dogs and rabbits it 
causes trembling, stupor, epileptiform convulsions with involuntary 
evacuations, and sterterous breathing, which may or may not end in 
death. Similar symptoms may be produced in man. 

Use. — It is a bitter stomachic tonic, and is used for atonic dys- 
pepsia. It is said to be anthelmintic. 

U.S.P. Tanacetum. Tansy. The leaves and tops of Tanacetwn 
vulgare. 

Characters. — Leaves about six inches (15 centimetres) long ; bipin- 
natifid, the segments oblong, obtuse, serrate or incised, smooth, dark 
green, and glandular ; flower-heads corymbose, with an imbricated 
involucre, a convex, naked, receptacle, and numerous yellow, tubular 
florets ; odor strongly aromatic ; taste pungent and bitter. 

Composition. — Tansy contains a powerful and irritating volatile oil. 

Uses. — It is seldom used in regular practice. Fatal cases of poisoning 
from this drug have been reported, the symptoms being epileptiform 



808 VEGETABLE MATERIA MEDICA. 

convulsions and coma, feeble pulse and death. Its action thus resembles 
that of absinthe. It has been used as a diuretic and stimulant in 
rheumatism, ague, and hysteria, as an eninienagogue in amenorrhoea, 
and sometimes as an anthelmintic. It is generally given as an infusion. 

Santonica, U.S.P. and B.P. SANTONICA. — The unexpanded 
flower-heads of Artemisia maritima, var. Stechmanniana. Imported 
from Russia. 

Characters. — Flower-heads resembling seeds in appearance, fusi- 
form, blunt at each end, pale greenish-brown, smooth ; odor strong, 
taste bitter, camphoraceous. Flower-heads not round or hairy. 

Composition. — Santonin about 2 per cent., also essential oil and 
fatty acids. 

Peepaeation. 
u.s.p. b.p. dose. 

None. Santoninnni 1-3 grs. for a child. 

2-6 grs. or more for an adult. 

Santoninum, U.S.P. and B.P. Saxtoxin. C 30 H 18 O 6 or C 15 H 18 3 . 
— A crystalline neutral principle prepared from Santonica. 

Characters and Tests. — Colorless, flat, rhombic prisms, feebly 
bitter, fusible and sublimable by a moderate heat ; scarcely soluble in 
cold water, sparingly in boiling water, but abundantly in chloroform and 
in boiling rectified spirit. Sunlight renders it yellow ; not dissolved by 
diluted mineral acids ; entirely destructible by a red heat with free access 
of air. 

Preparation. — The santonica is boiled with milk of lime, strained 
and partially evaporated. Hydrochloric acid is added to the solution 
while hot, which is set aside to allow the santonin to subside and sepa- 
rate from oily matter which is removed by skimming. The precipitate 
is washed with water and ammonia, purified by boiling in spirit with a 
little animal charcoal, which is separated by filtering. On the liquid 
cooling crystals of santonin are deposited. It is to be protected from 
light. 

Peepaeation. 

L'.S.P. DOSE. 

Sodii Santinonas 8-10 grs. 

Trochisci Sodii Santoninatis 1-8 troches. 

Physiological Action. — Large doses of santonin given to a frog 
cause paralysis of the cerebrum with abolition of voluntary movement, 
followed by stimulation of the medulla causing convulsions, which cease 
on section of the cord. In man, large doses cause headache, giddiness, 
vomiting, and sometimes death by convulsions, with a tendency to 
paralysis of the respiration between the convulsions ; hence in a case of 
poisoning treat with chloroform to lessen the convulsions and keep up 
artificial respiration. 

It produces a peculiar disturbance of vision, so that at first every- 
thing appears of bluish and afterwards yellowish or greenish-yellow. 
The blue appearance lasts only a short time, the yellow vision lasts much 
longer. This condition is usually regarded as due to stimulation, and 
subsequent paralysis of those fibres of the retina by which blue light is 



COKOLLIFLOR.E. 809 

perceived. It is eliminated as a soda salt in the urine and colors it 
bright yellow ; if the urine is rendered alkaline it becomes blood red ; 
these colors are probably due to some product of the oxidation of santo- 
nin. The quantity of urine is increased and the patient has a constant 
desire to micturate ; in children it may give rise to incontinence of urine. 

Therapeutics. — It is used almost entirely as a vermicide for round 
worms, in doses of 2-5 grs. every other night, followed by a purgative. It 
should be given three or four times. It is useless against tapeworms. 
It has been frequently used as an injection against threadworms (2-5 
grs. in §i. of castor oil). 

The best method of administration probably is to give it in castor oil, 
although not unfrequently it is given in powder for two or three nights 
running, the last powder being followed by a dose of castor oil next 
morning. It is best given at bed time as the effect on the sight passes 
off to a great extent during the night. 

Anthemis, U.S.P. ; Anthemidis Flores, B.P. Anthemis, 

U.S. P.; Chamomile Flowers, B.P. — The dried single and double 
flower-heads of the common chamomile, Anthemis nobilis (collected 
from cultivated plants, U.S. P.). 

Characters. — Subglobular heads, about three-quarters of an inch 
(2 centimetres) broad. The single variety consists of both yellow tubu- 
lar and white strap-shaped florets ; the double, of white strap-shaped 
florets only ; all arising from a conical scaly receptacle ; both varieties,, 
but especially the single, are bitter and very aromatic. 

Composition. — Essential oil, removed by distillation, also a bitter 
acid in small quantity. 

Peepaeations. 
u.s.p. b.p. dose. 

None. Extractum Anthemidis 2-10 grs. 

Infusum Anthemidis 1-4 fl. oz. 

- Oleum Anthemidis 1-5 min. 

B.P. Infusum Anthemidis. INFUSION OF CHAMOMILE. — Chamomile flowers, 

% oz. ; boiling water, 10 fl. oz. ; infuse for quarter of an hour and strain. 

B.P. Oleum Anthemidis. Oil of Chamomile. — The oil dis- 
tilled in Britain from chamomile flowers. 

Characters. — Pale blue or greenish-blue, but gradually becoming 
yellow ; with the peculiar odor and aromatic taste of the flowers. 

Peepaeation. 

B.P. DOSE. 

Extractum Anthemidis 2-10 gr. 

Uses. — It is an aromatic tonic and stomachic and carminative, 

and is used in atonic dyspepsia accompanied by flatulence, also in sum- 
mer diarrhoea in children, and sick headache. 

U.S.P. Matricaria. German Chamomile. — The flower-heads 
of Matricaria chamomilla. 

Characters. — About three-fourths of an inch (18 millimetres) 
broad, composed of a flattish, imbricate involucre, a conical, hollow, 
naked receptacle, about fifteen white, ligulate, reflexed ray-flowers, and 
numerous yellow, tubular, perfect flowers without pappus. 



810 VEGETABLE MATERIA MEDICA. 

Action and Uses. — Strongly aromatic, bitter, carminative and 
anthelmintic. It is generally used as infusion or decoction like 
chamomile. 

U.S.P. Eupatorium. Eupatomtjm. Thoroughwokt. — The 
leaves and flowering tops of Eupatorium perfoliatum. 

Characters. — Leaves opposite, united at base, lanceolate, from four 
to six inches (10 to 15 centimetres) long, tapering, crenately serrate, 
rugosely veined, rough above, downy and resinous-dotted beneath ; 
flower-heads corymbed, numerous, with an oblong involucre of lance- 
linear scales, and with from ten to fifteen white florets, having a bristly 
pappus in a single row ; odor weak and aromatic ; taste astringent and 
bitter. 

Officinal Peepaeation. 

DOSE. 

Extractum Eupatorii Fluidum 15-30 min. 

Composition. — It contains a volatile oil and a bitter glucoside, 
eupatorin. 

Use. — It is used as a tonic and diaphoretic. In large doses it causes 
catharsis and emesis. As a tonic it is employed in dyspepsia and gen- 
eral debility. As a diaphoretic it is used to prevent any bad conse- 
quences from exposure to cold, and to cut short an attack of catarrh or 
muscular rheumatism at its commencement. It may then be given as 
infusion or as fluid extract mixed with hot water. When given in 
large doses as an emetic and cathartic, it is useful in causing expulsion 
of tapeworm. 

Taraxacum, U.S.P. ; Taraxaci Radix, B.P. Dandelion Root. 
Taraxacum. — The fresh and dried roots of Taraxacum densleonis, var. 
officinale. 

Characters. — Tap-shaped roots, smooth and dark-brown exter- 
nally, white within, easily broken, and giving out an inodorous, bitter, 
milky juice, which becomes pale-brown by exposure. 

Composition. — They contain a bitter principle — taraxacin — sugar, 
inulin, and a considerable quantity of potash of lime salts. 

Impurity. — Common hawkbit fraudulently mixed. 

Tests. — Not wrinkled or pale-colored externally ; juice not watery; 
any adherent leaves runicate and quite smooth. 

Peepaeations. 

U.S.P. DOSE. 

Extractum Taraxaci 30-60 gr. 

11 " £-2fl. drm. 

B. P. DOSE. 

Decoctum Taraxaci (dried root, 1 oz.; water, 1 pint) 2-4 fl. oz. 

Extractum Taraxaci (fresh) 5-30 gr. 

Succus Taraxaci (fresh) 1-2 fl. dr. or more. 

Action and Uses. — It is supposed to have a stimulant action on 
the liver, increasing its secretion, and is used in biliary disorders and 
dyspepsia. It has also a diuretic action. 

B.P. Lactuca. Lettuce. — The flowering herb of Lactuca virosa. 
COMPOSITION. — It contains lactucarium. 



COROLLIFLOR^. 811 

Pkepakatiox. 
u.s. p. b.p. dose. 

None. Extractum Lactucae 5-30 gr. 

XJ.S.P. Lactucarium. Lactucarium. — The concrete milk juice 
of Lactuca virosa. 

Characters. — In sections of plano-convex, circular cakes, or in 
irregular, angular pieces, externally gray-brown or dull reddish-brown, 
internally whitish or yellowish, of a waxy lustre ; odor heavy, somewhat 
narcotic ; taste bitter. It is partly soluble in alcohol and in ether, and 
when triturated with water it yields a turbid mixture. 

Composition. — Its chief ingredient is a bitter substance — lactucin. 

Peepaeations. 

dose. 

Extractum Lactucarii Fluidum 3-60 min. 

Syrupus Lactucarii 2 fl. drm. 

Dose. — Of lactucarium, 5 grs.-30 grs. 

Action and Use. — Lettuce has a somewhat soporific action, and 
the extract has been used for sleeplessness. Lactucarium is used instead 
of opium to allay cough, quiet nervousness, and induce sleep in cases 
where, from idiosyncrasy, opium is not borne. 

Arnicge Radix, U.S. P. and B.P. Arnica Root. — The dried 
rhizome and rootlets of Arnica montana. Middle and Southern Europe 
and North-west of the United States. 




Fig. 167.— Arnica, transverse section of rhizome, natural size'and magnified 10 diameters. 

Characters. — Rhizome cylindrical, contorted, rough from the scars 
of the coriaceous leaves, of which some usually remain attached, and 
furnished with numerous long, slender fibres ; has a peppery taste and 
peculiar odor. 

Composition. — Arnicin, a substance having some of the properties 
of a glucoside. Arnica also contains about one per cent, of an essential 
oil, with a considerable quantity of inulin. 

Adulteration. — Sometimes adulterated with other and similar 
roots. These may be distinguished on close inspection. 

Peepaeations. 
U.S. p. dose. 

Extractum Arnicae Radicis 5-10 gr. 

Extractum Arnicas Radicis Fluidum 10-30 min. 

Tinctura Arnicae Radicis 2-5 fl. drm. 

Emplastrum Arnicas 

B.P. dose. 

Tinctura Arnicae (1 oz. to 1 pint) 30 min. to 1 fl. drm. 



812 VEGETABLE MATERIA MEDICA. 

U.S.P. Arnicae Flores. Arnica Flowers. — The flower-heads 
of Arnica montana. 

Characters. — About one and one-fifth inches (30 centimetres) broad, 
depressed-roundish, consisting of a scaly involucre in two rows, and a 
small, flat, hairy receptacle, bearing about 16 yellow, strap-shaped, ray- 
florets ; and numerous yellow, five-toothed, tubular disk-florets having 
slender, spindle-shaped achenes, crowned by a hairy pappus. It has a 
feeble, aromatic odor, and a bitter, acrid taste. 

Peepaeation. 
u.s.p. DOSE. 

Tinctura Arnicse Floruni £-2 fl. drm. 

Action. — Arnica, externally, has a stimulant effect on the skin, and 
if evaporation be prevented it will produce redness and sometimes an 
erysipelatous inflammation, spreading some distance. 

Internally it gives rise to a feeling of warmth in the mouth, stomach, 
and intestines, also increasing their peristaltic movements. In large 
doses it produces partial insensibility, convulsions, and sometimes 
syncope. 

Uses. — It is most generally used in bruises and sprains, but it has 
been shown by Dr. Garrod to be no more serviceable than spirit of the same 
strength, and it has the disadvantage of sometimes producing the erysip- 
elatous inflammation. It has been used internally in dysentery, chronic 
bronchitis, rheumatism, nervous diseases, and malarious conditions. Its 
value is doubtful. 

U.S.P. Calendula. Calendula Marigold. — The fresh, flower- 
ing herb of Calendula officinalis. 

Characters. — Stem somewhat angular, rough; leaves alternate, 
thickish, hairy, spatulate or oblanceolate, slightly toothed, the upper ones 
sessile ; flower-heads nearly two inches (5 centimetres) broad, the yellow 
strap-shaped ray-florets in one or several rows, fertile, the achenes 
incurved and muricate ; odor slightly narcotic ; taste bitter and saline. 

Officinal Peepaeatiojst. 
Tinctura Calendulse (used externally). 

Composition. — It contains a bitter principle and calendulin. Its 
physiological action is not well understood. 

Uses. — It is used as an application to sprains and bruises in some- 
what the same way as arnica. 

U.S.P. Grindelia. Grindelia. — The leaves and flowering tops 
of Grindelia robusta. 

Characters. — Leaves about two inches (5 centimetres) or less long, 
varying from broadly spatulate or oblong to lanceolate, sessile or clasp- 
ing, obtuse, more or less sharply serrate, pale green, smooth, finely 
<lotted, brittle ; heads many-flowered ; the involucre hemispherical, about 
half an inch (12 millimetres) broad, composed of numerous, imbricated, 
squarrosely-tipped scales ; ray-florets yellow, ligulate, pistillate ; disk- 
florets yellow, tubular, perfect ; pappus consisting of about three awns 






COROLLIFLOK.E. 813 

of the length of the disk-florets ; odor balsamic ; taste pungently aro- 
matic and bitter. 

Peepaeation. 

DOSE. 

Extractum Grindeliae Fluidum 15 min.-l fl. dr. 

Composition. — It probably owes its medicinal properties to a resin 
and a volatile oil. 

Uses. — It has been found useful in spasmodic asthma, hay asthma, 
asthmatic attacks in bronchitis and emphysema, whooping-cough, and in 
chronic bronchitis or bronchorrhoea, especially in old persons. It has 
also been found to give relief in dyspnoea depending on cardiac disease. 
The oleoresin appears to be excreted by the kidneys, and is useful in 
catarrh of the urinary passages. As a local application it has been 
recommended to relieve the eruption caused by Rhus toxicodendron and 
to relieve itching and pain in vaginitis and in priapism. 

The fluid extract of another non-officinal species, G-rindelia squamosa, 
growing in California, has been recommended as a remedy for enlarged 
spleen, ague, and malarious conditions generally, in doses of 1 fl. dr. 

U.S.P. Inula. Inula. Elecampane. — The root of Inula 
Selenium. 

Characters. — In transverse, concave slices or longitudinal sections, 
with overlapping bark, externally wrinkled and brown ; flexible in damp 
weather ; when dry, breaking with a short fracture ; internally grayish, 
fleshy, slightly radiate, and dotted with numerous shining, yellowish- 
brown resin cells ; odor peculiar, aromatic ; taste bitter and pungent. 

Administration. — The powder may be given in doses of 20-60 gr. 
It may be given as a decoction, made by boiling \ oz. of the root in a pint 
of water. The dose of this is 1-2 fl. oz. 

Composition. — It contains a substance closely allied to starch — inulin 
- — a bitter neutral principle — helenin — and a little volatile oil. 

Uses. — It is used chiefly as a domestic remedy in amenorrhoea, 
chronic bronchitis, and skin diseases. Helenin has been said to be 
peculiarly destructive to the tubercle bacillus. If this statement be 
•substantiated, inula may be useful in phthisis. 

U.S.P. Lappa. Lappa. Burdock. — The root of Lappa officinalis. 

Characters. — About twelve inches (30 centimetres) or more long, 
and about one inch (25 millimetres) thick ; nearly simple, fusiform, 
fleshy, longitudinally wrinkled, crowned with a tuft of whitish, soft, hairy 
leafy-stalks; gray-brown, internally paler; bark rather thick, the inner 
part and the soft wood radially striate, the parenchyma often with cavities 
lined with snow-white remains of tissue ; odor feeble and unpleasant ; 
taste mucilaginous, sweetish, and somewhat bitter. 

Uses. — It has no marked therapeutic properties, but is said to be 
alterative, diaphoretic, diuretic, and purgative. It is chiefly used as a 
domestic remedy as a decoction prepared by boiling 2 oz. of the recent 
oruised root in three pints of water to two. One pint is taken daily. 
Burdock is employed in obstinate skin diseases, both internally and in 
the form of poultices of the leaves. It is given also in syphilis, scrofula, 
rheumatism, gout, and renal disease. 



814 VEGETABLE MATERIA MEDICA. 

LOBELIACEiE. 

Lobelia, U.S.P. and B.P. Lobelia. — The leaves and tops of 
Lobelia inflata collected after a portion of the capsules have become 
inflated, U.S.P. The dried flowering herb of Lobelia inflata. North 
America, B.P. 

Characters. — U.S.P. Leaves alternate, petiolate, the upper ones 
sessile, ovate or oblong, about 2 inches (5 centimetres) long, irregularly 
toothed, pubescent, pale green; branches hairy, terminating in long 
racemes of small, pale blue flowers, having a superior five-toothed calyx, 
which is inflated in fruit, a two-lipped corolla, and five united stamens ; 
odor slight, irritating; taste mild, afterwards burning and acrid. B.P. 
Stem angular ; leaves alternate, ovate, toothed, somewhat hairy beneath ; 
capsule ovoid, inflated, ten-ribbed. Usually in compressed rectangular 
parcels. 

Composition. — Lobelina, a yellowish liquid with alkaline reaction, 
soluble in water, spirit, and ether, and possessing the poisonous proper- 
ties of the drug ; also an acrid principle, lobelacrin, yielding lobelic acid ; 
resins and a volatile oil are obtained in minute quantities. 

Peepaeations. 

U.S.P. DOSE. 

Acetum Lobelise (in dilute acetic acid 10 per cent.) ^-1 fl. dr. 

Extractum Lobelise Flnidum 1-5 gr. 

Tinctura Lobelise (20 per cent.) £-2 fl. dr. 

B.P. DOSE. 

Tinctura Lobelise (2£ oz. in 1 pint spirit) 10 min. to ? fl. dr. 

Tinctura Lobelise iEtherea (2j oz. in 1 pint spirits of ether)... 10 min. to £ fl. dr. 

or more. 

Physiological Action. — Taken internally it causes a feeling of 
burning in the oesophagus, stomach, and intestines ; vomiting, headache, 
giddiness, and great prostration ; sometimes followed by convulsions and 
coma. Hence its action is very like that of tobacco, only differing in 
the greater intensity of the local burning sensations. It is often used to 
excess by the Coffinites, whose theory is " Heat is life," and most cases 
of poisoning by it are due to its employment by such herbalists. It pro- 
duces death by paralysis of the respiratory centre. Small doses first 
raise and then depress the blood-pressure ; large doses paralyze the 
vaso-motor centre and the peripheral vagi (Attwood). 

Therapeutics. — It is chiefly used as a remedy in spasmodic 
asthma and other affections of air-passages accompanied by dyspnoea, 
e.g., chronic bronchitis with a tendency to spasm of the bronchial muscles. 
Ringer states that larger doses must be used than those given in most 
text-books; he recommends 10 min. every ten minutes while the fit is on. 
In a case of poisoning, evacuate the stomach ; give demulcents and stim- 
ulants. 

ERICACEAE. 

Uva Ursi, U.S.P. Uva Ursi. [Bearberry.] — The leaves of 
Arctostaphylos Uva Ursi. 

Uvae-Ursi Folia, B.P. Bearberry Leaves. — The dried leaves 
of Arctostaphylos Uva- Ursi. From indigenous plants. 



COROLLIFLOK^. 815 

Characters. — Obovate, entire, coriaceous, shining leaves, about 
three-fourths of an inch in length, reticulated beneath ; with a strong 
astringent taste, and a feeble hay-like odor when powdered. 




- Fig. 168.— Uva Ursi. 

Composition. — Tannic and gallic acids and a bitter neutral extractive 
— arbutin — which is soluble in warm water. 
Adulteration. — Red whortleberry leaves. 
Tests. — Leaves not dotted beneath nor toothed on the margin. 

Peepaeations. 
U.S. p. dose. 

Extractum Uvae Ursi Fluidum 30-60 min. 

B.P. DOSE. 

Infusum Uvse-Ursi (1 ounce to 1 pint) 1-2 fl. oz. 

Uses. — Bearberry is an astringent and diuretic. It is chiefly 
used in catarrh of the bladder and of other parts of the genito-urinary 






The utility of the leaves is probably due not to the tannic and gallic 
acids which they contain, but to the arbutin. This substance is partially 
excreted unchanged and part of it is decomposed in the body, yielding 
hydroquinone. The hydroquinone is excreted by the kidneys in com- 
bination with sulphuric acid. Hydroquinone-sulphuric acid is colorless 
and is not poisonous. It may become decomposed in the bladder, and 
the hydroquinone becoming oxidized will give a brown color to the urine 
and impart to it antiseptic and irritant properties, which are useful in 
catarrh of the bladder. The quantity of arbutin, in the infusion, is too 
small to be very useful, and yet if the infusion be made stronger it may 
disagree with the stomach. Pure arbutin is therefore to be preferred, 
and may be given in doses of 4 gr. or more, three or four times a day, 
either in powder or in solution. 

U.S.P. Chimaphila. Chimaphila. [Pipsissewa.] — The leaves 
of CMmapliila umbellata. 

Characters. — About two inches (5 centimetres) long, oblanceolate, 
sharply serrate above, wedge-shaped and nearly entire toward the base ; 
coriaceous, smooth, and dark green on the upper surface. It is nearly 
inodorous, and has an astringent and bitterish taste. 

Officinal Peepaeation. 
u.s.p. DOSE. 

Extractum Chimaphilae Fluidum 1 fl. dr. 

Of Chimaphila 30-60 gr. 

Composition. — It contains tannin and several neutral principles 
found in other Ericaceae. It is astringent and has a diuretic action. 

Use. — It is employed in disorders of the urinary passages and in the 
treatment of rheumatic pains. 



816 VEGETABLE MATERIA MEDICA. 

U.S.P. Oleum Gaultherise. Oil of Gaultheria. — Oil of 
wintergreen, a volatile oil distilled from gaultheria. 

Characters. — A colorless, yellow, or reddish liquid, of a peculiar, 
strong, and aromatic odor, a sweetish, warm, and aromatic taste, and a 
slightly acid reaction. It is readily soluble in alcohol. When heated 
to about 80° C. (176° F.) the oil should not yield a colorless distillate 
having the characteristics of chloroform or of alcohol. On mixing five 
drops of the oil with five drops of nitric acid, the mixture should not 
acquire a deep red color, and should not solidify to a dark red resinous 
mass (absence of oil of sassafras). 

Peepaeatioxs. 

DOSE. 

Spiritus Gaultlieria? (oil 3, spirit 97) 10-20 min. 

Syrupus Sarsaparillae Compositus 

Trochisci Morphias et Ipecacuanhas 

Composition. — Oil of wintergreen consists chiefly of salicylate of 
methyl, which forms about -j^-ths of it, the remaining y^-th being a hydro- 
carbon called gualtherilene. 

Actiox and Use. — It is used on account of its agreeable smell and 
taste to flavor medicines. It is also given as an antipyretic to reduce 
the temperature in rheumatism, its antipyretic action being somewhat 
the same as that of salicylate of soda or salicine. 

SAPOTACEiE. 

Gutta-percha, U.S.P. and B.P. Gutta-percha. — The concrete 
juice of Isonandra gutta. 

Characters and Tests. — In tough, flexible pieces, of a light brown 
or chocolate color. Soluble, or nearly soluble, in chloroform, yielding a 
more or less turbid solution. 

Preparation. 

U.S.P. B.P. 

Liquor Gutta-perchse. Liquor Gutta-percha. 

Use. — Chiefly employed on account of its physical properties for 
making splints, &c. ; also as a temporary stopping for decayed teeth. 
Gutta-percha tissue and similar articles are used to prevent the evapora- 
tion of lotions, and to cover poultices and fomentations. 

STYRACAC.E. 

Benzoinum, U.S.P. and B.P. Bexzoix. — A balsamic resin 
obtained from Styrax Benzoin. Siam and Sumatra. 

Characters. — In lumps, consisting of agglutinated tears, or of a 
brownish mottled mass, with or without white tears embedded in it ; has 
little taste, but an agreeable odor ; gives off, when heated, fumes of benzoic 
acid ; is soluble in rectified spirit and in solution of potash. 

COMPOSITION. — Contains about 14 per cent, of benzoic acid in com- 
bination with several amorphous resins. 

Dose.— 10-30 gr. 



COROLLIFLORJE. 817 

Preparations. 

U.S.P. DOSE. 

Adeps Benzoinatus 

Tinctura Benzoini %-l fl. dr. 

Tinctura Benzoini Composita |-1 fl. dr. 

B.P. DOSE. 

Acidum Benzoicum 10-15 gr. 

Adeps Benzoatus 

Tinctura Benzoini Composita J-l fl. dr. 

Tinctura Benzoini Composita. COMPOUND TINCTURE OF BENZOIN (FEIAES' 

Balsam). — Benzoin, 12; purified aloes, 2; storax, 8; balsam of tolu, 4 ; alcohol up 
to 100, U.S.P. 

Benzoin, 2 oz.; prepared storax, 1^ oz.; balsam of tolu, j oz.; socotrine aloes, 160 
gr.; rectified spirit, 1 pint, B.P. 

Acidum Benzoicum, U.S.P. and B.P. Benzoic Acid, HC 7 

H 5 2 . 

Preparation. — By heating benzoin, when benzoic acid sublimes. 

Properties. — In light, feathery, crystalline plates and needles, which 
are flexible, nearly colorless, and have an agreeable, aromatic odor, 
resembling that of benzoin. It is sparingly soluble in water, but is readily 
dissolved by rectified spirit ; soluble also in solutions of the caustic alkalies 
and of lime. 

Reactions.— When dissolved in solutions of caustic alkalies or of 
lime, it is precipitated from them on the addition of hydrochloric acid, 
unless the solution be very dilute. When heated to 462° F. it passes off 
in vapor, leaving only a slight residue. 

Peepaeations. 

U.S.P. 

Ammonii Benzoas 

Tinctura Opii Camphorata 

B.P. DOSE. 

Ammonia? Benzoas 10-20 gr. 

Tinctura Camphoras Composita 15 min. to 1 fl. dr. 

Tinctura Opii Ammoniata %-l fl. dr. 

Ammonia* Benzoas, U.S.P. and B.P. BENZOATE OF AMMONIA. NH 4 C 7 H 5 C 2 ; 139 
(cf. p. 635). 

Peepaeation. — By dissolving benzoic acid in a slight excess of ammonia, 
evaporating, and crystallizing. 

HC 7 H 5 2 + NH 4 HO = NH 4 C 7 H 5 2 + H 2 0. 

Peopeeties. — In colorless, laminar crystals ; soluble in water and in alcohol. 

Reactions. — It gives a bulky, yellowish precipitate withpersalts of iron (benzo- 
ate). Its aqueous solution, when heated with caustic potash, evolves ammonia, and, 
if it be not too dilute, when acidulated with hydrochloric acid, it gives a deposit of 
benzoic acid. 

Impurities. — Fixed salts. 

Test. — When heated it sublimes without any residue. 

Physiological Action. — Benzoic acid is a stimulant and irritant 
to raw surfaces. It has an antiseptic action, destroying low organisms, 
and is used in the form of the tincture for ulcers, wounds, blisters, and 
chapped hands. It was owing to its antiseptic action that Friars' Balsam 
was successfully used for the treatment of wounds in the Middle Ages, 
although at that time its mode of action was unknown (p. 106). 
52 



818 VEGETABLE MATERIA MEDICA. 

It acts as a stimulating expectorant, diminishing the secretion of 
the mucous membrane. 

Benzoic acid, when absorbed into the blood, is excreted by the kidneys, 
and acts as a diuretic. It does not diminish the uric acid. In the 
kidneys it unites with glycocoll, and is excreted as hippuric acid, render- 
ing the urine acid and somewhat irritating. This is proved by the fol- 
lowing experiments : — 

(1) If you give benzoic acid it is found in the urine as hippuric acid, 
but in the blood still remains as benzoic acid. 

(2) If you give to a rabbit hippuric acid, it is excreted as such, but 
is found in the blood as benzoic acid. 

(3) If you tie the renal arteries and give benzoic acid, no conversion 
into hippuric acid takes place, but if you ligature the ureters the change 
takes place, and hippuric acid is found in the blood. This localizes the 
seat of the change to the kidneys. 

Therapeutics. — It is used in chronic bronchitis and phthisis, both 
internally and as an inhalation, and extraordinary results have been 
ascribed to its uses ; many, however, deny its beneficial effect. It is used 
in catarrh of the bladder to acidify the urine, and the compound tincture 
has been used in urticaria. Ammonium benzoate has a similar action to 
benzoic acid. 

VERBEISTACEJE. 

Iiippia Mexicana. Not officinal. — An evergreen creeping shrub 
growing in Mexico. The parts used are the leaves and flowers. 

Composition. — It contains a volatile oil — lippiol — a camphor-like 
body, and a substance allied to quercitin. 

Action. — Lippiol in doses of 3 gr. (0-2 Gm.) caused in a cat within 
half an hour slight dilatation of the pupil and nictitation (probably due 
to gastro-enteric irritation, p. 198). A repetition of the dose caused 
vomiting, restlessness, and sleep lasting for two hours. In doses of 4J 
gr. (0*3 Gm.) it causes warmth, flushing, diaphoresis, and drowsiness 
(Podwissotzki). 

Uses. — As a respiratory sedative in cough. Given as tincture in 
doses of §-1 fl. drm. 

OL.EACEJE. 

Oleum Olivae, U.S.P. and B.P. Olive Oil. — A fixed oil 
expressed from the ripe fruit of Olea europcea, U.S.P. The oil expressed 
in the South of Europe from the ripe fruit of Olea europcea, B.P. 

Characters. — Pale yellow, with scarcely any odor, and a bland, 
oleaginous taste ; congeals partially at about 36°. Specific gravity about 
0-916 at 63°. 

Composition. — Olein, the liquid principle of the oil, and the quantity 
of which determines its excellence. It also contains palmitin and other 
fatty compounds. 

Adulteration. — Other, and usually heavier, oils fraudulently added. 

Tests. — Specific gravity. Olive oil when treated with sulphuric 
acid evolves a small amount of heat compared with other similar oils. 



COROLLIFLOE.E. 819 

PEEPA RATIONS. 
U.S.P. 

Emplastrum Plumbi. Emplastrum Ferri. 

" Kesinae. " Galbani. 

" Ammoniaci cum Hydrargyro. Hydrargyri. 

" Arnicae. " Opii. 

" Asafoetidas. " Saponis. 

" Belladonnas. Unguentum Diachylon. 

" Capsici. 

B.P. 

Charta Epispastica. Linimentum Ammoniae. 

Cataplasmi Lini. " Calcis. 

Emplastrum Ammoniaci cum Hydrargyro. Camphorse. 

Cerati Saponis. Unguentum Cantharidis. 

" Hydrargyri. " Hydrargyri Compositum . 

" Picis. " Hydrargyri Nitratis. 

" Plumbi. " Veratrise. 

Enema Magnesias Sulphatis. 

Dose. — Of olive oil, 1 fl. dr. to 1 fl. oz. or more, as a demulcent or 
laxative; of hard soap or soft soap, as an antacid, &c, 5-20 gr. ; of 
glycerine, J-2 fl. dr. 

Uses. — Lead plaster is the basis of many of the plasters ; it is a 
good protective to prevent abrasions. Diachylon ointment is very 
useful in the treatment of eczema and other skin diseases. 

Sapo, U.S.P. Soap. Sapo Durus, B.P. Hard Soap. — Soap 
made with olive oil and soda. 

Characters. — Grayish- white, dry, inodorous ; horny and pulveriz- 
able when kept in dry, warm air ; easily moulded when heated ; soluble 
in rectified spirit ; not imparting an oily stain to paper. Incinerated it 
yields an ash which does not deliquesce. 

Peepabations. 

U.S.P. 

Emplastrum Saponis. Pilulse Aleos et Asafcetidse. 
Linimentum " " Asafcetidae. 

Linimentum Chloroformi. " Opii. 

Pilulse Aloes. " Khei. 

B.P. 

Emplastrum Kesinae. Pilula Aloes et Assafoetidse. 
Emplastrum Saponis. " " Socotrinae. 

Extractum Colocynthidis Compositum. " Cambogiae Composita. 

Linimentum Potassii Iodidi cum Sapone. " Ehei Composita. 

Linimentum Saponis. Pilula Saponis Composita (p. 709). 

Pilula Aloes Barbadensis. Pilula Scillae Composita. 

Sapo Viridis, U.S.P. Green Soap. Sapo Mollis, B.P. Soft 
Soap. — Soap prepared from potassa and fixed oils, U.S.P. Soap made 
with olive oil and potash, B.P. 

Characters. — Yellowish-green, inodorous, of a gelatinous consist- 
ence. Soluble in rectified spirit ; not imparting an oily stain to paper. 
Incinerated it yields an ash which is very deliquescent. 

Peepaeations. 

U.S.P. B.P. 

Tinctura Saponis Viridis (green Linimentum Terebinthinae. 

soap, 65 ; oil of lavender, 2 ; 
alcohol, up to 100). 



820 VEGETABLE MATERIA MEDICA. 

Uses. — Soft soap is more alkaline than the hard ; if too long applied 
it may be a decided irritant to the skin. Tincture of soft soap is an 
elegant form of alkaline preparation for certain cutaneous diseases. 

Glyceriimm, U.S.P. and B.P. Glycerin - , U.S. P. Glycerine, 
B.P. — A sweet principle, C 3 H 5 (HO) 3 ; 92. Obtained from fats and fixed 
oils, and containing a small percentage of water (not less than 95 per 
cent, of absolute glycerin, U.S. P.). 

Characters. — A clear, colorless fluid, oily to the touch, without 
odor, of a sweet taste ; freely soluble in water and in alcohol. When 
decomposed by heat it evolves intensely irritating vapors. Specific 
gravity 1*25. 

Peepaeations (vide p. 437). 
r.s.p. 
Glyceritum Aniyli. Glyceritum Vitelli. 

Mucilago Tragacanthae. 

B.P. 

Glycerinum Acidi Carbolici. Glycerinum Amyli. 

" " Gallici. " Boracis. 

" " Tannici. Linimentuin Potassii Iodidi cum Sapone. 

Dose.— J-2 fl. dr. 

Action and Uses. — Olive oil is used externally in the form of lini- 
ments as a lubricating- substance ; internally as a demulcent in cases 
of irritant poisoning except by phosphorus. In large doses it is slightly 
laxative, as in oily salads. 

Soap is used chiefly as a detergent, and for its mechanical effect, 
in pills, and as an adjunct in suppositories. A small piece of soap cut 
into a conical form and used as a suppository is very useful in constipation 
occurring in infants. Soap and water forms a useful enema for consti- 
pation in adults. 

Glycerin acts as a laxative, and when used along with castor oil 
increases its power. It is largely destroyed in the system, has an influ- 
ence on nutrition, and has been proposed as a substitute for cod liver oil, 
but without much benefit. Very large doses cause a red coloration in the 
urine, due to the coloring matter of the blood, without any free corpuscles. 

It is used as a laxative in haemorrhoids ; as a solvent of other 
drugs, as borax, tannic acid; as an emollient to soften the hands and 
applied to sore nipples, fissure of the tongue in advanced phthisis, croup, 
laryngitis, etc. It has been painted on in eczema, psoriasis, pruritus ; 
also as a preventive of bed sores. It must be diluted with water or it 
will irritate the part. It has been proposed as a substitute for sugar in 
diabetes. 

Manna, U.S.P. and B.P. Manna. — A concrete saccharine exu- 
dation from the stem of Fraxinus ornus and F. rotundifolia. The con- 
crete saccharine exudation of F. ornus, U.S.P. Obtained by making 
incisions in the stems of the trees, which are cultivated for the purpose, 
chiefly in Calabria and Sicily, B.P. 

Characters. — In stalactiform pieces from one to six inches in 
length, and one or two inches in width, uneven, porous, and friable, 
curved on one side, of a yellowish-white color. 

Dose. — 60 grains to 1 ounce. 



COKOLLIFLOILE. 821 

Peepaeation. 
u.s.p. dose. b.p. 

Infusum Sennae Compositum 2J fl. oz. None. 

Composition. — It consists principally of mannite, C 6 H 7 6 or C 3 H 7 3 , 
together with common sugar and extractive matter. The mannite, which 
forms from 60 to 80 per cent, of the manna, may be extracted by means 
of boiling rectified spirit, from which it will afterwards separate on cooling 
in colorless, shining crystals. It requires five parts of cold water for its 
solution, and this does not undergo vinous fermentation in contact with 
yeast, thus distinguished from grape sugar. 

Use. — Manna is used as a simple laxative. 

L.OGANIACE^]. 

Nux "Vomica. Nux Vomica. — The seeds of Strychnos Nux Vomica. 
Imported from the East Indies. 

Characters. — Nearly circular and flat, about an inch in diameter, 
umbilicated and slightly convex on one side ; externally of an ash-gray 
color, thickly covered; with short, satiny hairs ; internally translucent, 
tough, and horny ; taste intensely bitter ; inodorous. The seeds to be 
pulverized, must be heated by steam and dried. 

Composition. — Two alkaloids, strychnine and brucine. The former 
is much less soluble in boiling water than the latter, and differs further 
in not being colored by nitric acid, with which brucine gives a brilliant 
red. Both alkaloids are found combined with strychnic or igasuric acid 
— similar to malic acid. 

Peep a rations. 

U.S.P. DOSE. 

Abstraction Nucis Vomicae \ gr. 

Extractum Nucis Vomicae ^-1 gr. 

Extractum Nucis Vomicae Fluidum 1-5 min. 

Strychnina sVtV gr- 

Tinctura Nucis Vomicae 10-20 min. 

B.P. DOSE. 

Extractum Nucis Vomicae J-2 gr. 

Strychnia sVtV g r - 

Tinctura Nucis Vomicae 10-20 min. 

(of the powdered seed) 2-5 grs. 

U.S.P. Ig-natia. Ignatia. Bean of St. Ignatius. — The seed 
of Strychnos Ignatii. 

Characters. — About an inch and a fifth (3 centimetres) long, 
oblong or ovate, irregularly angular, dull brownish or blackish, very 
hard, horny ; fracture granular, irregular ; the albumen somewhat trans- 
lucent, inclosing an irregular cavity with an oblong embryo ; inodorous ; 
very bitter. 

Officinal Peepaeations. 

DOSE. 

Abstractum Ignatiae 1 gr. 

Tincturae Ignatiae 15 min.-l fl. dr. 

Composition. — Its activity depends on its contained brucine and 
strychnine. 



822 VEGETABLE MATERIA MEDICA. 

Strychnina. Strychnine. U.S.P. Strychnia. Strychnia. B.P. 
— C 21 H 22 N 2 2 ; 334. — An alkaloid prepared from Kux Vomica or 
Ignatia, and also occurring in other plants of the Nat. Ord. Loganiacese, 
U.S.P. An alkaloid prepared from Nux Vomica, B.P. 

U.S.P. Strychninae Sulphas. Sulphate of^Strychnine. 

Preparation. — Softening the tough seeds by steam, chopping, dry- 
ing, and grinding them. Exhausting powdered seeds with rectified 
spirit, which is recovered by distillation. Precipitating coloring matter 
and acids by acetate of lead. Precipitating strychnine and brucine from 
concentrated solution by ammonia. Dissolving precipitate in rectified 
spirit and crystallizing out strychnine from concentrated solution. The 
brucine being more soluble remains in the mother liquor. The strych- 
nine is purified by washing and boiling with rectified spirit. 

Impurity. — Brucine from imperfect preparation, and mineral matter. 

Characters. — In right square octahedrons or prisms, colorless and 
inodorous ; sparingly soluble in water, but communicating to it its 
intensely bitter taste ; soluble in boiling rectified spirit and in chloroform, 
but not in absolute alcohol or in ether. Pure sulphuric acid forms with 
it a colorless solution, which, on the addition of bichromate of potash, 
acquires an intensely violet hue, speedily passing through red to yellow. 
A very active poison. 

Tests. — Not colored by nitric acid (no brucine), leaves no ash when 
burned with free access of air (no mineral matter). 

Peepaeatioxs. 
u.s.p. dose. 

Ferri et Strychninae Citras 1-3 gr. 

Syrupus Ferri Quininae et Strychninse Phosphatum (p. 639).... 1-2 fl. dr. 

B.P. dose. 

Liquor strychnine (4 gr. in 1 fl. oz. , with 6 min. dilute hydro- 
chloric acid, and 2 fl. drm. of spirit to keep it in solution). .5-10 min. 

Physiological Action. — Strychnine added to water containing low 
organisms in small doses, increases their activity ; in large doses it les- 
sens it. The drug lessens oxidation of protoplasm and oxidation taking 
place in the blood ; it also lessens fermentation, but its action on it is 
not nearly so great as might be expected from its powerful action on 
higher organisms (pp. 72, 75, 79, 82, 93). 

General Action. — The most marked feature in the general action 
of strychnine is the great increase which it produces in the reflex 
excitability of the spinal cord and other reflex nerve centres, such as 
vaso-motor and respiratory centres. When the dose is large this increase 
is so great as to cause convulsions and death. 

Taken in small doses strychnine gives rise to a bitter taste and 
increases the appetite ; sometimes also it increases the peristaltic move- 
ments of the intestines, and lessens constipation. When taken in 
small doses for a long time the drug produces increased sensibility of the 
sensory nerves, so that impressions are felt more acutely and are of 
longer duration, and the sense of touch is rendered more acute; the 
field of vision is increased and distant objects are rendered more distinct ; 



COKOLLIFLOKJE. 823 

the sense of hearing is also sharpened (pp. 204, 205, and 206). Taken 
in larger doses the drug produces increased sensibility more markedly, 
and excites sexual desire. If pushed still further the drug causes malaise, 
anxiety, restlessness ; twitchings of the muscles, stiffness of the neck 
and convulsions. 

After a dose of half a grain of strychnine, symptoms of poisoning- 
appear in a period varying from five minutes to five hours, coming on 
without vomiting or any other warning, the first symptom being general 
convulsions ; the teeth are clenched, the pupils dilated, and the body 
forced into the opisthotonic position, resting on the head and feet, with 
the hands clenched and the arms drawn tightly towards the body; the 
spasms last from half to one minute, followed by a period of relaxation, 
during which sensibility to reflex stimuli is enormously increased, the 
slightest stimulus, such as a draught of cold air, bringing on a fresh 
attack of spasms. Death results either from asphyxia occurring during 
a spasm, or from paralysis and collapse coming on during a period of 
relaxation. The diagnosis between convulsions occasioned by strych- 
nine and ordinary tetanus depends (1) on the history of the case, and 
(2) on the fact that the spasms of tetanus are tonic, whilst those of 
strychnine poisoning are clonic. In tetanus, too, the muscles of the jaw 
are first affected, hence the term lock-jaw, whilst in strychnine convul- 
sions these muscles are not affected before others. 

The treatment of strychnine poisoning consists in evacuating the 
stomach, if possible before the convulsions begin, but if this cannot be 
done, chloroform must be given and the stomach washed out whilst the 
patient is under the influence of the anaesthetic ; and lastly, chloral should 
be given by subcutaneous injection. 

Special Action. — On the Alimentary Canal. — Strychnine pro- 
duces by its bitter taste an increased flow of saliva ; it also increases the 
peristaltic action of the bowels. 

On the Blood. — When mixed with the blood it lessens oxidation 
to a slight extent, but probably it has little action on oxidation in the 
living body from the small doses which can alone be used. 

On the Circulation. — It increases the blood-pressure. This is 
due to several causes. (1) It stimulates the vaso-motor centre 
directly, or else greatly increases its excitability to the ordinary stimuli 
it receives even when the dose is too small to produce convulsions. When 
these occur, other factors help to increase the pressure. (2) The vaso- 
motor centre during the convulsions is stimulated indirectly by the action 
of the carbon dioxide of the venous blood, which accumulates during the 
asphyxia caused by the convulsions. (3) The violent muscular contrac- 
tions during the convulsions increase the resistance to the flow of blood 
through the arteries and capillaries. 

After section of the cord in a normal animal, stimulation of a sen- 
sory nerve no longer produces vaso-motor spasm, but in an animal 
poisoned with strychnine it does. The explanation of this is that strych- 
nine increases the excitability of the vaso-motor centre to such an extent 
that that portion of it which is in the cord becomes able to take on 
to a great extent the normal functions of the whole centre (pp. 251 
and 252). 



824 VEGETABLE MATERIA MEDICA. 

The medicinal use of strychnine is said to cause in some cases fits 
resembling those of tertian ague. 1 It is not improbable that these are 
true ague fits, due to malaria, the action of which has been aided by that 
of strychnine on the vaso-motor centre (cf. p. 252, and action of opium, 
p. 725). 

The heart is stimulated, but during the convulsions it is slowed in 
the frog. In mammals it is quickened during the spasms, but if curare 
be previously given it is slowed. 

Strychnine stimulates the motor ganglia of the heart, for Dr. Cash 
and I found that when a frog is under the action of strychnine a ligature 
placed between the sinus venosus and auricle did not stop the auricle and 
ventricle as in Stannius' experiment (p. 282) ; and if this experiment has 
already been performed, strychnine injected into the interior of the ven- 
tricle causes the auricle and ventricle to recommence beating (St, Bar- 
tholomew's Hospital Reports, vol. xvi.). The action of strychnine on the 
motor centre in the heart is probably similar to its action on the vaso- 
motor and respiratory centres. 

Respiration is quickened and rendered more deep, owing to stimu- 
lation of the respiratory centre, just as in the case of the vaso-motor 
centre the spinal part of the respiratory centre is rendered so active ; if 
strychnine be given to an animal and the cord be divided below the 
medulla, respiration is not entirely arrested as it usually is, and if strych- 
nine be given to an animal after division of the cord, respiration will 
recommence (p. 211). 

On the Muscles. — These are but little affected directly, but indi- 
rectly they become greatly exhausted by the wear and tear due to the 
convulsions. After death they quickly enter into rigor mortis. 

Nervous System. — The sensory nerves are so stimulated that the 
slightest impression is most distinctly felt; the action of the drug has 
not been shown to be on the nerves themselves, but probably is due to 
stimulation of the nerve centres (pp. 204, 205, and 206). Small doses 
do not affect the motor nerves, large doses paralyze them. This 
paralysis is partly due to exhaustion from the convulsions, but not 
entirely, since if one sciatic nerve of a frog be divided before poisoning, 
so as to prevent any convulsions in the corresponding limb it still loses 
its irritability, though not so soon as the undivided nerve. 

On the Brain. — Small doses increase the mental powers and 
sharpen the senses. Large doses cause anxiety and malaise, but the 
functions of the cerebrum continue until death ; the mind remaining 
clear to the last. The convulsions are not cerebral (p. 165). 

On the Spinal Cord. — The spinal cord is greatly stimulated, so 
that a slight stimulus through a sensory nerve produces not merely 
increased reflex action, but by increasing the diffusion or " radiation " of 
impulses causes general convulsions. This action of strychnia has been 
supposed to be due to increased excitability of the nerve cells in the spinal 
cord, but is more probably caused by an alteration in the comparative 
rate of transmission of stimuli from one cell to another (pp. 150 and 
160). The convulsant action of strychnine was first localized to the 

1 Lewin, Nebenwirkungen der Arzneimitlel, p. 50. 



COEOLLIFLOR^. 825 

spinal cord by the experiments of Magendie, as already described 
(p. 165). 

Strychnine acts more powerfully when injected into the rectum than 
when swallowed, contrary to the general rule. 

Brucine, thebaine, and some other opium alkaloids act in the 
same way as strychnine. ■ 

The effect of brucine in producing convulsions has been said to depend 
on admixture with strychnine. Mr. Shenstone prepared some pure 
brucine, and in experiments with this I have found it cause convulsions 
and death in rabbits when injected subcutaneously. It appears to be 
both less powerful than strychnine, and to be eliminated more rapidly, 
for when given tb rats as a paste with butter it caused no symptoms 
whatever. 

Methyl-strychniue, methyl-brucine, and methyl-thebaine do not 
affect the cord, but paralyze the ends of the motor nerves like curare. 

Therapeutics. — Strychnine is one of the best gastric tonics in dys- 
pepsia when there is a tendency to catarrh and congestion. It probably 
acts by perfecting co-ordination between the various functions of the 
parts concerned in the processes of digestion and assimilation. It prob- 
ably also increases the movements of the stomach and gives tone to the 
gastric vessels, and thus relieves congestion of the stomach due to bron- 
chitis, cirrhosis, and cardiac disease (p. 321). As a tonic it is very 
useful during convalescence from acute diseases, in anoeniia, in dyspepsia 
due to indigestible articles of diet or excess of alcoholic stimulants ; also 
in "sick headache" in doses of 1 TTL of tinct. nux vom. in a teaspoonful 
of water every ten minutes (Ringer). 

In doses of 10 min. before meals I have found it prevent frontal 
headache in persons liable to it. 

It also gives contractile power to the intestines and is used as an 
adjunct to purgative pills. A very good dinner pill is Pil. Rhei Co. gr. 
iv. Pulv. Ipec. \ gr. Ext. Nux Vom. \ gr. ; given before dinner. A few 
drops of tincture of nux vomica just before dinner both increase the 
appetite and tend to lessen habitual constipation. In dilated heart it is 
useful, as a cardiac tonic. It is useful as a respiratory stimulant in 
bronchitis, especially when there is a tendency to failure of respiration. 

The night sweats of phthisis are usually checked by taking 10 m. of 
tinct. nux vom. at bed time. The probable mode of action has already 
been discussed (p. 382). It may also increase the cough during the day. 

In depression due to mental overwork it is very valuable, as it increases 
the mental powers, but we must be cautious not to give it for too long a 
time. One of the chief dangers of giving it to overworked men is that 
it increases their powers temporarily and they are tempted to overwork 
themselves still more. 

In some forms of paralysis (hemiplegia, paraplegia, wrist-drop), except 
where there still exist symptoms of irritation, it is serviceable ; it is also 
useful in some forms of local paralysis, as atony of the bladder. 

In sexual debility it is often serviceable. Its marked aphrodisiac 
action is sometimes inconvenient, and interferes with its use as a tonic 
(p. 388). In some cases where debility is associated with sexual excess, 
strychnine increases instead of diminishing the weakness, and in such 



826 VEGETABLE MATERIA MEDICA. 

cases bromide of potassium should be employed. It has been used in 
hysteria and chorea with low spirits. It is a cumulative poison, as it 
contracts the renal arteries and thus prevents its own excretion (p. 57). 

Curare. Not officinal. Synonyms — Curara, Woorari, Wourali, 
Urari, T19UNAS. 

This substance appears to be an extract from a species of strychnos 
mixed with some mucilaginous juice. 

Characters. — A black extractiform body, readily soluble in water. 

Composition. — It contains an alkaloid, curarine. 

Action. — It paralyzes the peripheral ends of motor nerves even 
when given in very minute doses (p. 140). Larger doses paralyze the 
vag-us and the ends of sensory nerves. As poisoning progresses, the 
spinal cord is paralyzed, and finally the heart. Voluntary muscles 
appear to be little affected, yet their contractility is somewhat diminished, 
and this diminution begins even before the motor nerves themselves are 
paralyzed. The vessels of the surface become dilated, and sometimes a 
peculiar erythematous rash appears on the skin in dogs. The "blood- 
pressure is little affected by small doses, but is much lowered by large 
ones. When injected into the salivary gland it causes intense salivation 
which appears to be paralytic (p. 313). In men who have been slightly 
poisoned by it, it has produced increased secretion of the sweat, tears, 
nasal mucus, saliva, and urine, with a feeling of weariness and disinclina- 
tion to move. Large doses produce death by paralysis of the muscles 
of respiration, but the motor nerves of the extremities being paralyzed, 
no convulsions occur. Although the motor nerves are paralyzed to such 
an extent that they will not excite muscular contractions, even when the 
nerve centres are powerfully stimulated by asphyxial blood, they still 
cause muscular contractions when irritated by an interrupted current in 
a warm-blooded animal poisoned by curare. In frogs the poisoning may 
be so complete that no irritation of the trunk of a nerve will excite con- 
traction in the muscles supplied by it. Curare is rapidly eliminated 
by the kidneys, and if artificial respiration be kept up, complete recovery 
occurs. I have succeeded in restoring an animal completely by this 
means after it had been apparently dead for four hours. When given 
internally, curare is so rapidly eliminated that it usually produces no 
symptoms. When given in a very large dose on an empty stomach, 
symptoms of poisoning may occur. If elimination be prevented by 
excision of the kidneys or ligature of the renal vessels, poisoning occurs, 
and in this case death is usually preceded by convulsions. So rapidly 
does elimination occur, that the urine of a frog poisoned by curare will 
paralyze a second frog injected subcutaneously, and the urine of a second 
will even paralyze a third. 

Uses. — It has been employed, but without much benefit, in epilepsy 
and chorea, and has been used with success in traumatic tetanus. In 
poisoning by strychnine it is not so useful as chloral. A case of hydro- 
phobia has been described by Offenburg, in which the subcutaneous 
injection of curare to such an extent as to keep the patient almost, though 
not quite, paralyzed for some time, effected a cure. If this were really 
so it would be most important, but, from a comparison of the symptoms 
described by Offenburg with those of three fatal cases I have myself 



COROLLIFLOR.E. 827 

seen, I am inclined to think that his case was one of hysteria mimicking 
hydrophobia. 

U.S.P. Gelsemium. Gelsemium. Yellow Jasmine. — The 
rhizome and rootlets of G-elsemium sempervirens. 

Characters. — Cylindrical, long, or cut in sections, occasionally an 
inch and a quarter (3 centimetres) thick, the roots much thinner; 
externally light brown-yellow, with purplish-brown longitudinal lines, 
tough, fracture splintery ; bark thin, with silky bast-fibres, closely 
adhering to the pale, yellowish, porous wood, having fine medullary rays, 
and in the rhizome a thin pith ; odor aromatic, heavy ; taste bitter. 

Composition. — It contains an alkaloid, gelsemine. 

U.S.P. Preparations. 

DOSE. 

Extractum Gelsemii Fhridum 5-20 min. ('30-1 "20 c.c.) 

Tinctura Gelsemii f-2£ fl. dr. (2-18 c.c.) 

Action. — When applied to the eye it produces dilatation of the pupil 
and paralysis of accommodation. It appears to paralyze the sensory 
columns of the spinal cord, while it excites the motor centres both 
in the brain and cord. The motor centres themselves become paralyzed 
subsequently. This action causes in frogs paralysis, which is at first 
accompanied by increased reflex excitability, so that irritation gives rise 
to tremor or tetanus. Afterwards the reflex excitability completely 
disappears. In mammals a peculiar affection of the head is noticed, 
consisting in spasmodic attacks of tremor. The tremor affects the fore 
feet also, and sometimes the hind legs. A kind of ataxia is also observed 
in the fore legs, which sometimes slip about and sometimes make abnormal 
running movements. This is succeeded by paralysis of the voluntary 
muscles and of respiration. The vag-us is paralyzed, the blood-pressure 
is diminished, the pulse rapid, and the heart weak. Death occurs 
from paralysis of the respiration. In man large doses have caused 
giddiness, double vision, numbness of the fingers, tremor of the head, 
difficult respiration, nausea, vomiting, and partial paralysis of the tongue 
and eyes, so that ptosis occurs, and difficulty is felt in moving the eyes 
or tongue. 

Use. — It is chiefly used in cases of neuralgia of the fifth nerve, in 
toothache, sick headache and in rheumatism. 

U.S.P. Spig-elia. Spigelia. Pinkroot. Maryland Pink. 
Carolina Pink. — The rhizome and rootlets of Spigelia marilandica. 

Characters. — Rhizome two inches (5 centimetres) or more long, 
about one-eighth of an inch (3 millimetres) thick, horizontal, bent, some- 
what branched, on the upper side with cup-shaped scars ; on the lower 
side with numerous thin, brittle rootlets, about four inches (10 centi- 
metres) long; dark purplish-brown; somewhat aromatic, sweetish and 
bitter. 

It should not be confounded with the underground portion of Phlox 
Carolina, the rootlets of which are brownish-yellow, rather coarse, 
straight, and contain a straw-colored wood underneath a readily remov- 
able bark 



828 VEGETABLE MATERIA MEDICA. 

Peepaeation. 

DOSE. 

Extractuni Spigelise Fluidum 10-20 min. 

Use. — It is very generally used as an anthelmintic, and is best 
given with a cathartic, as senna. 

APOCYNACE^E. 

U.S. P. Apocynum. Apocynum. Canadian Hemp. — The root 
of Apocynum cannabinum. 

Characters. — Long, cylindrical, somewhat branched, one-fourth to 
one-third of an inch (6 to 8 millimetres) thick, pale brown, longitudinally 
wrinkled and transversely fissured; brittle, fracture short, white; the 
bark rather thick ; the wood porous, spongy, with delicate, medullary rays 
and a thin pith; inodorous; taste bitter, disagreeable. 

Dose. — 15-30 gr. (1-1*95 Gm.) of powdered root. A decoction is 
more convenient. It is made by boiling J oz. in 1J- pint of water to 1 
pint. Of this 1-2 fl. oz. (30-60 c.c.) may be given twice or thrice a day. 

Composition. — It contains an amorphous substance — apocynin — 
easily soluble in alcohol, but insoluble in water, and a glucoside — 
apocynein — easily soluble in water. 

Action. — In small doses it is laxative, in large doses emetic and 
cathartic. Apocynin and apocynein act on the heart as cardiac tonics- 
like digitalis, and are also diuretic. 

Use. — It is chiefly used in dropsy. 

Quebracho Cortex. White Quebracho Bark. Not officinal. — 
The bark of Aspidospermo quebracho. Imported from the Argentine 
Republic. 

Characters. — In large pieces, about three-quarters of an inch thick, 
grayish-brown outside, yellowish inside, intensely bitter. It contains 
several alkaloids, the most important being aspidospermine. 

Peepaeation. 

DOSE. 

Tinctura Quebracho (1 in 5 of proof spirit) £-1 fl. drm. 

Action. — In frogs all the alkaloids produce motor paralysis, weaken, 
and finally arrest the respiratory movements and heart. In warm- 
blooded animals aspidospermine paralyzes voluntary movement, the respi- 
ration and the heart. In small doses aspidospermine increases the fulness 
and frequency of the respiration. 

Uses. — It has been used to lessen dyspnoea in astlinia and phthisis. 

ASCLEPIADACEiE. 

I'.s.P. Asclepias. Asclepias. Pleurisy Root. — The root of 
Asclejnas tuberosa. 

Characters. — Root large and fusiform, dried in longitudinal or 
transverse sections ; from one to six inches (25 to 150 millimetres) long, 
and about three-quarters of an inch (two centimetres) or more in thick- 
ness; the head knotty, and slightly but distinctly annulate, the remainder 



COEOLLIFLOK^. 829 

longitudinally wrinkled; externally orange-brown, internally whitish; 
tough and having an uneven fracture; bark thin, and in two distinct 
layers, the inner one whitish ; wood yellowish, with large, white medullary 
rays; it is inodorous, and has a bitterish, somewhat acrid taste; when 
long kept it acquires a gray color. 

Composition. — It contains resins and an odorous fatty matter. 

Dose.— 20-60 grs. 

Use. — It may be used as a diaphoretic or expectorant. In large 
doses it acts as an emetic and purgative. 

Asclepias Incarnata. White Indian Hemp. Not officinal. — 
America. The root appears to act like digitalis, strengthening the 
beats of the heart, and producing diuresis. A fluid extract has been 
used in doses of J— 1 fl. drm. every three hours. 




Fig. 169. — Heruidesnius. 

B.P. Hemidesmi Radix. Hemidesmus Root. — The dried root 
of Hemidesmus indieus, Indian sarsaparilla. India. 

Characters. — Yellowish-brown, cylindrical, tortuous, furrowed and 
with annular cracks; having a fragrant odor and a very agreeable 
flavor. 

Composition. — The chemical constituents of the root have not yet 
been fully investigated. A substance supposed to be a volatile acid has 
been separated by distillation with water. 

Prepabation. 

B.P. DOSE. 

Syrupus Hemidesmi (1 to 10| ounces) 1-2 fl. dr. 

Use. — Hemidesmus is supposed to have the same action as sarsa- 
parilla, (q.v.) and is used in rheumatism and syphilis. The syrup is of 
little use except for flavoring. 

Condurang-o. Not officinal. — The bark of Gfonolobus Oundurango, 
from Ecuador. It is said, however, that there are several species of 
plants yielding a bark known by the name Condurango. 

Characters. — Condurango is a climbing plant ; the bark is gener- 
ally of a grayish color outside, with a few adherent lichens, and occurs 
in thin, curled pieces. 

Action. — It does not seem to have any definite physiological action. 
It has been stated by Gianuzzi to produce tetanus like strychnine. I 
found that an infusion injected into the jugular vein caused convulsions 
and death, but this appeared to be really due to embolism of the pul- 
monary vessels by fine particles suspended in fluid, for when injected into 
the peritoneal cavity the solution has no action. 

Uses. — It has been recommended as a remedy in cancer, but is useless 
in this disease. It has been found beneficial, however, in cases of 
dyspepsia, and has been given also as an alterative in syphilis. 



830 VEGETABLE MATERIA MEDICA, 

GENTIAXACEJE. 

Gentiana, U.S. P.; Gentianse Radix, B.P. Gentian, U.S.P; 
Gentian Root, B.P. — The dried root of G-entiana lutea. Mountainous 
districts of Central and South Europe. 




'%£m 



Fig. 170.— Gentian. 

Characters. — From half an inch to one inch in thickness, several 
inches in length, often twisted, much wrinkled, or marked with close 
transverse rings ; brown externally, yellow within ; tough and spongy ; 
taste at first sweetish, afterwards very bitter. > 

Composition. — Gentio-picrin, from which the root derives its bitter 
taste ; it is soluble in water. Also gentianin, which is tasteless and only 
slightly soluble in water. 

Peepaeations. 
u.s.p. DOSE. 

Extractum Gentianse 2-10 gr. 

Extractum Gentianse Fluidum 8-30 min. 

Tinctura Gentianse Composita 1-4 fl. dr. 

B.P. DOSE. 

Extractum Gentianse 2-10 gr. 

Tnfusum Gentianse Compositum 1-2 fl. oz. 

Mistura Gentianse \-l fl. oz. 

Tinctura Gentianse Composita |-1 fl. dr. 

B.P. Infusum Gentianae Compositum.— Eoot, 60 gr. ; bitter orange peel, 60 gr. ; 
fresh lemon peel, \ oz.; and boiling water, 10 fl. oz. 

B.P. Mistura Gentianse.— Root, \ oz.; bitter orange peel, 30 gr.; coriander, 30 gr. ; 
proof spirit, 2 fl. oz. ; and water, 8 fl. oz. By maceration, first in spirit, and afterwards 
in spirit and water. 

Tinctura Gentianae Composita.— Gentian, 8 ; bitter orange peel, 4 ; cardamom, 2 ; 
diluted alcohol up to 100, U.S.P. Root, 1£ oz.; bitter orange peel, f oz.; cardamoms, 
\ oz.; proof spirit, 20 fl. oz., B.P. 

Use. — Gentian is a simple, bitter stomachic tonic. It is used in 
atonic dyspepsia to give tone to the stomach and increase the appetite. 
Also used as a general tonic. 

Chirata, U.S.P. and B.P. — Chiretta. — The entire plant, Ophelia 
chirata. Northern India. 

Characters. — Stems about three feet long, of the thickness of a 
goose-quill, round, smooth, pale brown, branched ; branches opposite ; 
flowers small, numerous, panicled; the whole plant intensely bitter. 

Composition. — Ophelic acid, soluble in water and forming a soluble 
compound with tannic acid; and chiratin, soluble in warm water and 
forming an insoluble compound with tannic acid. Both substances are 
intensely bitter. 



COKOLLIFLOK^E. 

Preparations, 
u.s.p. DOSE. 

Extractum Chiratas Fluidum 15-30 min. 

Tinctura Chirata3 $-2 fl. drm. 

B.P. DOSE. 

Infusum Chiratse (1 in 40 of water at 120° F.) 1-2 fl. oz. 

Tinctura Chiratse J-2 fl. drm. 



831 




Fig. 171.— Chiretta. 

Uses. — As a bitter tonic like gentian. It has been supposed by 
some to be specially useful in disorders of the liver. 

COXVOLVULACE^E. 

B.P. Scammoniae Radix. Scammony Root. — The dried root 
of Convolvulus Scammonia. Syria and Asia Minor. 

Characters. — Tap-shaped roots, often twisted, sometimes three 
inches in diameter at the top, brown without, white within, slightly 
odorous but tasteless. Ether agitated with the powder and evaporated 
leaves a residue having the properties of scammony resin. 

Composition. — Resina Scammoniae, q.v. 

Preparations. 

U.S. p. DOSE. 

Eesina Scammonii 4-8 gr. 

B.P. DOSE. 

Eesina Scammoniae 3-8 gr. 

Sc ammonium, U.S.P. and B.P. Scammony. — A resinous exu- 
dation from the root of Convolvulus Scammonia, U.S.P. A gum-resin, 



832 VEGETABLE MATERIA MEDICA. 

obtained by incision from the living root of Convolvulus Scammonia. 
Chiefly in Asia Minor. 

Characters. — In irregular, angular pieces or circular cakes, ash- 
gray and rough externally; fresh fracture resinous, splintery, shining, 
black when dry ; odor and flavor cheesy ; causes, when chewed, a slight 
prickly sensation in the back of the throat; easily triturated into a dirty- 
gray powder, and converted with water into a smooth emulsion. 

Composition. — Gum and resin. 

Adulterations. — Chalk, starch, wood-ashes, and gum. 

Tests. — It does not effervesce with hydrochloric acid (no chalk). 
Boiling water agitated with the powder, cooled and filtered, does not 
strike a blue color with tincture of iodine (no starch). Ether removes 
from 80 to 90 per cent, of resin ; and what remains is chiefly soluble 
gum, with a little moisture (no wood-ashes). 

PREPARATIONS. 
U.S. P. DOSE. 

Resina Scammonii 4-8 gr. 

B.P. DOSE. 

Confectio Scammonii 10-30 gr. or more. 

Pilula Colocynthidis Composita 5-10 gr. 

Pilula Colocynthidis et Hyoscyanii 5-10 gr. 

Pulvis Scammonii Compositus 10-20 gr. 

Resina Scammonise 3-8 gr. 

B.P. Confectio Scammonii. COXFECTIOX OF SCAMMOXY. — Scammony, 3 OZ. ; 
ginger, 1£ oz.; oil of caraway, 1 fl. drm.; oil of cloyes, ? fl. drm.; syrup, 3 fl. oz. ; 
clarified honey, l£ oz. 

B.P. Pulvis Scammonii Compositus. COMPOUND POWDEE OF SCAMMOXY. — 
Scammony, 4; jalap, 3; ginger, 1. 

Resina Scammonii, U.S. P. ; Scammonise Resina, B.P. 

Resin of Scammony. 

Characters. — In brownish translucent pieces, brittle, resinous in 
fracture, of a sweet, fragrant odor if prepared from the root. It cannot 
form singly an emulsion with water. Ether dissolves it entirely. 

Preparation. — Extracted from the root by percolating with alcohol. 

Composition. — Principally jalapin, soluble in ether; in this respect 
differing from the convolvulin of jalap. The resin also contains other 
substances the properties of which are imperfectly known. Contains 
no gum. 

Impurity. — Guaiacum fraudulently added. 

Test. — The tincture does not render the fresh-cut surface of a potato 
blue. 

Preparatioxs. 

U.S. P. DOSE. 

Extractum Colocynthidis Compositum 5-20 grs. 

B.P. DOSE. 

Extractum Colocynthidis Compositum 5-15 gr. 

Mistura Scammonii 1-2 fl. OZ. 

Pilula Scammonii Composita 5 gr. 

u.r. Mistura Scammonii. Scammony Mixture. — Resin of scammony (2gr.) 
triturated with milk (1 fl. oz.). 



COROLLIFLOR.E. 833 

B.P. Pilula Scammonii Composita. COMPOUND SCAMMOXY PlLL. — Resin of 
scarnmony, 1; resin of jalap, 1; curd soap, 1; strong tincture of ginger, 1; rectified 
spirit, 2. 

Action and Use. — It increases the secretion of the intestines and 
acts as a drastic purgative. It is used as a derivative in dropsy and 
cerebral affections. It is also used, in combination with other drugs, as 
a vermifuge for tapeworm in children. It combines with the soda in 
the bile and its solution in bile is necessary to its action (Buchheim). 

Jalapa, U.S. P. and B.P. Jalap. — The tuberous root of Exo- 
gonium Purga, U.S. P. The dried tubercles of Exogonium Purga 
(lpomcea Purga), B.P. Mexico. 




Fig. 172. — Jalap, transverse section, natural size. 

Characters. — Varying from the size of a nut to that of an orange, 
ovoid, the larger tubercles frequently incised, covered with a thin, brown, 
wrinkled cuticle ; presenting, when cut, a yellowish-gray color, with dark 
brown concentric circles. 

Jalapae Kesina, U.S. P. and B.P. Resin of Jalap. — Extracted 
from jalap by rectified spirit. 

Characters and Tests. — In dark brown, opaque fragments, trans- 
lucent at the edges, brittle,* breaking with a resinous fracture, readily 
reduced to a pale brown powder, sweetish in odor, acrid in the throat, 
easily soluble in rectified spirit, but only partially so in ether, and insol- 
uble in oil of turpentine. 

Preparation. — Digesting and gently heating the jalap with recti- 
fied spirit, precipitating the resin with water, evaporating by a water 
bath, and drying. 

Composition. — The resin consists of convolvulin in combination 
with another resinous substance (gammaresin) which is the part dissolved 
by ether. The convolvulin of jalap differs from the jalapin of scam- 
mony in being insoluble in ether. 

Peepaeations. 

U.S. p. DOSE. 

Abstractum Jalapa? 7-10 gr. 

Pulvis Jalapae Compositus 30-60 gr. 

Kesina Jalapae 2-5 gr. 

Pilulae Catharticae Composite ~ 1-3 pills. 

53 * 



834 VEGETABLE MATERIA MEDICA. 

P reparations— {continued ) . 

B.P. DOSE. 

Extractura Jalapae 5-15 gr. 

Pulvis Jalapae Compositus 20-60 gr. 

Pulvis Scammonii Compositus 10-20 gr. 

Re sina Jalapae 2-5 gr. 

Tinctura Jalapae 5-2 fl. drm. 

Resin of Jalap is contained in Pilula Scammonii Composita. 

Pulvis Jalapae Compositus. COMPOUND JALAP POWDEE. — U.S. P. Jalap, 35; 
acid tartrate of potash, 65. B.P. Jalap, 5; acid tartrate of potash, 9; ginger, 1 part. 

Action and Uses. — Jalap is a hydragogue purgative, used for con- 
stipation, dropsy due to renal disease, and cerebral affections. It is best 
given with acid tartrate of potash, as in Pulv. Jalapae Co. Like scam- 
mony, it is dissolved by the bile, and appears to require it in order to 
act. It has no action when injected subcutaneously, nor when injected 
into the veins. It has no irritant action when locally applied to the 
skin or mucous membranes of the eye or nose, nor has it any diuretic 
action ; or any action on the nervous system. 



SOLANACE^E. 

Dulcamara, U.S.P. and B.P. Dulcamara. 
The dried young branches of Solanum Dulcamara. 
plants which have shed their leaves. 



Bittersweet. — 
From indigenous 




Fig. 173. — Solanum Dulcamara. 



Characters. — Light, hollow, cylindrical, about the thickness of a 
goose-quill, bitter and subsequently sweetish to the taste. 

Composition. — It contains solanine, and less dulcamarine, both 
alkaloids, amorphous and of a bitter taste. It yields also sugar. 



Preparations. 

D.8.P. DOSE. 

Extractum Dulcamanc Fluidum 1 fl. drm. 



COROLLIFLOR^. 835 

Preparation — (continued). 

B.P. DOSE. 

Infusum Dulcamarse (1 oz. in J pint) 1-2 fl. oz or more. 

Action. — The action of dulcamarine has not been investigated. 

Solanine, both in warm and cold-blooded animals, paralyzes the 
central nervous system without affecting the peripheral nerves or 
voluntary muscles. It slows the heart and respiration, lessens sen- 
sibility, and causes death with convulsions. In warm-blooded animals 
there is constant fall of temperature, and there is entire absence of 
any action on the pupil. In man it produces weakness, labored breath- 
ing, nausea, vomiting and drowsiness, but no true sleep. The pupil is 
unaffected and there is no increased movement of the bowels, diuresis, 
or diaphoresis. 

Uses. — Dulcamara is chiefly used as an alterative in scaly skin 
diseases, in which it is often combined with antimony. It has been 
recommended by Husemann in chronic bronchial catarrh, asthma and 
whooping-cough. 

Capsicum, U.S. P. ; Capsici Fructus, B.P. Capsicum, U.S. P. ; 
Capsicum Fruit, B.P. — The dried ripe fruit of Capsicum fastigiatum, 
and of C. annuum. Zanzibar. 

Characters. — Pod membranous, from five to eight lines long, two 
lines broad, straight, conical, pointed, smooth, shining, but somewhat 
corrugated, orange-red, intensely hot in taste. 

Composition. — An exceedingly acrid, volatile substance, Capsaicin, 
and an alkaloid resembling con'ine in odor. 

Adulteration. — The powder is occasionally found adulterated with 
red lead. 

Test. — -Digest in nitric acid and add sulphate of soda. There should 
be no precipitate of sulphate of lead. Should burn away without residue 
of lead. 

Preparations, 
u.s.p. DOSE. 

Extractum Capsici Fluidum 2-10 min. 

Oleoresina Capsici ^-1 min. 

Tinctura Capsici 8 min. to 2 fl. dr. 

Emplastrum Capsici 

B.P. DOSE. 

Tinctura Capsici 5-20 min. 

(as a gargle, J-2 fl. drm. in 5 oz. of fluid.) 

Action and Uses. — Externally capsicum is an irritant, producing 
warmth, redness, and vesication. Internally it is an irritant, and in 
large doses will produce gastro-enteritis. 

It has been used for unbroken chilblains, neuralgia, and rheumatic 
pains. Internally it may be used as a gargle for tonsillitis, pharyngitis, 
and relaxed sore throat. It is used as a condiment, and to relieve flatu- 
lence. It is also recommended to relieve the sinking in the epigastrium 
felt by dipsomaniacs. It promotes appetite and stimulates the stomach. 

ATKOPACE^E. 

Belladonnse Folia, U.S.P. and B.P. Belladonna Leaves. — 
The leaves of Atropa Belladonna, U.S.P. The fresh leaves, with the 



836 VEGETABLE MATERIA MEDICA. 

branches to which they are attached, of deadly nightshade. Atropa Bel- 
ladonna ; also the leaves separated from the branches and carefully 
dried ; gathered from wild or cultivated British plants when the fruit has 
begun to form, B.P. 

Characters. — Leaves alternate, three to six inches long, ovate, 
acute, entire, smooth, the uppermost in pairs and unequal. The expressed 
juice, or an infusion, dropped into the eye, dilates the pupil. 

Composition. — Less than one per cent, of atropine, and a small 
proportion of asparagine. More atropine is obtained from the leaves of 
mature plants than from those gathered before inflorescence. 

Peepaeations. 
u.s.p. DOSE. 

Extractum Belladonnas Alcoholicum \ gr. 

Tinctura Belladonna? 8-30 min. 

Unguentum Belladonnse 

B.P. DOSE. 

Extractum Belladonna? (green) 1 gr. 

Tinctura Belladonna? (from dried leaves) 5-30 min. 

Succus Belladonnse (from fresh leaves) 5-15 min. 



Unguentum Belladonna? l fromextrart 
Emplastrum Belladonna? / lrom extract - 



Belladoniige Radix, U.S.P. and B.P. Belladonna Root. — 
The dried root of Atropa Belladonna. 

Characters. — From one to two feet long, and from half an inch to 
two inches thick, branched and wrinkled, brownish-white. An infusion 
dropped into the eye dilates the pupil. Roots which are tough and 
woody, breaking with a splintery fracture, should be rejected. 

Composition. — Two alkaloids, atropine and belladonnine, the former 
under one per cent. Also a red coloring matter, atrosin. 

Peepaeations. 
u.s.p. DOSE. 

Atrophia , vhnk gr. 

Abstractum Belladonna? £ gr. 

Emplastrum Belladonnse 

Extractum Belladonna? ..1-2 min. 

Linimentum Belladonnse Fluidum 

B.P. DOSE. 

Atropia shriu &• 

Linimentum Belladonna? (1 oz. to 1 fl. oz.) 

Atrophia, U.S.P. ; Atropia, B.P. Atropine, U.S.P. ; Atropia, 
B.P. C^H^NC^ ; 289. — An alkaloid obtained from belladonna. 

Preparation. — It cannot be profitably prepared on a small scale. 
The chief parts of the process are the precipitation of acid coloring 
matters from a strong tincture by means of lime, removal of the alcohol, 
addition of water and carbonate of potash, taking up the alkaloid from 
the alkaline solution by chloroform, and subsequent purification. 

Characters and Tests. — In colorless, acicular crystals, sparingly 
soluble in water, more readily in alcohol and in ether. Its solution in 
water has an alkaline reaction, gives a citron-yellow precipitate with 
terchloride of gold, has a bitter taste, and powerfully dilates the pupil. It 
leaves no ash when burned with free access of air. It is an active poison. 



COROLLIFLOR^. 837 

The following test has been proposed for the members of the group of 
mydriatic alkaloids — atropine, hyoscyamine, daturine, duboisine, and 
homatropine. To a small portion of atropine in a test-tube add about 2 
ccm. of a 5 per cent, solution of mercuric chloride in 50 per cent, of 
alcohol, and warm gently. A precipitate will at once appear, and become 
brick-red in color. This test does not answer in dilute solutions, neither 
does it turn out well if atropine be added to the mercury. Other alka- 
loids give for the most part a white precipitate (Gerrard). 

Peepaeations. 

B.P. DOSE. 

Atropine Liquor (4 gr. ; spirit, 1 fl. dr. ; water, 7 fl. dr.).... 4 gr. in 1 fl. oz....$-6 min. 

Atropise Sulphas sVsihr S r - 

Atropise Sulphatis, Liquor 4 gr. in 1 fl. oz £-6 min. 

Atropiae Unguentum (with rectified spirit, % fl. dr., and 

prepared lard, 1 oz.) 8 gr. in 1 oz. 

Atropinse Sulphas, U.S.P.; Atropise Sulphas, B.P. Sul- 
phate of Atropine, U.S.P. ; Sulphate of Atropia, B.P. 

Preparation. — By dissolving atropia in dilute sulphuric acid and 
evaporating. 

Characters and Tests. — A colorless powder, soluble in water, 
forming a solution which is neutral to test-paper, and when applied to 
the eye, dilates the pupil as the solution of atropia does. It leaves no 
ash when burned with free access of air. 

Intended for external application. It is a powerful poison. 

Peepaeation. 

U.S.P. B.P. 

None. Liquor Atropine Sulphatis (4 gr. in 1 fl. oz. of water). 

General Action of Belladonna or Atropine. — The first symp- 
toms to appear after a small dose are dryness of the mouth and head- 
ache. After full doses the pupils become dilated, a red rash appears 
on the skin like that of scarlatina, and a delirium of a peculiar and often 
of a pleasant character ensues, in which there is a great desire for move- 
ment and activity, with a feeling of great lassitude (p. 182). The pulse 
becomes rapid. This is generally followed by sleep. 

With large doses the mouth becomes so dry that swallowing is 
almost impossible, and the attempt to swallow may bring on general 
convulsions like hydrophobia ; these convulsions are followed by "paralysis, 
stupor, often alternating with delirium, coma, and death, preceded by 
marked failure of the heart's action and of respiration. Death is due to 
asphyxia. 

Special Action. — Locally applied it diminishes the sensibility of 
the sensory nerves (whether applied as liniment or injected subcu- 
taneously). It can be absorbed from the skin and produce its general 
symptoms. 

It stimulates the centres in the Drain, but tends to paralyze the ends 
of the motor nerves, hence causing that peculiar form of delirium in which 
a constant desire for action is associated with lassitude. The spinal 
cord is first stimulated, then paralyzed. 



838 VEGETABLE MATERIA MEDICA. 

In a frog the first stimulation quickly passes off, and there follows 
gradually increasing weakness, both of respiratory and voluntary move- 
ments, until these become entirely abolished. If the frog be kept in this 
condition for four or five days, this state of absolute paralysis passes off, 
and is succeeded by a condition of excitement with violent tetanic con- 
vulsions, which may be brought on by the slightest afferent stimulus. 
Various explanations of this action have been given (vide p. 158). 

The endings of motor nerves in voluntary muscles are paralyzed 
by large doses, but small doses will paralyze the efferent nerve endings 
which terminate in peripheral ganglia (e.g., vagus), and in involuntary 
muscle (p. 134). The converse is the case with curare. 

Atropine has no action on voluntary muscles. Involuntary muscle 
is paralyzed by large doses (p. 134). 

On the Eye. — The pupils are dilated and the eye becomes bright, 
dry, and injected. The power of accommodation is paralyzed, and by 
large doses intraocular tension is increased. For the mode of action vide 
pp. 199-203. 

On the Circulation. — The action of atropine on the excised heart 
of the frog affords an illustration of the statement I have made (p. 59), 
that in all probability contradictory observations frequently depend on 
differences in the temperature at which the observations were made. 
Thus Bowditch and Luciani found the contractions, both of the frog's 
heart containing ganglia and of the apex (p. 272) alone, were rendered 
more powerful by atropine, while Gnauck, on the contrary, found that 
the contractions of the ventricle were diminished both by atropine and 
hyoscyamine. Kronecker and Schapiro have found that these contra- 
dictory observations are both correct, but at different temperatures. 
When the temperature is low (7°-8° C.) the ventricular contractions are 
enlarged by atropine, but diminished by it when the temperature rises 
over 15° C. Large doses of atropine completely paralyze the intracardiac 
inhibitory apparatus, while at the same time they stimulate the vagus 
centres in the medulla. 

Atropine is supposed to act upon inhibitory ganglia in the heart itself, 
not upon the vagus endings, in which respect it differs from nicotine 
(vide p. 277). 

Sometimes there is a primary slowing of the pulse rate, followed by 
quickening, but it is uncertain whether this is due to stimulation of the 
vagus centre or of the inhibitory apparatus in the heart. 

Small doses raise the blood-pressure by stimulating the vaso-motor 
centre in the medulla, but large doses diminish it by paralyzing the vaso- 
motor centre and partly by paralyzing the peripheral vaso-motor ganglia 
or muscular fibres of the walls of the arteries themselves (p. 247). 
Atropine also diminishes the sensibility of the heart to changes of pres- 
sure within it (p. 263). 

On Respiration. — Atropine first quickens and then slows respira- 
tion. This is due to stimulation and subsequent paralysis of the respira- 
tory centre in the medulla. When injected into the jugular vein it 
appears to paralyze the ends of the sensory fibres of the vagus in the 
lungs, and thus tends to slow respiration at first (p. 219). It arrests 
secretion from the bronchial mucous membrane (p. 223). 



COKOLLIFLOR.E. 839 

On Secretion. — Atropine paralyzes the secreting fibres of the chorda 
tyrupani without affecting the vaso-dilator fibres, so that when the chorda 
tympani is stimulated, either directly or reflexly, the flow of blood to the 
gland is increased, but no fluid exudes from the duct (p. 318). 

It probably has a similar action on many if not all glands, including 
the sweat glands, milk glands, mucous glands, pancreas, and liver. When 
locally applied it stops the secretion of milk and sweat. In the case of 
the sweat it probably paralyzes the efferent sweat-fibres which accompany 
the vaso-motor fibres and start from centres in the lumbar and lower 
dorsal parts of the cord (Luchsinger). It does not, however, prevent 
secretion in the intestine after division of the intestinal nerves (Brunton 
and Pye-Smith). 

The secretion of urine is sometimes increased, but large doses may 
cause retention, from paralysis of the bladder. 

On the Intestines. — Small doses increase the movements of the 
intestines. This action is probably due to paralysis of the inhibitory 
fibres of the splanchnic, since stimulation of the peripheral end of the cut 
splanchnic will cause arrest of movement in the unpoisoned, but not in 
the poisoned, animal. Moderate doses completely arrest peristaltic 
movements, but the muscular fibres of the intestine retain their irrita- 
bility. Local irritation causes a local contraction, but no peristalsis. 
This is probably due to paralysis of the intestinal ganglia. 

Large doses stop the movements and paralyze the involuntary 
muscular fibres of the intestine, so that they only contract feebly or not 
at all when directly irritated. 

The Temperature is increased by small doses, lessened by large 
ones. 

Certain animals, especially pigeons and rodents, such as rabbits, 
guinea-pigs, and rats, are peculiarly unsusceptible to the action of atropine. 
It is not improbable that the unsusceptibility of rodents to the action 
of atropine depends on the very slight tonic action which the vagus exerts 
on the heart in them in their normal condition. When it is paralyzed 
there is little change in the circulation, while in dogs the case is very 
different (p. 252). 

Methyl- and ethyl-atropine paralyze the ends of the motor nerves, 
but do not tetanize ; they however retain the action of atropine on the 
eye, heart, &c. 

Therapeutics. — Locally applied belladonna lessens irritability 
and pain, and is hence used as a lotion in photophobia. 

Solution of atropine is employed to dilate the pupil and paralyze 
accommodation in many conditions which have already been mentioned 
(p. 203). Migraine frequently depends upon astigmatism or other visual 
disturbances, and an attack may sometimes be cut short by the local 
application of atropine to the eye. 

In the form of a plaster or liniment over the tender spots, it is useful 
in myalgia, neuralgia, especially supraorbital and intercostal neuralgia, 
pleurodynia, hypersensitiveness of skin, and irritability of the chest- 
muscles seen in phthisical patients. The pain arising from old adhesions 
due to pleurisy is relieved by a belladonna plaster. 

In the form of ointment it lessens pain and spasm in fissures of the anus. 



840 VEGETABLE MATERIA MEDICA. 

It is used to check local sweating on the head, hands, or feet, m the 
form of the liniment two or three times a day. 

Atropine is used internally to check the sweating of phthisis and other 
exhausting diseases, in doses of yj-g- gr., gradually increased. It may be 
given in pill, or mixture, or hypodermically. The beneficial effect may 
here be due to paralysis of nerves of sweat glands, but is probably due 
also to the stimulating effect on the respiratory centre (p. 383). 

Belladonna stops the secretion of milk, and is hence used when the 
mother from any cause is unable to suckle her child, and the breast 
becomes swollen and inflamed. For its uses in ophthalmic practice vide 
p. 203. Given internally, atropine is useful in extreme salivation, as in 
mercurial ptyalism. In chronic constipation relief is often afforded by 
small doses of \ gr. of the extract of belladonna. Its action here may 
be due to diversion of a stimulus from the inhibitory to the motor fibres 
of the splanchnic, or to paralysis of the inhibitory fibres of the splanchnics 
(p. 336). It lessens griping, hence it is a useful adjunct to purgatives. 
It is useful in cases of spasm of involuntary muscles, as in lead colic, 
simple colic, asthma, and in the spasm set up by renal and biliary calculi 
(cf. p. 134). 

Internally it is useful in palpitation due to cardiac strain (p. 263), 
and sometimes gives relief in angina pectoris. One of the most useful 
applications in all cases of palpitation, whether accompanied by pain or 
not, is a belladonna plaster to the cardiac region. As atropine, while it 
appears to lessen the excitability of the ends of the vagus in the lung, 
excites the respiratory centre, its action in preventing cough is slight and 
uncertain. As it has the power of completely arresting secretion from 
the bronchial tubes, it is useful in cases where there is excessive secre- 
tion, but where the bronchial mucous membrane is already too dry, it is 
injurious (p. 223). In incontinence of urine in children belladonna is a 
most useful remedy. It probably acts by lessening the irritability of the 
bladder. It is also very serviceable in irritability of the bladder with 
frequent micturition in adults (p. 384). 

In epilepsy and chorea it is not much use, but in frontal headaches it 
is useful in doses of 3 m. of tincture every three hours. 

In leucorrhoea with ulceration of the os uteri, a pessary made up of 
2 grs. of ext. belladonna, with 7 grs. of tannin, and cacao butter q.s., is 
very useful (Trousseau). 

As an antidote to opium, 4 min. of liquor atropise, B.P., may be 
injected subcutaneously, and repeated every quarter of an hour until the 
pupil dilates. 

It has also been used in poisoning by calabar bean, and in chloroform 
poisoning, when death is impending from stoppage of the heart. Doses 
sufficiently large to paralyze the inhibitory apparatus must be used. 

Hyoscyamns, U.S.P. ; Hyoscyami Folia, B.P. HyoSCYAMUS, 
U.S. P. ; Hyoscyamus Leaves, B.P. — The fresh leaves, with the branches 
to which they are attached, of Hyoscyamus niger ; also the leaves separ- 
ated from the branches and carefully dried ; collected from plants of the 
second year's growth. 

Characters. — Leaves sinuated, clammy, and hairy. The fresh 
herb has a strong, unpleasant odor, and a slightly acrid taste, which 



COKOLLIFLORJE. 841 

nearly disappears on drying. The fresh juice, dropped into the eye, 
dilates the pupil. 

Composition. — A volatile alkaloid, hyoscyamine, soluble in water 
and spirit. It is decomposed, and its physiological action neutralized by 
caustic alkalies. It is isomeric with, but not identical with, atropine. 
Nitrate of potassium and other inorganic salts are present in the leaves. 

Peepaeations. 

U.S. P. DOSE. 

Abstractum Hyoscyami 3-5 gr. 

Extractum Hyoscyami Alcoholicum....2 gr. 

Extractum Hyoscyami Fluidum 5-10 min. 

Tinctura Hyoscyami 1 fl. drm. 

B.P. DOSE. 

Extractum Hyoscyami 5-10 gr. or more. 

Tinctura Hyoscyami 30 min. to 1 fl. drm. or more. 

Succus Hyoscyami 30 min. to 1 fl. drm. 

XJ.S.P. Hyoscyaminse Sulphas. Sulphate of Hyoscyamine, 
(C 17 H 23 N0 3 ) 2 .H 2 S0 4 ; 676. — The neutral sulphate of an alkaloid prepared 
from hyoscyamus. 

Characters. — Small golden-yellow or yellowish-white scales or crys- 
tals, or a yellowish-white, amorphous powder, deliquescent on exposure 
to air, odorless, having a bitter and acrid taste, and a neutral reaction. 
Very soluble in water and in alcohol. When heated on platinum foil, 
the salt chars and is finally completely dissipated. An aqueous solution 
of the salt is not precipitated by test solution of platinic chloride. With 
chloride of gold it yields a precipitate, which, when recrystallized from 
boiling water acidulated with hydrochloric acid, is deposited on cooling 
(without rendering the liquid turbid) in brilliant, lustrous, golden-yellow 
scales (difference from atropine). The aqueous solution yields, with test 
solution of chloride of barium, a white precipitate insoluble in hydro- 
chloric acid. 

It is found also in the seeds of Belladonna Stramonium, and in 
Duboisia myoporoides, the alkaloid of which (duboisine) is identical with 
hyoscyamine. Hyoscyamine is isomeric with atropine. 

Dose.— fo gr. to 1 gr. 

Action and Uses. — The physiological action of hyoscyamine is like 
that of atropine and daturine. Hyoscyamus is used chiefly as an adjunct 
to purgatives to lessen griping. It is also used to lessen spasm, and to 
allay pain and irritation of the bladder. It has also been employed as a 
sedative to the nervous system. 

Stramonii Folia, XJ.S.P. and B.P. Stramonium Leaves. — 
The dried leaves of Datura Stramonium. Thorn Apple. Cultivated in 
Britain. 

Characters. — Large, ovate, sinuous, deeply cut; of a heavy odor, 
which is strongest while they are drying, and of a mawkish, faintly bitter, 
nauseous taste. 

Composition. — A very small proportion of daturine. The other 
constituents are chiefly saline and mineral matters. 



842 VEGETABLE MATEKIA MEDICA. 

Strainonii Seinen, U.S. P.; Strainonii Semina, B.P. Stra- 
monium Seed, U.S. P.; Stramonium Seeds, B.P. — The ripe seeds of 
Datura Stramonium. 




Fig. 174.— Stramonium Seed and section, magnified 3 diameters. 

Characters. — Brownish-black, reniform, flat, rough; inodorous 
unless bruised, when they emit a peculiar, heavy smell. 

Composition.— Contains an alkaloid, daturine, identical with atropine, 
and also some hyoscyamine. 

Peepaeatioxs. 

U.S. p. DOSE. 

Extractum Strainonii J gr. 

Extractum Stramonii Fluidum 1 min. 

Tinctnra Stramonii 10-30 min. 

Unguentum Stramonii 

B.P. DOSE. 

Extractum Stramonii \-% gr. 

Tinctura Stramonii 10-30 min. 

Action and Use. — The impure alkaloid, daturine, consisting of atro- 
pine and hyoscyamine, has exactly the same physiological action as 
atropine, though less powerful. 

The chief use of stramonium is as an antispasmodic in cases of 
asthma. It is often employed in the form of cigarettes during the attack, 
or the fumes of the ignited powder are inhaled. A mixture of potassse 
nitras, potassse chloras, stramonium, and ipecacuanha has been employed 
with good effect in asthma by inhaling the fumes of the ignited mixture. 
The leaves of Datura Tatula have been substituted for Datura Stra- 
monium. 

Tabacum, U.S. P.; Tabaci Folia, B.P. Tobacco, U.S. P.; 
Leaf Tobacco, B.P. — The dried leaves of Virginian Tobacco, Nieotiana 
Tabacum. Cultivated in America. 

Characters. — Large, mottled-brown, ovate or lanceolate, acuminate 
leaves, up to twenty inches (50 centimetres) long, bearing numerous short, 
glandular hairs ; having a peculiar, heavy odor and nauseous-bitter, acrid 
taste ; yielding, when distilled with solution of potash, an alkaline fluid, 
which has the peculiar odor of nicotine, and precipitates with perchloride 
of platinum and tincture of galls. Not manufactured. 

Preparatiox. 

r.s.p. B.P. DOSE. 

None. Enema Tabaci 20 gr. to 8 fl. oz. 

Composition. — A volatile liquid alkaloid, nicotine, is contained in 
tobacco as a malate, and is obtained by distillation with an alkali. The 
leaves contain also nicotianin, or tobacco camphor, which crystallizes out 
from an aqueous distillate. Resin, gum and several inorganic com- 
pounds are also present. 



corolliflor^:. 843 

General Action. — Tobacco stimulates and then paralyzes the 
motor nerves of involuntary muscles and the secreting- nerves of 
glands. In consequence of this action of tobacco on the intestine, 
there is in poisoning by it nausea and vomiting, with intense prostration 
and wretchedness. In consequence of the action of the drug on the 
lieart and vaso -motor system, there is paleness of the face, cold 
sweats, feebleness of circulation, and tendency to faint. The action of 
tobacco is the same as that of its alkaloid, nicotine, though less power- 
ful. In frogs, nicotine, after a period of temporary excitement, causes 
a tetanic condition in a peculiar attitude, the head being drawn down, 
the fore legs back, and the hind legs forward. This is followed by 
muscular relaxation. In warm-blooded animals there is excitement, 
difficulty of breathing, followed by trembling, with expulsion of urine 
and foeces, stupor, staggering gait, convulsions and death. When the 
dose is very large, the animal may fall with a loud cry and the convul- 
sions begin at once, deepening into muscular paralysis ; and death ensues 
from failure of respiration, the heart continuing to beat after respiration 
ceases. Convulsions also occur in frogs. 

Special Action. — Spinal cord is first stimulated (p. 167), giving 
rise to convulsions, and is afterwards paralyzed. The convulsions are 
of spinal origin in the frog, as is shown by such experiments as have 
been already mentioned (p. 166), but those which occur before death in 
mammals are probably asphyxial. 

Circulation. — Nicotine causes a great diminution of pulse rate and 
a fall of blood-pressure, followed by a rise of blood-pressure, the pulse 
rate still remaining slow ; but if a large dose be given, the pulse rate 
rises very quickly. The drug first stimulates both the vagus roots and 
its ends in the heart (causing slow pulse rate), and then paralyzes the 
latter (causing high pulse rate). It does not, however, paralyze the 
the inhibitory ganglia of the heart, like atropine, since stimulation of 
the sinus will slow the heart in frogs after nicotine poisoning. The 
primary fall of blood-pressure is due to the slowing of the lieart, 
and the subsequent rise to contraction of the peripheral vessels. 

Alimentary Canal. -Nicotine stimulates peristalsis markedly (p. 334). 

Tlie methyl and etliyl derivatives of nicotine have no tetanizing 
influence on the cord, neither, curiously enough, do they paralyze the 
ends of the motor nerves. 

Therapeutics. — Tobacco is used as an enema in supposed intus- 
susception, but it must be employed with care. 

Owing to its influence on the cord, nicotine has been used in tetanus 
and strychnia poisoning, but is not much use. 

Tobacco-smoking. — The effects produced on the system by tobacco- 
smoking may be partly due to nicotine, but are probably rather due to 
products of its decomposition, such as pyridine and collidine. In pipe- 
smoking pyridine (p. 686) preponderates, but when smoked in cigars, 
where there is free access of air, the chief product of the dry distillation 
undergone by the tobacco is collidine, which is far less active than pyri- 
dine (Vohl and Eulenburg). 

In those accustomed to smoke tobacco, it has a soothing effect on the 
nervous system, but it often acts as a nervous stimulant to mental work, 



844 VEGETABLE MATERIA MEDICA. 

as in reading. In these cases the effect is probably not due to the nico- 
tine itself, but to the stimulus of the smoke on the sensory nerves of the 
mouth, which reflexly stimulates the vaso-motor centre, and dilates the 
vessels of the brain ; since some people produce the same effect by sucking 
sweets, or sipping whisky and water (p. 177). 

There is no doubt that smoking in excess is injurious. It produces 
a furred tongue, irritation of the throat, hoarseness, often dyspepsia and 
irritability of the heart, with a characteristic rhythm and palpitation 
(smoker's heart). This effect on the heart is like that produced by partial 
paralysis of the vagus, and disappears when the habit is given up for a 
time. 

Sudden faintness is also apt to occur, so that a previously strong 
and healthy man will suddenly fall down in a state of syncope without 
apparent cause, or the faint may be brought on by some mental emotion. 

The sight is impaired by habitual excess in tobacco smoking. 

Tobacco smoking is often very useful in asthma, and a pipe after 
breakfast will often relieve constipation. 

Tobacco snuff is used as an errhine. 

SCKOPHULARIACE^E. 

Digitalis, U.S. P. ; Digitalis Folia, B.P. Digitalis, Foxglove, 
U.S. P.; Digitalis Leaf, B.P. — The dried leaf of Digitalis purpurea, 
purple foxglove. The leaves of Digitalis, U.S. P. Collected from wild 
indigenous plants, when about two-thirds of the flowers are expanded, 
B.P. 

Characters. — Ovate-lanceolate, shortly petiolate, rugose, downy, 
paler on the under surface, crenate. 

Composition. — Contains a number of active principles formerly 
included under the name of digitaline. 

Peepaeations. 

U.S.P. DOSE. 

Abstractum Digitalis $-1 gr. 

Extractum Digitalis J--J gr. 

Extractum Digitalis Fluidum 1-2 min. 

Infusum Digitalis 1-2 fL dr. 

Tinctura Digitalis 5-10 min. 

B.P. DOSE. 

Digitalinum inrsV g r - 

Infusum Digitalis (3 gr. to 1 fl. oz.) 2-4 fl. dr. or more. 

Tinctura Digitalis (54 gr. to 1 fl. oz.) 5-30 min. 

infusum Digitalis. Infusion of Digitalis. — Digitalis, in No. 20 powder, 3 ; 
cinnamon, in No. 20 powder, 3; boiling water, 185; alcohol, 15; water, q.s. Pour 
the boiling water on the mixed powders and macerate for two hours in a covered 
vessel. Then strain, add the alcohol, and pass enough water through the strainer 
to make the infusion weigh 200 parts, U.S.P. Digitalis leaves, dried, 30 gr. ; boiling 
distilled water, 10 fl. oz. Infuse in a covered vessel for one hour, and strain, B.P. 

B.P. Digitalinum. DlGITALIN. 

Preparation. — Dissolving out digitalin from alcoholic extract of the 
leaves by acetic acid and water, decolorizing by animal charcoal. Neu- 
tralizing by ammonia and precipitating the digitalin by tannic acid. 



COROLLIFLOE^. 845 

Rubbing with oxide of lead and spirit to remove the tannic acid. Dis- 
solving out the digitalin with spirit, again decolorizing by animal char- 
coal, evaporating, and purifying by washing with ether. 

Characters and Tests. — In porous, mammillated masses or small 
scales, white, inodorous, and intensely bitter ; readily soluble in spirit, 
but almost insoluble in water and in pure ether ; dissolves in acids, but 
does not form with them neutral compounds ; its solution in hydrochloric 
acid is of a faint yellow color, but rapidly becomes green. It leaves no 
residue when burned with free access of air. It powerfully irritates the 
nostrils, and is an active poison. 

Dose. — ^ to -^ of a grain. 

Chemistry of Digitalis. — Formerly the active principle of digitalis 
was said to be digitaline, but the substances prepared and sold by different 
manufacturers under this name varied much in their solubility and in the 
intensity of their physiological action. The most important varieties 
were Homolle's amorphous digitaline, Nativelle's crystallized digitaline, 
and soluble or German digitalin. 

An examination of the chemistry of digitalis by Schmiedeberg has 
shown that there are at least five principles present in it, and possibly 
there are present also some products of their decomposition. They are 
all non-nitrogenous, and with the exception of one, digitoxin, are gluco- 
sides. They are: digitoxin, digitalin, digitale'in, digitonin, and digitin. 
The first three of these are cardiac poisons. Digitonin has an action like 
that of saponin, and digitin appears to be inert. 

Digitoxin is quite insoluble in water, and forms the chief constituent 
in Nativelle's digitaline. By boiling with dilute acids digitoxin yields 
toxiresin, and digitalin yields digitaliresin. 

Digitalin is also insoluble in water, and is the active principle of 
Homolle's digitaline. Digitalein differs from the two former in being 
readily soluble in water, and forms a large proportion of the soluble 
digitalin. 

The digitaline of the B.P. being almost insoluble in water probably 
consists chiefly of digitoxin or digitaline. 

General Action. — In large doses digitalis causes sickness, vomit- 
ing, muscular weakness, diuresis, subjective affections of vision, labored 
respiration, and death ; the heart usually failing before the respiration. 
The condition of the heart after death varies. Sometimes I have found 
it in diastole and sometimes in systole in dogs poisoned by digitalis. 

Special Action. — On the muscles. In a number of unpublished 
experiments on this subject made in 1867-68 in the laboratories of 
Professors Briicke and J. Rosenthal, I found that soluble digitalin did 
not lessen the excitability of the unweighted muscle, but diminished its 
power to lift a weight. According to Schmiedeberg and Koppe, digitalis 
paralyzes all voluntary muscles. Digitalin causes elongation of the 
muscle, with increased elasticity, in the frog. 

On the nervous system. It has no marked action on sensory or 
motor nerves. It has little action on the spinal cord. It has been 
stated to lessen reflex action in the frog by stimulation of Setchenow's 
centre, but this may be due to reflex irritation from the point of injection 
(p. 154). The "brain is unaffected, and in cases of poisoning remains 



846 



VEGETABLE MATERIA MEDICA. 



clear to the last. (Two of the products of the decomposition of digitalin, 
toxiresin and digitaliresin, however, produce convulsions like those of 
picrotoxin.) Large doses cause subjective affections of vision, consisting 
in dimness, occasional flashes of light, or in the constant appearance of a 
rainbow or bright light before the eyes. Locally applied to the eye it 
produces irritation at first, and afterwards causes a halo to surround 
bright objects. 

The respiration is generally somewhat slowed, and occasionally 
before death may become excessively slow. 

The effects produced on the circulation by the active principles of 
digitalis and by substances having a similar action, such as oleandrin, 
scilliain, adonidin, neriin, convalamarin, antiarin, and helleborein, may be 
divided according to Schmiedeberg into four stages: — 

1. Rise of blood-pressure, usually, though not invariably, accom- 
panied by slowing of the pulse. 

2. Continued rise of blood-pressure, with a quick pulse. 

3. Continued high pressure, with irregularity of the heart's action 
and pulse rate. 

4. Rapid fall of the blood-pressure, sudden stoppage of the heart, 
and death. 

The rise in blood-pressure is regarded by Schmiedeberg, Boehm, 
and others as entirely due to increased action of the heart, and not at 
all to contraction of the vessels. With this view I cannot agree, and I 
still hold to the opinion which I expressed many years ago, that the rise 
in pressure is due in great measure to contraction of the arterioles. 
Not only is it more difficult to raise the pressure in the arterial system 
by alterations in the heart's action than by contraction of the arterioles, 
as we find from experiments on a schema (p. 232), but the form of the 
pulse-curve under the action of digitalis conclusively demonstrates that 




■MMMM 
IKMWA 
Urn IKIIB* 



Fig. 175. — Pulse-wave (b) before and (a) after injection of digitalis in a dog. 

the arterioles are contracted (vide p. 241). This has also been demon- 
strated by Donaldson and Stevens, 1 who found that the addition of 
digitalis to blood lessens the flow through vessels in which circulation was 
artificially maintained. A similar result has been obtained by Ringer. 

The slow pulse in the first stage of digitalis poisoning is partly due 
to stimulation of the vagus roots of the medulla, and partly to increased 



1 Journal of Physiology, vol. iv., p. 165. 



COROLLIFLOILE. 847 

sensibility or actual stimulation of the ends of the nerves in the heart. 
This increased sensibility has been shown to exist by Boehm, who found 
that after the administration of digitalis, a faradaic current which pre- 
viously had no action on the heart would not only slow the pulse but 
produce prolonged diastolic arrest. 

The rapid pulse in the second stage of digitalis poisoning is due to 
paralysis of the vagus ends. The irregularities in the third stage 
depend on the action of the drug on the heart itself. 

The action of digitalis on the frog's heart is very peculiar. At 
first it causes the pulsations to become slower and more powerful, then 
the contraction during systole becomes peristaltic, and the dilation during 
diastole less and less complete, until finally the ventricle stands quite 
still in such complete systolic contraction that its cavity is entirely oblit- 
erated. The auricles are sometimes distended with blood, sometimes only 
moderately dilated. According to Schmiedeberg this contraction is not 
tetanic, but is rather due to increased elasticity of the cardiac muscle 
which prevents its normal relaxation during diastole. When it is over- 
come by driving a nutrient fluid into the ventricle under pressure, or by 
partially paralyzing the cardiac muscle by saponin, apomorphine, or 
hydrocyanic acid, the systolic stillstand is removed, and pulsation again 
recommences. 

Digestive Organs. — Small doses of digitalin have a pleasant bitter 
taste, but exercise no marked effect upon the digestive organs. Larger 
doses produce loss of appetite, nausea, and vomiting, with rumbling and 
pain in the abdomen, and sometimes diarrhoea. This occurs even when 
the drug is injected subcutaneously. 

Urine. — All observers are agreed regarding the diuretic power of 
digitalis in cardiac disease, but most of them state that it has no such 
power in health. In my own experiments, however, in which I took the 
same quantity of food by weight and of fluid by measure during more 
than a hundred days, I found that, while small doses had little or no 
action, marked diuresis occurred when the drug was pushed so as to pro- 
duce symptoms of poisoning. In these experiments also I found that 
while the diuresis continued the absolute quantity of solids excreted daily 
in the urine was increased, although their proportion to the urinary water 
was diminished. In cases of poisoning by digitalis, a marked diminution 
in the flow of urine frequently precedes a fatal issue; and on injecting 
digitalis into the veins of a dog, Mr. Power and I found that the secre- 
tion of urine became entirely arrested when the blood-pressure reached 
its maximum, and again commenced when the blood-pressure began to 
fall (p. 372). It is probably to the power of digitalis to arrest the action 
of the kidneys and thus stop its own excretion that its cumulative action 
is due (p. 56). 

Effect of Temperature on the Action of Digitalis. — It has 
already been mentioned (p. 61) that digitalis has sometimes no action on 
the pulse in pneumonia. The inhibitory action of the vagi on the heart 
is lessened by heat, but their peripheral terminations, although weakened, 
are not completely paralyzed. While this volume was passing through 
the press Cash and I made some experiments which appear to show 
that a very high temperature has an action on the vagus centre in the 



848 



VEGETABLE MATERIA MEDICA. 



medulla similar to its action on the ends of the nerve in the heart. It 
does not completely paralyze either the centre or the peripheral ends of 
the nerve, but it greatly weakens them. This weakening action is so 
great that it practically amounts to paralysis, for when the temperature 
rises above a certain point the pulse rate suddenly rises just as it would 
do if both vagi were cut. This is shown by Fig. 176. When the pulse 







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The unbroken line shows the pulse rate, the dotted line shows the temperature in the axilla in all 

the figures. 

Fig. 176.— Shows the effect of rise of temperature alone. At the 195th minute, both vagi were cut; the 
section was not followed immediately by any apparent effect. After eight minutes more, the pulse 
rate rose slightly and then fell. 

rate has been thus quickened by heat, section of the vagi does not render 
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Fig. 177. — Shove the effect of rise of temperature after injection of digitalis. At the 45th minute "75 
c.c. (12 minims) tincture of digitalis were injected, and another similar injection was made at the 
56th minute. At the 65th minute the heating was begun. After section of the vagi the pulse con- 
tinued to rise, but not more rapidly than before. 

its functional activity is not completely destroyed even by very high 
temperatures, and irritation of an afferent nerve will still cause reflex 



COROLLIFLOR^E. 



849 



slowing (p. 254) of the pulse, until immediately before the death of the 
animal from hyperpyrexia. 

These experiments render it probable that the rapid rise in the pulse 
rate, which a high temperature occasions, is chiefly of central origin, and 
is due to partial paralysis of the vagus centre, although diminished action 
of the peripheral ends of the vagus and increased action of the cardiac 
ganglia also aid in quickening the pulse. 

Although neither the vagus centre nor the vagus ends in the heart 
are completely paralyzed by very high temperatures, they are yet weakened 
so much that digitalis, and probably all drugs which act like it, such as 
adonidine (p. 294), no longer slow the pulse as they do at normal tem- 
peratures. This is shown in Fig. 177, where the pulse remained slow 
until the temperature rose to nearly 41° C. and then suddenly became 
very quick. Moderately high temperatures do not prevent digitalis from 
slowing the heart (Fig. 178). 



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. Fig. 178. — Shows the action of digitalis when given after the temperature has already risen. At the 
30th minute the warming was begun ; at the 100th minute '75 c.c. of tincture of digitalis was 
injected. 

Action of Different Preparations of Digitalis. — The two most 
marked effects of digitalis are a reduction in the rate of the pulse, and an 
increase in the amount of urine. These effects are not coincident, and, 
according to Christison, the diuretic action is less when the heart is much 
affected. The preparation generally employed to act on the heart is the 
tincture, while the infusion is regarded as the best diuretic. 1 The differ- 
ences between the action of the infusion and tincture of digitalis are 
probably due, in part at least, to the different proportions in which the 
active principles of the plant are dissolved by alcohol and water. 

In digitalis, as in physostigma (p. 762) and many other plants, there 
is a mixture of principles having antagonistic actions. Digitonin, which 
has an action very like saponin (pp. 271 and 774), will, to a greater or 
less extent, antagonize the action of digitoxin, digitalin, and digitalein. 
Digitonin is readily soluble in water, forming, like saponin, a solution 
which froths easily. Digitalein is soluble in water, but digitalin is only 
sparingly so, and digitoxin is hardly soluble in water at all. 

The solubility of these substances in alcohol is almost the converse of 
their solubility in water. Digitonin is sparingly soluble in alcohol, while 



54 



1 The National Dispensatory. 



850 VEGETABLE MATERIA MEDICA. 

digitalin and digitalein are readily soluble. Digitoxin is only sparingly 
soluble in cold alcohol. 

From the ready solubility of digitonin in water, infusion of digitalis 
will contain it in much larger proportion than digitalin or digitalein. 
This, indeed, is readily seen by putting some infusion of digitalis into 
one bottle and a corresponding dose of the tincture diluted with water 
into another, until both solutions have the same bulk. On shaking the 
bottles, the infusion will be found to froth much more strongly and to 
retain the froth much longer than the diluted tincture, although the latter 
also froths strongly. 

Tincture of digitalis will, on the other hand, contain a larger pro- 
portion of digitalin and digitalein with probably a small quantity of 
digitoxin. 

It is quite possible, however, that in addition to differences in the 
preparations due to the menstruum, there may be differences in the same 
preparation due to the plants used. Thus in Edinburgh the usual dose 
of the infusion is half an ounce, and this is usually readily tolerated, 
while in London I have frequently seen doses of one or two drachms pro- 
duce considerable gastric disturbance. The infusion of the U.S. P. is 
nearly twice as strong as that of the B.P., and yet the recognized dose 
is considerably larger. 

Whether these differences are or are not due to the amount and rela- 
tive proportions of the active ingredients in digitalis plants grown 
in Scotland, England, and America, is a point which requires investiga- 
tion, more especially when we have other examples, e.g., cannabis indica, 
where there is a notable difference between the action of plants of the 
same species growing in different climates. 

Therapeutics. — It is chiefly used as a tonic to the heart, especially 
when its action is irregular and feeble, and in dropsy, cardiac dropsy 
(pp. 295 and 298). 

It is used in functional palpitation, and in the irritable heart often 
seen in young soldiers (p. 300), but its chief use is in mitral disease. 

In pure aortic disease, with hypertrophy, it is not only injurious but 
dangerous, since by slowing the pulse rate it lengthens the time during 
which blood can regurgitate (p. 295). 

When the aortic disease is accompanied by mitral incompetence and 
the immediate danger is that from the mitral affection, it may be given 
with advantage (p. 296). In these cases, whilst taking the drug the 
patient must be kept perfectly quiet, as there is a great danger of sudden 
syncope (p. 296). 

Digitalis is of great use as a soporific in sleeplessness at night accom- 
panied by drowsiness during the day, for both these symptoms depend on 
want of tone in the vessels, the blood gravitating to the feet when the 
patient is erect, and to the head when in a lying posture (p. 177). 

It is very useful in haemorrhages, especially when occurring in the 
lungs, and it has been added to cough mixtures to lessen congestion of 
the mucous membrane. 

It was formerly used in fever and pneumonia, but is now discarded as 
being of very little use. 

In delirium tremens it has been given in very large doses, but its use 
is dangerous. 



COROLLIFLOR.E. 851 

In dropsy depending on mitral disease, also in renal dropsy and 
ascites, it has been used with good effect. 

It is very serviceable in some cases of menorrhagia. Its action in 
this case is due not to contraction of the vessels of the uterus, but of the 
walls of the uterus itself, since digitalis did not affect haemorrhage 
from a fungoid growth in the cervix (Dickinson). 

It is also useful in spermatorrhoea. 

Precautions. — (1) Stop the administration of digitalis on the 
appearance of sickness or a tendency to faint, or change the preparation 
of digitalis and lower the dose. 

(2) Do not give digitalis in large doses unless you see the patient 
frequently, and it is necessary to push the drug. Keep the patient in 
bed, and do not allow him even to sit up in bed, much less to rise, and 
above all not to rise up and make water, as otherwise fatal syncope may 
occur (p. 230). 

Treatment on Poisoning. — Keep the patient recumbent and give 
stimulants, e.g., alcohol. Tannin has been recommended in order to 
precipitate digitalin in the stomach. 

U.S.P. Leptandra. Leptandra. Culver's Root. — The rhizome 
and rootlets of Leptandra virginica ( Veronica virginica.) 

Characters. — Horizontal, from four to six inches (10 to 15 centi- 
metres) long, and about a quarter of an inch (6 millimetres) thick, some- 
what flattened, bent and branched, deep blackish-brown, with cup-shaped 
scars on the upper side, hard, of a woody fracture, with a thin, blackish 
bark, a hard, yellowish wood, and a large, purplish-brown, about six- 
rayed pith ; rootlets thin, wrinkled, very fragile, inodorous ; taste bitter 
and feebly acrid. 

Peepaeations. 

DOSE. 

Extractum Leptandrae (of the root, 2-4 gr.) 

Extractnm Leptandrae Fluidum 30-60 min. 

Composition. — It contains a resinous principle, leptandrin. 

Action. — It is an irritant to the gastro-intestinal mucous membrane, 
and stimulates the secretion of "bile (p. 351). It may be used as a 
cathartic in biliousness or constipation. 

LABIATE. 

Rosmarinus, U.S.P. Rosemary. — The leaves of Rosmarinus 
officinalis. 

Characters. — About one inch (25 millimetres) long, rigid, linear, 
entire, revolute, dark green above, woolly and glandular beneath ; pun- 
gently aromatic, somewhat camphoraceous. 

Peepaeation. 
Vinum Aromaticum. 

Oleum Kosmarini, U.S.P. and B.P. Oil of Rosemary. — A 
volatile oil distilled from rosemary, U.S.P. The oil distilled from the 
flowering tops of Rosmarinus officinalis. 

Characters. — Colorless, with the odor of rosemary, and a warm, 
aromatic taste. 



852 VEGETABLE MATERIA MEDICA. 

Preparations, 
u.s.p. DOSE. 

Linimentum Saponis for external use. 

Spiritus Odoratus do 

Tinctura Lavandulae Composita $-2 fl. dr. 

B.P. DOSE. 

Linimentum Saponis for external use. 

Spiritus Rosmarini 10-50 min. or more. 

Tinctura Lavandula? Composita j-2 fl. dr. 

(of the oil, 1-5 min.) 

Action axd Use. — It is a stimulant and carminative, and is used 
to lessen flatulence, and to allay pain and spasm of the intestines. It is 
a useful adjunct to purgatives, and is used in hysteria. 

U.S.P. Lavandula. Lavender. — The flowers of Lavandula vera. 

Characters. — Calyx tubular, blue-gray, hairy, five-toothed, the 
upper tooth largest and roundish-rhomboid; corolla violet-blue, hairy 
and glandular on the outside, tubular and two-lipped, the upper lip two- 
lobed, the lower lip three-lobed ; stamens four, short, on the corolla tube ; 
odor fragrant; taste bitterish, aromatic, somewhat camphoraceous. 

Preparation. 
Vinum Aromaticum. 

Oleum Lavandulae, U.S.P. and B.P. Oil of Lavender. — A 
volatile oil distilled from the flowering tops or whole herb of Lavandula 
vera, U.S.P. The oil distilled in Britain from the flowers of Lavandula 
vera, B.P. 

Characters. — Colorless or pale yellow, with the odor of lavender, 
and a hot, bitter, aromatic taste. 

Preparations, 
u.s.p. DOSE. 

Tinctura Lavandula? Composita £-2 fl. dr. 

B.P. DOSE. 

Linimentum Camphone Compositum 

Spiritus Lavandulae j-l fl. dr. 

Tinctura Lavandulae Composita £-2 fl. dr. 

(of the oil, 5 min.) 

U.S.P. Oleum Lavandulae Flo rum. Oil of Lavender 
Flowers. — A volatile oil distilled from fresh lavender. 

Characters. — A colorless or yellowish liquid, having the fragrant 
odor of lavender flowers, a pungent and bitterish taste, and a neutral 
reaction while fresh. Sp. gr. about 0*890. It is readily soluble in 
alcohol, and in acetic acid of 90 or more per cent. When heated to 
about 80° C. (176° F.) it should not yield a colorless distillate having 
the characteristics of alcohol. 
Dose. — 1-5 min. 

Preparations, 
u.s.p. DOSE. 

Spiritus Lavandulae (3 parts of the oil with 97 of alcohol) h-2 fl. dr. 

Spiritus Odoratus 

Action and Uses. — Lavender is a stimulant and carminative, 

and is used to lessen flatulence, to relieve colic, and in hysteria. 



COROLLIFLORJE. 853 

Oleum Menthae Piperita, U.S.P. and B.P. Oil of Pepper- 
mint. — A volatile oil distilled from peppermint, U.S.P. The oil distilled 
in Britain from fresh flowering peppermint, Mentha piperita, B.P. 

Characters. — Colorless or pale yellow, with the odor of pepper- 
mint ; taste warm, aromatic, succeeded by a sensation of coldness in the 
mouth. 

Peepaeations. 

U.S.P. DOSE. 

Aqua Menthae Piperitae 1-2 fl. oz. 

Spiritus Menthae Piperitae 10-15 min. 

Trochisci Menthae Piperitae (Peppermint Lozenges) ad. lib. 

B.P. DOSE. 

Aqua Menthae Piperitae 1J fl. dr. to 1 gallon 1-2 fl. oz. 

Essentia Menthae Piperitae 1 volume in 5 10-20 min. 

Pilula Rhei Composita 1 min. in 1 dr. nearly 5-10 gr. 

Spiritus Menthae Piperitae 1 volume in 50 | fl. dr. 

(of the oil, 1-5 min.) 

Action and Uses. — Carminative and stimulant ; used to relieve 
flatulence and colic ; and as an adjunct to purgatives, to lessen griping. 
Mosquito bites may be prevented by rubbing the skin of the face and 
hands, the lips and the margins of the nostrils with soap strongly scented 
with peppermint or lavender. A sprig of peppermint or pennyroyal, or 
a small bottle containing their volatile oils, hung near the head during 
sleep is said to have a similar effect. Peppermint lozenges are useful in 
relieving flatulence and tendency to faintness due to it. 

Menthol. C 10 H 20 O. Peppermint Camphor. Not officinal. 

Preparation. — It separates from peppermint oil after standing, or 
on cooling to 20° C. 

Characters. — Colorless crystals, with a taste and smell of pepper- 
mint oil, sparingly soluble in water, readily soluble in alcohol, ether, and 
ethereal oils. When rubbed up with an equal quantity of thymol it forms 
a colorless, oily liquid. The same is the case when it is rubbed with an 
equal quantity of pure carbolic acid or of chloral hydrate, or with croton 
chloral hydrate in the proportion of 1 part to 2 of menthol, or with 
camphor 2 parts to 3 of menthol. 

Action. — It is a powerful antiseptic. When applied to mucous 
membrane or skin it causes a feeling of warmth or burning, replaced by 
a feeling of coldness when the part is blown upon. 

Uses. — It is chiefly used as an anti -neuralgic. It is either applied 
in the form of a solid pencil rubbed lightly over the part where the pain 
is felt, or an alcoholic solution, or the oily liquids prepared by trituration 
with camphor, carbolic acid, &c, may be painted over the painful spots. 
These oily liquids are also applied on cotton-wool in order to relieve 
toothache. 

Oleum Menthae Viridis, U.S.P. and B.P. Oil oe Spearmint. 
— The oil distilled in Britain from fresh flowering spearmint, Mentha 
viridis, B.P. 

Characters. — Colorless or pale yellow, with the odor and taste of 
spearmint. 



854 VEGETABLE MATERIA MEDICA. 

Peepaeatioxs. 
tj.s.p. dose. 

Aqua Menthse Viridis 1-2 fl. oz. 

Spiritus Mentha Viridis 5-20 min. 

B.P. DOSE. 

Aqua Mentha? Viridis 1£ fl. dr. to 1 gallon 1-2 fl. oz. 

(of the oil, 1-5 min.) 

Action and Use. — Like other carminatives and stimulants, to 
relieve colic, flatulence, and with purgatives to prevent griping. 

TJ.S.P. Thymol. Thymol. C 10 H 13 HO, or G^.C^.GR.OR. 

(vide p. 166). 

Preparation. — It is obtained from the volatile oils of Thymus 
vulgaris (Labiatse), Thonarda punctata (Labiatae), and Ptyehotis ajowan 
(Umbelliferse). 

These oils contain thymol and thymene, C 10 H 16 , which is fluid. The 
thymol is separated by fractional distillation or prolonged refrigeration. 

Characters. — Large crystals of the hexagonal system, nearly or 
quite colorless, having an aromatic, thyme-like odor, a pungent, aromatic 
taste, with a very slight caustic effect upon the lips, and a neutral reaction. 
Soluble in about 1200 parts of water, and in 1 part of alcohol at 15° C. 
(59° F.) ; in 900 parts of boiling water ; freely soluble in burning alcohol, 
also in ether, chloroform, benzol, benzin, glacial acetic acid, and in fixed 
or volatile oils. It liquefies with camphor. Its sp. gr. as a solid is 
1*028; after fusion it is lighter than water. It melts at about 50° C. 
(122° F.), remaining liquid at lower temperatures, and boils at about 
230° C. (446° F.). A portion mixed with half its volume of glacial 
acetic acid, then with an equal or somewhat greater volume of sulphuric 
acid, and gently heated, gives a bright reddish-violet color. 

Impurity. — Carbolic acid. 

Test. — Water saturated with thymol, when treated with a few drops 
of test solution of ferric chloride, should not give a blue color (absence of 
carbolic acid). 

Dose. — Internally, J— 1J grains. For spray, 1 in 800 of hot water. 
As ointment, 5-30 grains to 1 oz. of petrolatum. As inhalation, 6 grains 
to an ounce of warm water. 

Action. — In respect of its physiological action, thymol appears to 
stand between carbolic acid and oil of turpentine. Like carbolic acid, it 
destroys low organisms, and is a powerful disinfectant. In higher 
animals it acts as a local irritant and anaesthetic to the skin and mucous 
membranes. When absorbed it paralyzes the nerve centres in the 
cord and medulla like carbolic acid, lessening reflex action, slowing 
respiration, and lowering the blood-pressnre and temperature. 
In poisonous doses it causes weakness, drowsiness, coma, and death. It 
differs from carbolic acid in being less volatile and less easily oxidized. 
Its action as a disinfectant is more permanent, and at the same time more 
powerful than that of carbolic acid. It is less irritating to the skin or 
mucous membrane, and does not act as a caustic like carbolic acid, and it 
i- a less powerful poison to mammals. Its action on the nerve centres is 
a paralyzing one from the first, and is not preceded by excitement as in 



COROLLIFLOR.E. 855 

the case of carbolic acid. While in the body it appears to affect tissue 
metabolism, for in animals poisoned by it the liver is found quite fatty, 
as in phosphorus poisoning. It appears to be eliminated by the 
respiratory and urinary organs, and to cause irritation of these organs 
during the process of excretion. In poisoning by it the bronchial mucous 
membrane is extremely congested, the secretion of mucus increased ; the 
lungs congested, and sometimes consolidated ; the kidneys inflamed, and 
the urine albuminous or bloody. 

Uses. — It has been used as an antiseptic instead of carbolic acid 
for dressing wounds ; as an application to skin diseases, ringworm, 
eczema, or psoriasis ; as a gargle, spray, or inhalation in sore throat, or 
as an injection in ozsena. Internally it has been used in diabetes and 
vesical catarrh. 

U.S.P. Hedeoma. Hedeoma. Pennyroyal. — The leaves and 
tops of Hedeoma pulegioides. 

Characters. — Leaves opposite, short-petioled, about half an inch 
(12 millimetres) long, oblong-ovate, obscurely serrate, glandular beneath ; 
branches roundish-quadrangular ; flowers in small, axillary cymules, with 
a tubular-ovoid, two-lipped and five-toothed calyx, and a pale blue, spotted, 
two-lipped corolla, containing two sterile and two fertile exserted stamens ; 
odor strong, mint-like ; taste warm and pungent. 

Officinal Peepaeation. 

U.S.P. DOSE. 

Oleum Hedeomae 1-5 min. 

Composition. — It contains a volatile oil. 

Action and Uses. — It is stimulant, carminative, diaphoretic and 
emmenagogne. It is used in flatulence and in amenorrhcea. It is 
frequently given in the form of hot infusion, to promote the menstrual 
flow when delay or recent suppression has occurred. 

U.S.P. Marrubium. Marrubium. Horehound. — The leaves 
and tops of Marrubium vulgare. 

Characters. — Leaves about one inch (25 millimetres) long, oppo- 
site, petiolate, roundish-ovate, obtuse, coarsely crenate, strongly rugose, 
downy above, white-hairy beneath ; branches quadrangular, white, tomen- 
tose ; flowers in dense, axillary, woolly whorls, with a stiffly ten-toothed 
calyx, a whitish bi-labiate corolla, and four included stamens ; aromatic 
and bitter. 

Composition. — It contains a volatile oil and a bitter principle, mar- 
rubiin. 

Dose.— 30-60 gr. (2-4 Gm.). 

Uses. — It is expectorant, tonic, diaphoretic and diuretic. In large 
doses it is laxative. It is employed in laryngeal and bronchial catarrh, 
and in chronic affections of the lungs attended with cough and copious 
expectoration. 

U.S.P. Melissa. Melissa. Balm. — The leaves and tops of 
Melissa officinalis. 

Characters. — Leaves about two inches (5 centimetres) long, petiolate, 
ovate, obtuse, crenate, somewhat hairy, glandular ; branches quadrangular ; 



856 VEGETABLE MATERIA MEDICA. 

flowers in about four-flowered cymules, with a tubular, bell-shaped, five- 
toothed calyx, a whitish or purplish two-lipped corolla, and four stamens ; 
fragrant, aromatic and bitterish. 

Composition. — It has a small quantity of a volatile oil. 

Uses. — It has scarcely any remedial action, but is used in the form 
of warm infusion or tea as a diaphoretic in slight febrile conditions. 

XJ.S.P. Origanum. Origanum. Wild Marjoram. — Origanum 
vulgare. 

Characters. — Stem branched above, often purplish, leaves opposite, 
petiolate, about an inch (25 millimetres) long, roundish-ovate, obtuse, 
nearly entire, pellucid-punctate, hairy beneath; flowers in corymbs, with 
reddish bracts, a five-toothed calyx, a somewhat two-lipped, pale purple 
corolla, and four exserted stamens ; aromatic, pungent and bitterish. 

Peepaeation. 
Vinum Aromaticum. Used externally. 

Composition. — It contains a volatile oil, which has been largely 
superseded by the oil of thyme. 

Action and Uses. — The infusion is tonic, diaphoretic, and 
eimiieiiagogne. It is also used externally as a fomentation. 

XJ.S.P. Salvia. Salvia. Sage. — The leaves of. Salvia officinalis. 
Characters. — About two inches (5 centimetres) long, petiolate, 
ovate-oblong, obtuse, finely crenulate, thickish, wrinkled, grayish-green, 
soft-hairy and glandular beneath; aromatic, bitterish, somewhat astrin- 
gent. 

Peepaeation. 
Vinum Aromaticum. Externally only. 

Composition. — The leaves contain a volatile oil. 

Uses. — They are chiefly used as a condiment. The infusion is tonic, 
carminative, and slightly astringent. It is used in atonic dyspepsia, 
and to check hectic sweating. 

U.S.P. Scutellaria. Scutellaria. Skull-cap. — Scutellaria 
lateriflora (whole plant). 

Characters.- — About twenty inches (50 centimetres) long, smooth; 
stem quadrangular, branched ; leaves opposite, petiolate, about two inches 
(5 centimetres) long, ovate-lanceolate or ovate-oblong, serrate; flowers in 
axillary, one-sided racemes, with a pale blue corolla and a two-lipped 
calyx, closed in fruit, the upper lip helmet-shaped ; odor slight ; taste 
bitterish. 

Officinal Peepaeation. 

U.S.P. DOSE. 

Extractum Scutellaria Fluidum 1-2 fl. drni. 

Uses. — As a remedy it has little value. It has been used as a nervine 
tonic in neuralgia, chorea, delirium tremens and nervous exhaustion. 

PEDALIACEiE. 

U.S.P. Oleum Sesami. Oil of Sesamum. (Benn<i Oil). — A 
fixed oil expressed from the seed of Sesamum indicum. 



so, 



APETAL.E. 857 

Characters. — A yellowish or yellow, oily liquid, inodorous, or nearly 
having a bland, nut-like taste, and a neutral reaction. 
Action. — Similar to olive oil. 



CHAPTER XXXIV. 
Sub-Class IV.— APETALiE. 

POLYGONACE^. 

Rheum, U.S. P. ; Rliei Radix, B.P. Rhubarb, U.S. P. ; Rhu- 
barb Root, B.P. — The root, U.S. P. The dried root deprived of the 
bark, from one or more undetermined species of Rheum. China, Chinese 
Tartary, and Thibet, B.P. 

Characters. — Trapezoidal, roundish, cylindrical or flattish pieces, 
frequently bored with one hole, yellow externally, internally marbled with 
fine waving grayish and reddish lines, finely gritty under the teeth ; taste 
bitter, faintly astringent and aromatic ; odor peculiar. 

Composition. — The chief constituent is chrysophanic acid, so named 
from its forming brilliant yellow crystals. It is extracted by ether or 
alcohol, not by water. Besides this there is also a glucoside, chrysophane, 
which splits up into chrysophanic acid and sugar. There are also several 
resinous matters, one of which, phaoretin, is purgative ; and mineral 
compounds are also present, especially oxalate of lime. The astringency 
of rhubarb is due to a peculiar tannic acid (Rheo-tannic), which is solu- 
ble in water and alcohol, but not in ether. 

Impurities. — English rhubarb and turmeric fraudulently added. 

Tests. — Odor and taste (English rhubarb). Boracic acid does not 
turn the yellow exterior brown (turmeric). 

Pbepabatioxs. 

U.S.P. DOSE. 

Eheum. 

Extractum Ehei 3-10 gr. 

Extractum Ehei Fluidum 1-10 niin. 

Pilulae Ehei (rhubarb, 3; soap, 1) 1-3 pills (3 gr. each). 

Pilulae Ehei Compositae 1-4 pills. 

Pulvis Ehei Compositus 30-60 gr. 

Syrupus Ehei 1_4 fl - drm - 1 for children 

Syrupus Ehei Aromaticus 1-4 fl. drm. j I0r cnnQren - 

Tinctura Ehei 1-6 fl. drm. 

Tinctura Ehei Aromatica 1-4 fl. drm. 

Tinctura Ehei Dulcis 1-4 fl. drm. for children. 

Vinum Ehei 1-4 fl. drm. 

Mistura Ehei et Sodae 2 drm.-3 oz. 



858 VEGETABLE MATERIA MEDICA. 

Peep aeations — (continued ) . 

B.P. DOSE. 

Extractum Rhei 5-15 gr. 

Infusum Rhei (J- oz. in £ pint for 1 hour) 1-2 fl. oz. 

Pilula Rhei Conrposita 5-10 gr. 

Pulvis Rhei Compositus 5-10 gr. (child). 

20-60 gr. (adult). 

Syrupus Rhei 1-4 fl. drm. 

Tinctura Rhei l-2fl. drm. (stomachic). 

" £-1 fl. oz. (purgative). 

Vinum Rhei 1-2 fl. drm. 

(of the powdered root, 1-5 gr. as stomachic ; 10-30 gr. as purgative). 

U.S.P. Pilula Rhei Composita. COMPOUND PlLLS OF RHUBAEB.— Rhubarb, 
200 gr. ; purified aloes, 150 gr. ; myrrh, 100 gr. ; oil of peppermint, 10 gr. ; beat up 
with water to make a mass, and divide into 100 pills. 

U.S.P. Pulvis Rhei Compositus. COMPOUND POWDEE OF RHUBAEB. — Rhubarb, 
25 ; magnesia, 65 ; ginger, 10 parts. 

U.S.P. Syrupus Rhei. Syeup of Rhubaeb. — Rhubarb, 90 ; cinnamon, 18 ; car- 
bonate of potassium, 6 ; sugar, 600 ; water, q.8. to make 1000. 

U.S.P. Syrupus Rhei Aromaticus. AEOMATIC SYEUP OF RHUBARB. — Aromatic 

tincture of rhubarb, 10 ; syrup, 90 parts. 

U.S.P. Tinctura Rhei. TlNCTUEE OF Rhubaeb. — Rhubarb, 12 ; cardamom, 2 ; 
diluted alcohol up to 100 parts. 

U.S.P. Tinctura Rhei Aromatica. AROMATIC TlNCTUEE OF RHUBAEB. —Rhu- 
barb, 20; cinnamon, 4; cloves, 4 ; nutmeg, 2 ; diluted alcohol up to 100. 

U.S.P. Tinctura Rhei Dulcis. SWEET TlNCTUEE OF RHUBAEB. — Rhubarb, 8 5 

glycyrrhiza, 4 ; anise, 4 ; cardamom, 4 ; diluted alcohol up to 100. 

U.S.P. Vinum Rhei. Wine of Rhubaeb.— Rhubarb, 10 ; calamus, 1 ; stronger 
white wine up to 100. 

B.P. Pilula Rhei Composita. COMPOUND RHUBAEB PlLL.— Rhubarb, 3 OZ. ; 
socotrine aloes, 2j oz. ; myrrh, 1£ oz. ; hard soap, 1£ oz. ; oil of peppermint, 1? fl. 
dr. ; treacle, by weight, 4 oz. The solid ingredients, which must all be in powder, 
are mixed with the oil, and then the treacle is added. 

B.P. Pulvis Rhei Compositus. COMPOUND POWDER OF RHUBARB (GREGORY'S 

Powder). — Rhubarb root, 2 oz. ; light magnesia, 6 oz. ; ginger, 1 oz. Mix the pow- 
dered ingredients and pass through a fine sieve. 

B.P. Syrupus Rhei. Syrup of Rhubarb. — Rhubarb root and coriander fruit, 
both in coarse powder, each 2 oz. ; refined sugar, 24 oz. ; rectified spirit, 8 fl. oz. ; 
distilled water, 24 fl. oz. Percolate the rhubarb and coriander with the spirit and 
water ; evaporate the filtrate to 13 fl. oz. ; filter ; dissolve the sugar in the filtrate. 

B.P. Tinctura Rhei. Tincture OF Rhubarb. — Rhubarb, 2 oz. ; bruised car- 
damom seeds, } oz. ; coriander fruit, £ oz. ; saffron, j oz. ; proof spirit, 1 pint. 

B.P. Vinum Rhei. Wine of Rhubarb. — Rhubarb root, l£ oz. ; Canella alba 
bark, 60 gr. ; sherry, 1 pint. 

Action and Uses. — Rhubarb when chewed increases the flow of 
saliva. Small closes have a tonic and astringent action and are 
employed in atonic dyspepsia, especially when there is an accumulation 
of mucus in the intestinal tube. Large doses are purgative in their 
action, increasing peristalsis. This is followed by an astringent effect. It 
is especially useful in cases of diarrhoea, when there is some irritating 
body in the intestines ; this is carried off, and then the after astringent 
action checks the diarrhoea. 

U.S.P. linmex. Rumex. Yellow Dock. — The root of Eumex 
crispm and of other species of Rumex. 

Characters. — From eight to twelve inches, (20 to 30 centimetres) 
long, about half an inch (12 millimetres) thick, somewhat fusiform, 



APETAL^. 859 

fleshy, nearly simple, annulate above, deeply wrinkled below ; externally 
rusty-brown, internally whitish, with fine, straight, interrupted, reddish 
medullary rays, and a rather thick bark ; fracture short ; odor slight, 
peculiar ; taste bitter and astringent. 

Peepaeation. 

dose. 
Extractum Rumicis Fluidum 30-60 min. 

Composition. — It contains tannic acid and rumicine, which is iden- 
tical with chrysophanic acid. 

Action. — It is astringent and bitter, and is supposed to possess 
alterative properties, which render it useful in scorbutic diseases. 

PHYTOL.ACCACEJE. 

U.S.P. Phytolacca? Bacca. Phytolacca Berry. Poke Berry. 
— The fruit of Phytolacca decandra. 

Characters. — A depressed-globular, dark purple, compound berry, 
about one-third of an inch (8 millimetres) in diameter, composed of ten 
carpels, each containing one lenticular, black seed; juice purplish-red ; 
inodorous ; sweet, slightly acrid. 

U.S.P. Phytolacca Radix. Phytolacca Root. Poke Root. 
— The root of Phytolacca decandra. 

Characters. — Branched, wrinkled, yellowish - brown externally, 
yellowish-white internally. Transverse sections exhibit numerous con- 
centric rings. No smell ; taste sweetish, and afterwards acrid. 

Action. — Poke is emetic, cathartic, and somewhat narcotic, pro- 
ducing in large doses vomiting, purging, drowsiness, dimness of vision, 
giddiness, and sometimes convulsions. It has been proposed as an emetic 
instead of ipecacuanha, but its action is too slow. As an alterative it has 
been recommended in rheumatism. Externally a strong infusion or 
decoction of the root has been used in piles, skin diseases, and cancer. 

CHENOPODIACEiE. 

U.S.P. Chenopodium. Chenopodium. American Wormseed. 
— The fruit of Chenopodium ambrosioides, var. anthelminticum. 

Characters. — Nearly one-twelfth of an inch (2 millimetres) in 
diameter, depressed-globular, glandular, dull greenish or brownish, the 
integuments friable, containing a lenticular, obtusely-edged, glossy, black 
seed. It has a peculiar, somewhat terebinthinate odor, and a bitterish, 
pungent taste. 

Dose. — 10-40 grains. 

U.S.P. Oleum Chenopodii. — A volatile oil distilled from worm- 
seed. 

Use. — It is used as a vermifuge to expel lumbricoid worms. The 
powdered seeds, which possess the active medicinal virtues, may be com- 
bined with some agreeable elixir, or the essential oil may be given on a 
lump of sugar, or in emulsion in doses of 3-5 minims. 



860 VEGETABLE MATERIA MEDICA. 

MYRISTICACEiE. 

Myristica. Nutmeg. — The kernel of the seed of Myristica fra- 
grant deprived of its testa, U.S. P. The kernel of the seed of Myristica 
officinalis, B.P. Malayan Archipelago. 

Characters. — Oval or nearly round, about an inch in length, marked 
externally with reticulated furrows, internally grayish-red with dark 
brownish veins. It has a strong, peculiar odor, and a bitter, aromatic 
taste. Nutmeg resembles areca nut, especially in its internal structure, 
but the latter is devoid of the strong odor. 

Composition. — Fixed oil (oil of mace) and volatile oil, the latter 
imparting the aromatic smell and taste. 

Preparations. 

U.S. P. DOSE. 

Tinctura Lavandulae Composita £-2 fl. drm. 

Pulvis Aromaticus 10-30 gr. 

B.P. DOSE. 

Oleum Myristicae 1-5 min. 

Oleum Myristicae Expressum 1-5 min. 

Pulvis Catechu Compositus 20-40 gr. 

Pulvis Cretae Aromaticus 10-60 gr. 

Spiritus Armoracias Compositus 1-2 fl. drm. 

Tinctura Lavandulae Composita ^-2 fl. drm. 

(of powdered nutmeg, 5-15 gT.) 

Oleum Myristicae, U.S.P. and B.P. Volatile Oil of Nutmeg. 
— A volatile oil distilled from nutmeg, U.S.P. The oil distilled in 
Britain from nutmeg, B.P. 

Characters. — Colorless or straw-yellow, having the odor and taste 
of nutmegs. 

Preparations. 

U.S.P. DOSE. 

Spiritus Myristicae 1-2 fl. drm. 

B.P. DOSE. 

Pilula Aloes Socotrinse 5-10 gr. 

Spiritus Ammoniae Aromaticus 30 min. to 1 fl. drm. 

Spiritus Myristicae 30-60 min. 

(Mistura Ferri Composita). 

B.P. Oleum Myristicae Expressum. Expressed Oil of Nut- 
meg. — A concrete oil obtained by means of expression and heat from 
nutmegs. 

Characters. — Of an orange color, firm consistence, and fragrant 
odor like that of nutmeg. 

Preparations. 

15.]'. 

Emplastrum Calelaciens. Emplastrum Picis. 

Action and Uses. — Nutmeg is aromatic, stimulant, and carmi- 
native. The expressed oil is used externally as a stimulant, and with 
other stimulants is contained in emplastrum picis and emplastrum cali- 
faciens. It is very little used in medicine, but chiefly to flavor articles 
of food. 



APETAL^. 861 

U.S.P. Macis. Mace. — The arillus of the fruit of Myristica 
fragrans. 

Characters. — In narrow bands, one inch (25 millimetres) or more 
long, somewhat branched and lobed above, united to broader bands below ; 
brownish-orange; fatty when scratched or pressed; odor fragrant; taste 
warm and aromatic. 

Uses.— It contains the same volatile oil as nutmeg-, and has the 
same uses. 

LAURACE^. 

Ciiinamomum, U.S. P. ; Cnmamomi Cortex, B.P. Cinnamon, 

U.S.P. ; Cinnamon Bark, B.P.— The inner bark of shoots from the 
truncated stocks of Cinnamomum zeylanicwm. Imported from Ceylon. 
Characters. — In closely rolled quills, containing several small quills 
within them, light yellowish-brown, with a fragrant odor and warm, sweet, 
aromatic taste ; breaks with a splintery fracture. 

Composition. — A volatile oil to the extent of 1 per cent, with man- 
nite, sugar, mucilage, and tannic acid. 
Adulteration. — Cassia lignea. 

Test. — Decoction of cassia lignea is colored blue : black by tincture 
of iodine. 

Prepaeations. 
u.s.p. DOSE. 

Pulvis Aromaticus 10-30 gr. 

Tinctura Cinnamonii j-2 fl. dr. 

Oleum Cinnarnorni 1-5 min. 

Tinctura Lavandulae Composita £-2 fl. dr. 

Vinum Opii 6 min. 

B.P. DOSE. 

Acidum Sulphuricum Aromaticum 5-30 min. 

Aqua Cinnamonii 1-2 fl. OZ. 

Decoctum Hsematoxyli 1-2 fl. oz. 

Infusum Catechu 1-2 fl. oz. 

Oleum Cnmamomi 1-5 min. 

Pulvis Catechu Compositus 20-40 gr. 

Pulvis Cinnamonii Compositus 10-30 gr. 

Pulvis Cretae Aromaticus 10-60 gr. 

Pulvis Kino Compositus 5-20 gr. 

Tinctura Cardamomi Composita £-2 A- dr. 

Tinctura Catechu ....|-2 fl. dr. 

Tinctura Cinnamomi j-2 fl. dr. 

Tinctura Lavandulae Composita J-2 fl. dr. 

Vinum Opii 10-40 min. 

Pulvis Aromaticus, U.S.P. ; Pulvis Cinnaiiiomi Compositus, 

B.P. Aromatic Powder, U.S.P.; Compound Cinnamon Powder, 
B.P. — Cinnamon 35, ginger 35, cardamoms 15, nutmeg 15, U.S.P. 
Equal parts of cinnamon, cardamoms, and ginger, B.P. 

Oleum Cinuamomi, U.S.P. and B.P. Oil of Cinnamon. — The 
oil distilled from cinnamon bark. 

Characters. — Yellowish when recent, gradually becoming red; 
having the odor and taste of cinnamon. 

Composition. — Consists principally of cinnamic aldehyde, or hydride 
of cinnamyl, with other hydrocarbons, one of which, a camphor, is 



862 VEGETABLE MATERIA MEDICA. 

deposited at low temperatures, thus causing the change in color. The 
oil has a specific gravity of from 1*025 to 1*050, so that it sinks in water. 
It is slightly laevulose. 

Preparations, 
u.s. p. dose. b.p. 

Aqua Cinnamomi Indefinite. None. 

Spiritus Cinnamomi 5-15 min. 

Acidum Sulphuricum Aromaticum 5-15 min. 

Action and Uses. — Cinnamon is an aromatic carminative, and, 
since it contains tannic acid, slightly astringent. It is chiefly used in 
conjunction with other astringents, and from its agreeable taste is very 
frequently employed. 

Coto Bark. Not officinal. — The bark of a tree imported from 
Bolivia. 

Composition. — It contains an alkaloid, cotoin. Cotoin forms a pale 
yellow powder or minute crystals, sparingly soluble in water ; soluble in 
alcohol, ether, and chloroform. 

Action. — It appears greatly to increase intestinal absorption 
(p. 337). 

Uses. — It is useful in gastric and intestinal catarrh, in infantile 
diarrhoea, and in the diarrhoea of phthisis. It is said also to check 
salivation and the night sweats of phthisis. 

Dose. — \ to 2 gr. every two or three hours in mucilage or syrup. A 
solution of 1 part in 4 of acetic ether is recommended for hypodermic 
injection. Tincture of coto bark may be used in doses of 10 min. 

Not officinal. Paracoto Bark. — Contains an alkaloid, paracotoin, 
similar in its actions and uses to cotoin, but less powerful. 

Camphora, U.S. P. and B.P. Camphor. — A concrete volatile 
oil (stearoptin, U.S. P.) obtained from the wood of Oinnamomurn cam- 
phora, U.S. P.; Camphora officinarum, B.P. Imported in the crude 
state from China and Japan, and purified by sublimation. 

Characters. — White, translucent, tough, and crystalline; has a 
powerful, penetrating odor, and a pungent taste followed by a sensation 
of cold ; floats on water ; volatilizes slowly at ordinary temperatures ; is 
slightly soluble in water, but readily soluble in rectified spirit and in 
ether. 

Composition. — A stearoptin, having the formula C 10 H 16 O, and yield- 
ing camphoric acid on oxidation. 

Impurities. — Fixed salts. 

Test. — Sublimes entirely when heated. 

Preparations containing Camphor, 
u.s.p. DOSE. 

Aqua Camphora? 1 fl. dr. 

Linimentum Belladonnae 

Linimentum Camphora} 

Linimentum Chloroformi 

Linimentum Saponis 

Spiritus Camphora) 5-10 min. 

Tinerura Opii Camphorata 1-2 fl. dr. 

Ceratum Camphora? 



APETALJE. 863 

Peepaeations containing Camphoe — (continued). 

B.P. DOSE. 

Aqua Camphorse (saturated aqneous solution) 1-2 fl. oz. 

Linimentum Aconiti 

Linimentum Belladonnse 

Linimentum Camphorse 

Iiinimentum Camphorse Compositum 

Linimentum Chloroformi 

Linimentum Hydrargyri 

Linimentum Iodi 

Linimentum Opii 

Linimentum Saponis 

Linimentum Sinapis Compositum 

Linimentum Terebinthinse 

Linimentum Terebinthinae Aceticum 

Spiritus Camphorse (camphor, 1; rectified spirit, 10) 10-30 min. 

Tinctura Camphorse Composita (vide Opium) 15 min. to 1 fl. dr. 

Unguentum Plumbi Subacetatis Compositum 

Unguentum Hydrargyri Compositum 

(of camphor, 1-10 gr.) 

Aqua Camphorse. Camphoe Watee, U.S. P. and B.P. — The U.S. P. directs cam- 
phor (8) to be dissolved in alcohol (16), and then added to cotton (16). After the 
alcohol has nearly evaporated the cotton is packed in a percolator, and distilled 
water poured on till 1000 parts are obtained. It is prepared according to the B.P. 
by tying small pieces of camphor in a muslin bag, which is kept immersed in water 
in a bottle. 

Iiinimentum Camphorse. LINIMENT OF CAMPHOE, U.S.P. and B.P. — Camphor 1, 

dissolved in cotton-seed oil 4, U.S.P. In the B. P. the proportions are the same, but 
olive oil is used instead of cotton-seed oil. 

B.P. Linimentum Camphorse Compositum. COMPOUND LINIMENT OF CAM- 
PHOE. — Camphor, 2£ oz. ; oil of lavender, 1 fl. dr. ; strong solution of ammonia, 5 
fl. oz. ; rectified spirit, 15 fl. oz. 

U.S.P. Ceratum Camphorse. Camphoe Ceeate. — Camphor liniment, 3; olive 
oil, 12 ; cerates, 85. 

Physiological Action. — Externally camphor is stimulant and 
rubefacient. 

Internally in small doses it acts as a carminative, in large doses as 
an irritant, causing nausea and vomiting. It is diaphoretic and 
antaphrodisiac, and stimulates the heart (pp. 279 and 281). It 
stimulates the circulation, but may slow the pulse ; and stimulates the 
nerve centres, causing exhilaration, but finally paralyzes them, caus- 
ing lassitude. It produces, in large doses, a form of delirium, and 
sometimes death, occasionally preceded by epileptiform convulsions 
and maniacal excitement. In small doses it is said to be aphrodisiac, and 
in large doses antaphrodisiac (p. 388). It lowers the temperature. 

Therapeutics. — Externally, in the form of liniment, it is applied 
to sprains, enlarged joints, &c. 

Inhalation of its vapor ( J-l dr. in J- pint hot water) has been recom- 
mended for coryza. 

Internally it is used in catarrh and coryza. It is very useful in 
summer diarrhoea, cholera, tympanitic distention of the abdomen, and 
hysterical vomiting. 

It is also used as a nervine stimulant, especially in debility of the 
respiratory organs ; as a nervine and cardiac stimulant in fever ; and as 
an antispasmodic in epilepsy, chorea, pertussis, hysteria, and other ner- 
vous affections, especially those connected with the sexual organs. 



864 VEGETABLE MATERIA MEDICA. 

I7.S.P. Campliora Monobromata. Monobromated Camphor. 
— C 10 H 15 BrO; 230-8. 

Preparation. — By heating camphor with bromine and crystallizing 
from petroleum benzin. 

Characters. — Colorless, prismatic needles or scales, permanent in 
air, unaffected by light, having a mild camphoraceous odor and taste, 
and a neutral reaction. Almost insoluble in water, freely soluble in 
alcohol, ether, chloroform, hot benzin, and fixed oils ; slightly soluble in 
glycerine. 

Dose. — 2-10 grains. It may be given in pills, made by rubbing 5 
grains with 1 grain of Canada balsam in a warm mortar. 

Action. — Like other bromides it produces weakness and paralysis, 
stupor and sleep. It slows the pulse (p. 281) and respiration and reduces 
the temperature. In the rabbit the vessels of the eye and ear are 
contracted. When given for a length of time it produces marked 
emaciation. 

Uses. — Monobromated camphor has been used as a sedatiAe instead 
of the bromides, but it is less efficient. It has been recommended in 
insomnia, chorea, hysteria, and delirium tremens. In large doses it has 
caused epileptiform convulsions, like camphor. 

B.P. Sassafras Radix. Sassafras Root. — The dried root of 
Sassafras officinalis. From North America. 

Characters. — In branched pieces ; bark externally grayish-brown, 
internally rusty-brown, of an agreeable odor, and a peculiar aromatic 
warm taste ; wood light, porous, grayish-yellow. Also in chips, resem- 
bling quassia, but browner, and distinguished by their smell. 

Composition. — Contains 1 to 2 per cent, of a volatile oil. The bark 
contains tannic acid to a small extent. 

Pbepaeation. 

B.P. DOSE. 

Decoctum Sarsae Compositum \ oz. to 1 pint 2-10 fl. oz. 

(of the oil, 1-5 min). 

XJ.S.P. Sassafras. Sassafras. — The bark of the root of Sassafras 
officinalis. 

Characters. — In irregular fragments, deprived of the gray, corky 
layer ; bright rust-brown, soft, fragile, with a short, corky fracture ; 
strongly fragrant ; sweetish, aromatic, and somewhat astringent. 

U.S. P. Oleum Sassafras. Oil of Sassafras. — A volatile oil 
distilled from sassafras. 

Characters. — A colorless or yellowish liquid becoming darker and 
thicker by age and exposure to air, having the characteristic odor of 
sassafras, a warm, aromatic taste, and a neutral reaction ; sp. gr. about 
1-090. It is readily soluble in alcohol. When treated with cold nitric 
acid it becomes dark red, and is finally converted into a red resin. 

Peepaeations. 

U.8.P. DOSE. 

OletUD Sassafras 1-5 min. 

Decoctum SarsaparillsB Compositum 4-6 fl. oz. 

Extractum Sarsaparillse Compositum Fluirium :50-60 min. 

Syrupus Sarsiiparilla- Compositus 1-4 fl. drm. 



APETAL.E. 865 

Action and Use. — Sassafras has a destructive action on infusoria 
(p. 73). It is a stimulant diaphoretic, and is used in rheumatism and 
syphilis, generally in combination with other drugs. 

U.S. P. Sassafras Medulla. Sassafras Pith. — The pith of Sas- 
safras officinalis. 

Characters. — In slender, cylindrical pieces, often curved or coiled, 
light, spongy, white, inodorous, insipid. Macerated in water it forms a 
mucilaginous liquid, which is not precipitated on the addition of alcohol. 

Peepaeatiox. 

DOSE. 

Mucilago Sassafras MeduHae (sassafras pith, 2 parts; water, 100 parts Ad libitum. 

Uses. — As a demulcent either internally or externally. 

B.P. Xectandrae Cortex. Bebeeru Bark. — The bark of Nec- 
tandra Hodicei, the Greenheart tree. Imported from British Guiana. 

Characters. — In large, flat, heavy pieces. External color grayish- 
brown, internal dark cinnamon-brown. Taste strongly and persistently 
bitter, with considerable astringency. 

Composition. — Contains beberine, a peculiar alkaloid. Beberine is 
a colorless, amorphous substance, soluble in alcohol, but sparingly soluble 
in boiling water. 

Peepaeatiox. 
u.s.p. b.p. dose. 

None. Beberiae Sulphas 1-10 gr. 

B.P. Beberiae Sulphas. Sulphate of Beberia. C^H^N^. 
H 2 S0 4 . — The sulphate of an alkaloid prepared from Nectandra or Bebeeru 
bark. 

Properties. — In dark brown, thin, translucent scales, yellow when 
in powder, with a strong bitter taste ; soluble in water and in alcohol. 

Reactions. — Its watery solution gives a white precipitate with chlo- 
ride of barium (sulphate) ; and with caustic soda a yellowish-white pre- 
cipitate, which is dissolved by agitating the mixture with twice its volume 
of ether (beberia). 

Impurities. — Mineral matter. 

Tests. — The ethereal solution, separated by a pipette and evaporated, 
leaves a yellow translucent residue, entirely soluble in dilute acids. It is 
entirely destructible by heat. Water forms with it a clear brown solution. 

Action and Uses.— Bebeeru bark is seldom used in medicine ; 
both it and the sulphate of beberia are said to have a similar action to 
quinine, and have been used as touics and antiperiodics, but sulphate 
of beberia is but a poor substitute for the cinchona alkaloids. 



ARISTOLOCHIACE^E. 

Serpentaria, U.S.P. ; Serpentariae Radix, B.P. Serpen- 

taria, U.S.P. ; Serpentart Root, B.P. — The dried rhizome of Aristo* 
lochia Serpentaria. From the Southern parts of North America. 
55 






866 VEGETABLE MATERIA MEDICA. 

Characters. — A small, roundish rhizome, with a tuft of numerous 
slender rootlets, about three inches long, yellowish, of an agreeable cam- 
phoraceous odor, and a warm, bitter, camphoraceous taste. 




Fig. 179.— Serpentary, rhizome with rootlets. 

Composition. — An essential oil, and resin, tannin, and sugar. 
Adulteration. — Other roots fraudulently or inadvertently added, 
distinguished by appearance and smell. 

U.S. p. Peepaeations. dose. 

Extractum Serpentarise Fluidum 10-30 min. 

Tinctura Cinchonas Composita 1-4 fl. drm. 

Tinctura Serpentaria 1-3 fl. drm. 

B.P. DOSE. 

Infusum Serpentarise (£ oz. to £ pint) 1-2 fl. oz. 

Tinctura Cinchonse Composita £-2 fl. drm. 

Tinctura Serpentarise £-2 fl. drm. 

Action and Uses. — Serpentary is a stimulant tonic, and is used in 
atonic dyspepsia with nervous depression. Owing to its having some 
diaphoretic and diuretic properties, it is used in chronic rheumatism. 

Asarum Europium or Asarabacca belongs to this order ; its leaves 
were formerly used as an errhine. They cause powerful vomiting and 
purging when administered internally. 

SANTALACEA. 

U.S.P. Oleum Santali. Oil of Santal (Oil of sandal-wood). 
— A volatile oil distilled from the wood of Santalum album. 

Characters. — A pale yellowish or yellow liquid of a peculiar, 
strongly aromatic odor, a pungent and spicy taste, and a slightly acid 
reaction. It is readily soluble in alcohol. 

Action and Use. — Its action and uses are similar to those of 
copaiba, than which its smell is less disagreeable. 

Dose. — 10 to 20 min. in capsules or mixture. 

EUPHORBIACEiE. 

Cascarilla, U.S.P. ; Cascarillre Cortex, B.P. Cascarilla, 
U.S.P. ; Cascarilla Bark, B.P. — The bark of Croton Eluteria* 
Bahama Islands. 



APETAL.E. 867 

Characters.— In quills, two or three inches in length and about J 
to J inch in diameter, dull brown, but more or less coated with white 
crustaceous lichens ; breaks with a short resinous fracture ; is warm and 
bitter to the taste ; and emits a fragrant odor when burned. 




Fig. 180.— Cascarilla-bark, transverse section, magnified. 

Composition. — The active principle is cascarillin, a bitter substance, 
soluble in hot spirit or ether. Resin, gum, and a small quantity of 
volatile oil are also present. 

Peepaeations. 
U.S. p. dose. 

Cascarilla 30 gr. 

B.P. DOSE. 

Infusum CascariUae (1 oz. to £ pint) 1-2 fl. oz. 

Tinctura Cascarilla? £-2 fl. drm. 

Action and Uses. — Cascarilla is aromatic, stimulant and tonic. 
It is also a stimulant to the mucous membranes, and is used as an 
expectorant in chronic bronchitis. It is useful in atonic dyspepsia 
and as a general tonic to the system. 

U.S.P. Stillingia. Stillingia. Queen's Root. — The root of 

Stillingia sylvatica. 

Characters. — About twelve inches (30 centimetres) long, and 
nearly two inches (5 centimetres) thick, sub-cylindrical, slightly branched, 
compact, wrinkled, tough, grayish-brown, breaking with a fibrous frac- 
ture, showing a thick bark and porous wood, the inner bark and medul- 
lary rays with numerous yellowish-brown resin-cells; odor peculiar, 
unpleasant; taste bitter, acrid, pungent. 

Peepaeation. 

DOSE. 

Extractum Stillingia? Fluidum 15-30 min. 

Composition. — It contains a resinous substance. 
Uses. — In large doses it causes vomiting and purging. It has been 
used as an alterative in secondary syphilis and cutaneous diseases. 




# 



Fig. 181. — Croton-seed, lateral and ventral view, and longitudinal section, showing embryo. 

Oleum Tiglii, U.S.P. ; Oleum Crotonis, B.P. Croton Oil. — 
A fixed oil expressed from the seeds of Croton Tiglium. East Indies. 

Characters. — Slightly viscid ; color brownish-yellow, taste acrid, 
odor faintly nauseous. 



868 VEGETABLE MATERIA MEDICA. 

Composition. — Very complex. It contains several fatty acids. Its 
active principles have not yet been separated. An oily substance named 
crotonal is said to possess the irritant properties of croton oil. 

Dose. — Of the oil, -J— 1 min. placed on the tongue, or formed into a 
pill with crumb of bread. As an adjunct, ^ m j n# upwards. 

Preparation, 
b.p. 
Linimentum Crotcmis 1 volume in 8. 

Physiological Action. — Externally it is an irritant, and gives 
rise to a pustular eruption. This effect is increased by the addition of 
an alkali. 

Internally it is a violent purgative, causing great congestion of the 
intestinal canal, and may cause death from gastro-enteritis with collapse. 

Therapeutics. — Externally it is used as a counter-irritant in 
phthisis, bronchitis, inflammation of the brain and its membranes, and 
inflammation of the ovary, in the form of the liniment. 

Internally it is given as a purgative in obstinate constipation 
(J-l min. in pill). It is especially useful in paralysis, mania, and apo- 
plexy, when there is a difliculty in swallowing and a purgative of small 
bulk is required. It can be mixed with a little bread crumb, and placed 
on the back of the tongue and will be swallowed involuntarily. It is 
sometimes added to castor oil to increase its effect. 

One drop of croton oil with 1 drachm of chloroform in 1 ounce of 
glycerine has proved an effectual anthelmintic, removing tapeworm after 
other remedies had failed. It should be given the first thing in the 
morning, and its efficacy is increased by a saline purgative given over 
night. 

Treatment in Poisoning. — Evacuate by stomach pump after giving 
demulcents (linseed, oatmeal, &c), or give linseed tea or gruel, mixed 
with mustard, and thus procure emesis. 

Oleum Ricini, U.S. P. and B.P. Castor Oil. — A fixed oil 
expressed from the seeds of Ricinus communis. Calcutta. 



m 






Fig. 182.— Castor Oil fruit, seed, and two longitudinal sections of seed, showing embryo and albu- 
men, natural size. 

Characters. — Viscid, colorless, or pale straw-yellow, having a 
slightly nauseous odor, and a somewhat acrid taste. 

Preparations, 
u.s.p. dose. 

Linimentum Sinapis Compositum for external use. 

Collodium Flexile do. 



APETAL^. 869 

b.p. Peepaeations — (continued). dose. 

Collodium Flexile for external use. 

Linimentum Sinapis Composition do. 

Pilula Hydrargyri Snbchloridi Composita 5-10 gr. 

(of the oil, 1 fl. drm. to 1 fl. oz.) 

Composition. — Yields several fatty acids, including ricinoleic acid, 
peculiar to castor oil. The seeds contain an alkaloid, ricinine (not 
purgative), also an acid drastic principle, of which only a small propor- 
tion is separated with the oil. 

Dose.— 1-8 fl. dr. 

Action and Uses. — Castor oil is one of our best purgatives, as it 
leaves no injurious effects, and can be given whenever purging is wanted 
without any irritant effect, as in children, pregnant women, piles and 
fissure of anus, or after parturition, and to delicate people. Its nauseous 
taste is its only objection. It is one of the best remedies for acute diar- 
rhoea, given in one dose of J to J fl. oz. with 5-10 min. of laudanum. 
This removes any irritating substances (p. 338) and soothes the intestine. 
In chronic dysentery 15 min. castor oil and 5-10 min. tincture of opium 
given three times a day is a useful remedy. In lead colic it acts as a 
preventive to constipation, and has been used as a cure (p. 595). It is 
better, however, to give potassium iodide and sulphate of magnesia. A 
drop of castor oil dropped into the eye will often allay the irritation pro- 
duced by a particle of sand, &c. As a local application castor oil or 
poultices of the leaves of the castor-oil plant are used to the breasts in 
order to promote the secretion of milk. 

Administration. — If the oil be given the first thing in the morning, 
an hour before breakfast, ten or twenty drops are generally sufficient to 
open the bowels. This dose may be given in a teaspoonful of pepper- 
mint-water or brandy. The brandy should be added in such proportion 
that the oil neither sinks nor swims in the mixture. The same mixture 
of peppermint-water and brandy answers well as a vehicle for the adminis- 
tration of larger doses also. In all cases the glass, cup, or spoon should 
be thoroughly wetted first with water or peppermint-water to prevent 
the oil adhering to the side. A little brandy is then to be mixed with 
the peppermint-water, the oil carefully poured over the middle of it, and 
then more brandy added. If the whole be drunk at one draught the 
taste of the oil is not perceived. Lemon juice, coffee, and the froth of 
porter are also used as vehicles for the administration of castor oil. It 
may also be given in capsules, which are perfectly tasteless. 

Kamala, U.S.P. and B.P. Kamala. Wurrus. — A powder which 
consists of the minute glands that cover the capsules of Mallotus philip- 
pinensis, U.S.P., Rottlera tinctoria, B.P. India. 

Characters. — A fine, granular, mobile powder, of a brick-red color; 
it is with difficulty mixed with water. 

Composition. — A resin soluble in alcohol and ether, yielding a 
crystalline substance, rottlerin. 

Impurities. — Sand and earthy matters. 

Test. — When boiled with alcohol the greater part is dissolved, form- 
ing a red solution. Ether dissolves most of it, the residue consisting 
principally of tufted hairs. 

Dose. — 30 grains to J ounce. 



870 VEGETABLE MATERIA MEDICA. 

Action and Uses. — It is used as an anthelmintic against tape- 
worm. It is very efficacious, killing the worm and producing free 
purgation. It is best given with honey or thick gruel. 

PIPERACEiE. 

Piper, U.S.P.; Piper Nigrum, B.P. Black Pepper. — The 
unripe fruit of Piper nigrum, U.S. P. The dried unripe berries of Piper 
nigrum, B.P. East Indies. 

Characters. — Small, roundish, wrinkled; tegument brownish-black, 
containing a grayish-yellow globular seed. Odor aromatic. Taste pun- 
gent and bitterish. 

Dose. — 5-20 grains. 

Peepaeations. 
u.s.p. dose. 

Oleoresina Piperis 1-2 min. 

B.P. DOSE. 

Confectio Opii 5-20 gr. 

Confectio Piperis (pepper, 2; caraway, 3; honey, 15)... 60-120 gr. or more. 
Pulvis Opii Compositus 2-5 gr. 

U.S.P. Oleoresina Piperis. Oleoeesin of Peppee. — Exhaust pepper with 
stronger ether, remove the ether by distillation and evaporation, and separate the 
oleoresin from the piperine in the residue by expression through a muslin strainer. 

b.p. Confectio Piperis. Confection of Peppee. — Black pepper, 2 ; caraway 
fruit, 3 ; clarified honey, 15. 

Composition. — Piperine, resin, and volatile oil. Piperine is a 
crystalline principle, almost neutral, tasteless, inodorous, and insoluble in 
water, and is isomeric with morphia. The resin possesses the pungent 
taste of the drug, and gives the oil its aromatic smell. 

U.S.P. Piperina. Piperine. C 17 H 19 N0 3 ; 285. — A proximate 
principle of feebly alkaloidal power, prepared from pepper, and occurring 
also in other plants of the Nat. Ord. Piperacece. 

Characters. — Colorless or pale yellowish, shining, four-sided prisms, 
permanent in the air, odorless, and almost tasteless when first put in the 
mouth, but on prolonged contact producing a sharp and biting sensation. 
It has a neutral reaction, is almost insoluble in water, but soluble in 30 
parts of alcohol at 15° C. (59° F.), in 1 part of boiling alcohol, and but 
slightly soluble in ether. When heated to about 128° C. (about 262° F.), 
piperine melts, yielding a clear, yellowish liquid, which, on cooling, con- 
geals to a resinous mass. When heated on platinum foil it takes fire 
and is consumed without residue. Concentrated sulphuric acid dissolves 
piperine with a dark, blood-red color, which disappears on dilution with 
water. When treated with cold nitric acid, piperine turns rapidly green- 
ish-yellow, orange, and red, and gradually dissolves with a reddish color. 
On adding to this solution an excess of solution ofpotassa, the color is at 
first pale yellow, but on boiling it deepens to blood-red, while, at the 
same time, vapors of an alkaline reaction and of a peculiar odor (piperi- 
dine) are given off. 

Dose. — 1-10 gr. 



APETAL^. 



871 



Action and Uses. — Pepper is a stimulant stomachic. It is used 
chiefly as a condiment, but has been employed in the treatment of haem- 
orrhoids, and, on account of its stimulating action on mucous membranes, 
as a substitute for cubebs in the treatment of gonorrhoea. The action 
and uses of piperine are similar to those of pepper. 

Cubeba, U.S.P. and B.P. Cubebs. — The dried unripe fruit of 
Cubeba officinalis {Piper Cubeba). Java. 




Fig. 183.— Cubeba Officinalis. 

Characters. — Is like black pepper, but is distinguished from it by 
the adherent stalk of rather more than its own length, from which it gets 
its ordinary name of tailed pepper. It has a warm camphoraceous taste 
and characteristic odor. 

Composition. — A volatile oil, a resin, and cubebin. Cubebin is 
neutral and crystalline. It does not seem to have any important physio- 
logical action. The resin yields cubebic acid, and a volatile oil consisting 
of a hydrocarbon holding a camphor in solution. 

Peepaeations. 

U.S.P. DOSE. 

Cubeba 15 gr. 

Extractum Cubebae Fluidum 8-30 min. 

Oleoresina Cubebse 5-30 min. 

Tinctura Cubebse 8 min. to 3 fl. drm. 

Trochisci Cubebae (each contains ? gr. oleoresin). 

B.P. DOSE. 

Oleum Cubebae 5-20 min. 

Tinctura Cubebae ^-2 fl. drm. 

(of the powder, 30-120 gr.) 

Oleum Cubebae, U.S.P. and B.P. Oil of Cubebs. — A volatile 
oil distilled from cubebs. 



872 VEGETABLE MATERIA MEDICA. 

Characters. — Colorless or pale greenish-yellow, having the peculiar 
odor and taste of cubebs. 

Composition. — A hydrocarbon holding a camphor in solution. 

U.S.P. Oleoresina Cubebae. Oleoresin of Cubeb. 

Preparation. — By extracting cubeb with stronger ether, distilling 
off most of the ether ; letting the rest evaporate ; transferring the residue 
to a closed vessel till waxy and crystalline matter has ceased to deposit, 
and then pouring off the oleoresin. 

Dose. — 5 to 30 min. (0*3 to 2 Gm.) given in capsules. 

Action and Uses. — Cubebs owes its action to the oil and resin. It 
is carminative and stimulant to mucous membranes. It is used chiefly 
for its action on the mucous membrane of the bladder and urethra, as in 
gonorrhoea (p. 385). It is used in the form of lozenges for relaxed sore 
throat, and as an errhine for coryza when free secretion has become 
established. It is slightly diuretic, and has been used as an adjunct to 
other diuretics. Large doses may produce gastro-enteritis, and it some- 
times gives rise to a rash resembling urticaria. The oil has an action 
somewhat like oil of turpentine or oil of copaiba. The resin is said to be 
a more active diuretic than the oil, and the oleoresin is therefore intro- 
duced into the U.S.P. 

Matico. Matico. U.S.P. Maticse Folia. Matico Leaves. 
B.P. — The dried leaves of Artanthe elongata (Piper angustifolium). 
Peru. 

Characters. — From two to eight inches long, veined and tesselated 
on the upper surface, downy beneath. They may be confounded with 
digitalis leaves, but are distinguished by their marked reticulation in 
squares. 

Composition. — Essential oil, artanthic acid, tannin, and resin. 

Pbepaeations. 

U.S.P. DOSE. 

Extractum Matico Fluidum $-3 fl. drm. 

Tinctura Matico |-3 fl. oz. 

B.P. DOSE. 

Infusum Maticse (£ oz. in \ pint for \ honr) 1-4 fl. oz. 

(of the powder, 30-60 gr.) 

Action and Uses. — Matico is employed locally as a styptic to 
arrest hemorrhage from small wounds, such as leejch-bites. It acts 
mechanically, much in the same way as a spider's web. It has been 
administered in cases of vesical catarrh and gonorrhoea, but is now not 
much used. 

SALICACEiE. 

U.S.P. Salix. Salix. Willow. — The bark of Salix alba, and 
of other species of Salix. 

Characters. — In fragments or quills, from one-twenty-fifth to one- 
twelfth of an inch (1 to 2 millimetres) thick, smooth ; outer surface some- 
what glossy, brownish or yellowish, more or less finely warty ; under the 
corky layer, green ; inner • surface brownish-white, smooth, the liber 
separating in thin layers ; inodorous ; bitter and astringent. 



APETALJE. 873 

Composition. — It contains tannin and salicine. 
Use. — The infusion may be used as a bitter tonic. 

U.S.P. Salicinum. Salicin. C 13 H 18 O r ; 286. — A neutral prin- 
ciple prepared from the bark of Salix helix, and of other species of Salix. 

Characters. — Colorless or white, silky, shining crystals, permanent 
in the air, odorless, having a very bitter taste, and a neutral reaction. 
Soluble in 28 parts of water, and in 30 parts of alcohol at 15° C. (59° 
F.) ; in 0*7 part of boiling water, and in 2 parts of boiling alcohol; 
insoluble in ether or chloroform. When heated to about 198° C. (388*4° 
F.), salicin melts, yielding a colorless liquid, and, on ignition, it emits 
vapors having the odor of salicylous acid, and is finally wholly dissipated. 
If one part of salicin be agitated with 20 parts of water and 5 parts of 
solution of potassa, a clear, colorless solution is obtained. Cold, concen- 
trated sulphuric acid dissolves it with a red color ; the solution, after the 
addition of water, becomes colorless and deposits a dark red powder 
insoluble in water or alcohol. 

The aqueous solution of salicin should not be precipitated by tannic 
or picric acids, nor by iodide of mercury and potassium (absence of and 
difference from alkaloids). 

Dose. — 3-15 gr. 

Action. — Its action is similar to that of salicylic acid (p. 692). It 
appears to be decomposed in the body, and is eliminated in the urine 
partly as salicin and partly as salicylic acid, as salicyluric acid, and as 
saligenin. Its action is less powerful than that of salicylic acid, and its 
depressing effect on the circulation less marked. 

Uses. — It is an antipyretic, and has been used with success instead 
of salicylic acid in the treatment of acute rheumatism. It is useful also 
in headaches. 

JUGLANDACE^E. 

U.S.P. Juglans. Juglans. Butternut. — The inner bark of 
the root of Juglans einerea, collected in autumn. 

Characters. — In flat or curved pieces, from an eighth to a quarter 
of an inch (3 to 6 millimetres) thick ; the outer surface nearly free from 
soft cork ; deep brown ; the inner surface smooth and striate ; transverse 
fracture short, delicately checkered, whitish and brown ; odor feeble ; 
taste bitter and somewhat acrid. 

Pbepaeation. 

dose. 
Extractum Juglandis 20-30 gr. 

Uses. — It is a mild cathartic, especially useful in the treatment of 
chronic constipation, dysentery, and congestion of the abdominal viscera. 
It has a slight action as a hepatic stimulant (p. 351), and is useful in 
malarial conditions (pp. 327 and 354). 

HAMAMELACE^). 

U.S.P. Hamamelis. Hamamelis. Witchhazel. — The leaves 
of Hamamelis virginica, collected in autumn. 



874 VEGETABLE MATERIA MEDICA. 

Characters. — Short-petiolate, about four inches (10 centimetres) 
long, obovate or oval, slightly heart-shaped and oblique at the base, 
sinuate-toothed, nearly smooth ; inodorous ; taste astringent and bitter. 

Officinal Peepaeation. 

dose. 
Extractnm Hamamelidis Fhiidum 15 min. to 2 fl. drm. 

Composition. — It contains tannic acid and a bitter principle. 

Use. — It is used as an external application to piles, bruises and 
inflammatory swellings. Internally it is a very efficient haemostatic in 
bleeding from the lungs and other internal organs. In some cases of 
haemoptysis I have found it more efficient than digitalis and ergot, 
although in other cases digitalis and ergot have succeeded better. It 
checks the flow in menorrhagia when given during the period, and it 
lessens pain in dysmenorrhoea. In one case a patient informed me 
that it invariably caused seminal emissions, which ceased when it was 
discontinued. In this action it resembles strychnine (p. 388). It has 
been supposed by Dujardin-Beaumetz to owe its utility to an action on 
the muscular fibre of veins. 

BALSAMIFLTLE. 

Styrax, U.S.P. ; Styrax Prseparatus, B.P. Storax, U.S. P. ; 
Prepared Storax, B.P. — A balsam obtained from the inner bark 
of Liquidarnbar orientalis (U.S.P.) ; Liquidambar orientale (B.P.). 
Purified by means of rectified spirit and straining. 

Characters. — A semi-transparent, brownish-yellow, semi-fluid resin, 
of the consistence of thick honey, with a strong, agreeable fragrance and 
aromatic, bland taste. Heated in a test-tube on the vapor-bath, it becomes 
more liquid but gives off no moisture ; boiled with solution of bichromate 
of potash and sulphuric acid, it evolves the odor of oil of bitter almonds. 

Composition. — Styrol, cinnamic acid, styracin, and resin. Cinnamic 
acid yields, when oxidized, hydride of benzoyl (oil of bitter almonds). 

Peepaeations. 

U.S.P. DOSE. 

Tinctura Benzoini Composita £-1 fl. drm. 

B.P. DOSE. 

Tinctura Benzoini Composita £-1 fl. drm. 

(of the prepared resin, 5-20 gr.). 

Use. — Its action and use are similar to those of the balsam of 
Peru. 

CUPULIFER^E. 

B.P. Quercus Cortex. Oak Bark. — The dried bark of the 
small branches and young stems of Quercus robur. Collected in spring, 
from trees growing in Britain. 

Characters. — Covered with a grayish, shining epidermis, cinnamon 
colored on the inner surface, fibrous, brittle, and strongly astringent. 

U.S.P. Quercus Alba. — The bark of Quercus alba. 
Characters. — In nearly flat pieces, deprived of the corky layer, 
about a quarter of an inch thick, pale brown, inner surface with short, 



apetal^:. 875 

sharp longitudinal ridges, tough, of a coarse, fibrous fracture, a faint, tan- 
like odor, and a strongly astringent taste. 

Composition. — Querci-tannic acid and quercin, a bitter crystalline 
substance. 

Peepaeation. 
u.s.p. b.p. dose. 

None. Decoctum Quercus (1| oz. to 1 pint) 1-2 fl. oz. 

Action and Use. — Chiefly used externally as a local astringent, 
e.g., as a gargle in relaxed sore throat or as an injection in gonorrhoea 
and leucorrhcea. 

Galla, U.S.P. and B.P. Nutgalls, U.S.P. ; Galls, B.P.— 
Excrescences on Quercus lusitanica, var. infectoria, caused by the punc- 
tures and deposited ova of Cynips G-allce tinctorice, U.S.P. (Diplolepis 
Gallce tinctorice, B.P.). Asia Minor. 

Characters. — Hard, heavy, globular bodies, tuberculated on the 
surface, the tubercles and intervening spaces smooth ; of a bluish-green 
color on the surface, yellowish-white within, with a small central cavity ; 
intensely astringent. 

Composition. — G-allo-tannic acid (14 to nearly 70 per cent., accord- 
ing to the quality of the galls), gallic acid (3 per cent.), free sugar and 
resin in minute quantities. 

Peepaeatioxs. 

U.S.P. DOSE. 

Tinctura Gallae |-3 fl. drm. 

Unguentum Gallae (1 part in 10) 

B.P. DOSE. 

Acidum Gallicum 2-20 gr. 

Acidum Tannicum 2-30 gr. 

Tinctura Gallae. J-2 fl. drm. 

Unguentum Gallae (80 gr. to 1 oz.) 

Unguentum Gallae cum Opio (80 gr. to 1 oz. nearly) 

Action and Uses. — Galls are used in the form of galls and opium 
ointment as a local astringent in the treatment of haemorrhoids. The 
action of galls depends on the contained tannic and gallic acids, q.v. 

Acidum Tannicum, U.S.P. and B.P. Tannic Acid, C 14 H 10 O 9 ; 
322. — An acid extracted from galls. 

Preparation. — By dissolving out the tannic acid from powdered 
galls with ether mixed with very little water, gently evaporating the 
solution, and drying the acid. Although tannic acid is very sparingly 
soluble in pure ether, yet it appears to dissolve readily in ether contain- 
ing a very little water. 

Properties. — In pale yellow, vesicular masses, or thin, glistening 
scales, with a strongly astringent taste, and an acid reaction ; readily 
soluble in water and rectified spirit, very sparingly soluble in ether. 

Reactions. — The aqueous solution precipitates solution of gelatine 
yellowish- white, and the persalts of iron of a bluish-black color. 

Impurities. — Mineral matter. 

Tests. — It leaves no residue when burned with free access of air on 
platinum foil. 



876 VEGETABLE MATERIA MEDICA. 

Peepaeations. 

U.S.P. 

Collodium Stypticum (tannic acid 20, alcohol 5, stronger 

ether 20, collodion 55 parts) 1 part in 5. 

Trochisci AcidiTannici 1 grain in each. 

Unguentum Acidi Tannici (with benzoated lard) 1 part in 10. 

B.P. 

Glycerinum Acidi Tannici 

Suppositoria Acidi Tannici 

" cum Sapone 

Trochisci Acidi Tannici 

Physiological Action. — When applied externally to the unbroken 
skin, tannic acid has little or no action ; but applied to skin deprived 
of its epidermis, it coagulates the albumen and causes contraction of 
the cells of the skin. 

It acts locally on mucous membranes, coagulating the mucus. 
On account of the dryness in the mouth produced by the drug it was con- 
cluded that the vessels are contracted, and that the astringent action is 
due to this, but Rossbach found from direct observation that the vessels 
are dilated ; in this particular tannin differs from other astringents, such 
as nitrate of silver. This dilatation is not due to paralysis of the coats of 
the arteries, since they contract on stimulation or subsequent application 
of silver nitrate. 

Its astringent action on the skin and mucous membranes is probably 
due to coagulation of albumen and a "tanning" of all the tissues to which 
it is applied. 

When taken in the mouth it causes dryness, coagulation of mucus, 
and a partial paralysis of the ends of the sensory nerves (both the nerves 
of ordinary sensation and the special nerves of taste), so that it destroys 
to a great extent the sense of taste, and also lessens irritation in the 
throat. 

When taken into the stomach in large doses it is irritant and 
causes vomiting. When given to animals it does not lessen either 
secretion or peristaltic action of the intestines, and yet in man, even from 
small doses, there is a dryness of the faeces and lessened peristalsis ; prob- 
ably these different results are due to some imperfection in the experi- 
ments or to a difference of dose. 

Large doses cause diarrhoea, with subsequent constipation. 

It is absorbed into the blood, and passes out as gallic acid or some 
product of the oxidation of gallic acid. 

It restrains haemorrhage in distant organs, as the uterus, lungs, or 
kidneys, but the modus operandi is not known, and some authorities 
deny this action altogether. 

Uses. — Externally applied to the skin, tannic acid is used in 
intertrigo, impetigo, and eczema, especially when occurring behind the 
ears in children. 

It is also applied to mucous membranes, such as the external auditory 
meatus in otorrhcea (fill the meatus with glycerine of tannic acid and 
keep it there by a pledget of cotton-wool). Also to the nasal mucous 
membrane, when there is ulceration and offensive discharge. In this case 
it is applied either in aqueous solution by means of the nasal douche or 



APETAL^E. 877 

as glycerine of tannic acid with a brush. It is thus of use in ozsena after 
measles or scarlet fever, and in syphilitic children. In haemorrhages from 
the nose, dry tannin may be snuffed up. 

It is used in stomatitis and ulceration of gums ; and as a gargle in 
relaxed sore throat, or applied locally as glycerine of tannic acid. It is 
very useful in the hacking cough often met with in children, and also in 
adults, which is due to an irritation at the back of the pharynx, often 
accompanied by inflamed throat, covered with mucus ; in inflamed tonsils 
and deafness ; also in whooping-cough and other throat affections, either 
in the form of the glycerine or as lozenges. 

It has been used, dissolved in water, or mixed with olive oil, as an 
injection in leucorrhoea, gonorrhoea, and chronic discharges from the os uteri. 

Internally tannin is used in hsematemesis and intestinal haemor- 
rhage ; also as an antidote to poisoning by alkaloids, but when used for 
this purpose it must be followed by a purgative, as the tannates are all 
more or less soluble in the juices of the alimentary canal. It is also 
used in poisoning by tartar emetic, as tannic acid forms with antimony 
an insoluble tannate. It is used in diarrhoea, but usually the more 
sparingly soluble forms of tannin, such as kino, are preferred. Tannic 
acid lessens the amount of albumen in albuminuria. 

Acidum Gallicum, U.S. P. and B.P. Gallic Acid. H 3 C 7 H 3 
5 .H 2 ; 188. — A crystalline acid prepared from galls. 

Preparation. — From galls, by pulverizing, moistening with water, 
and allowing them to ferment for six weeks in a temperature of 60° to 
70°. The tannic acid present in the galls is split up by the fermentation 
into gallic acid and glucose according to some authors. According to 
others the glucose is a mere impurity, and the tannic acid simply splits 
up into gallic acid, C 14 H 10 O 9 + H 2 = 2C 7 H 6 5 . It is purified by solu- 
tion, and re-solution in boiling water, filtering and crystallizing. 

Properties. — Crystalline, in acicular prisms or silky needles, nearly 
white, or of a pale fawn color. Its taste is acidulous and astringent. It 
requires about 100 parts of cold water for its solution, but dissolves in 3 
parts of boiling water. Soluble also in rectified spirit. 

Reactions. — It gives a bluish-black precipitate with a persaltof iron. 
It leaves no residue when burned with free access of air. Its aqueous 
solution gives no precipitate with solution of isinglass, and is thus distin- 
guished from tannic acid. 

Impurities. — Tannic acid from imperfect fermentation. 

Tests. — No precipitate with solution of isinglass (no tannic acid). 

Dose.— 2-10 grains. 

Peepaeations. 
u.s.p. 
Unguentum Acidi Gallici (with benzoated lard, 1 part in 10). 

B.P. DOSE. 

Glycerinum Acidi Gallici .....12-60 min. 

Uses. — Gallic acid resembles tannic acid in its action, but does not 
coagulate albumen, and is used chiefly in cases of haemorrhages from the 
lungs or kidneys, or where the affected part can only be reached through 
the circulation. 



878 VEGETABLE MATERIA MEDICA. 

In haemoptysis it is useful in ten-grain doses every two hours. Like 
tannin it lessens the amount of albumen in the urine in albuminuria. 

U.S. P. Castanea. Castanea. [Chestnut.] — The leaves of 
Castanea vesca, collected in September or October, while still green. 

Characters. — From six to ten inches (15 to 25 centimetres) long, 
about two inches (5 centimetres) wide, petiolate, oblong-lanceolate, acumi- 
nate, mucronate, feather-veined, sinuate-serrate, smooth; having a slight 
odor, and a somewhat astringent taste. 

Peepaeation. dose. 

Extractum Castanese Fluiduni J-l fl. drm. 

Uses. — It has been used in whooping-cough. Its taste is not dis- 
agreeable, but it has no extraordinary physiological power. 

URTICACE^E ULMEiE (ULMACE^E). . 

B.P. Ulmi Cortex. Elm Bark. — The dried inner bark of Ulmus 
campestris, broad-leaved elm. From trees indigenous to and cultivated 
in Britain. 

Characters. — A tough, brownish-yellow bark, about half a line 
thick, without smell; taste mucilaginous, slightly bitter, and astringent. 
Its decoction is turned green by perchloride of iron, and precipitates 
with a solution of gelatine (tannin). 

Peepaeation. 

B.P. DOSE. 

Decoctum Ulmi (broad-leaved elm) 2£ oz. to 1 pint for 10 minutes... 2-4 fl. oz. 

U.S.P. Ulmus. Elm. Slippery Elm. — The inner bark of 
Ulmus fulva. 

Characters. — In flat pieces, varying in length and width, about 
one-eighth of an inch (3 millimetres) thick, tough, pale brownish-white, 
the inner surface finely ridged; fracture fibrous and mealy; the trans- 
verse section delicately checkered ; odor slight, peculiar ; taste mucilagi- 
nous, insipid. 

Peepaeation. 
u.s.p. DOSE. 

Mucilago Ulmi (slippery elm 6, boiling water 100, macerate 

for two hours and strain Ad libitum. 

Uses. — Elm bark is used as a demulcent, slight astringent and 
tonic, and in the treatment of skin diseases. 

3IORE.E. 

B.P. Mori Succus. Mulberry Juice. — The juice of the ripe 
fruit of Morus nigra. 

Characters. — Of a dark violet color, with a faint odor, and an 
acidulous, sweet taste. 

Composition. — Coloring matter, sugar, and acid, supposed to be 
malic. 



APETAL^. 879 

Peepaeation. 

B.P. DOSE. 

Syrupus Mori 1 fl. dr. or more. 

Use. — To flavor and color mixtures. 

ARTOCARPEtE. 

Ficus, U.S.P. Fig. — The fleshy receptacle of Ficus Carica, bear- 
ing fruit upon its inner surface. 

Ficus, B.P. Fig. — The dried fruit of Ficus Carica, B.P. Smyrna. 
Characters. — Compressed, of irregular shape, fleshy, covered with 
an efflorescence of sugar; of a sweet, fruity odor, and a very sweet, 
mucilaginous taste. When softened in water, figs are pear-shaped, with 
a scar or short stalk at the base, and a small scaly orifice at the apex ; 
hollow internally; the inner surface covered with numerous, yellowish, 
hard achenes. 

Composition. — Grape sugar (about 70 per cent.), a little gum, and 
fatty matter. 

Peepaeations. 
u.s.p. dose. b.p. dose. 

Confectio Sennae 60-120 gr. Confectio Sennae 60-120 gr. 

Use. — Figs are used locally as poultices, by splitting them and apply- 
ing them to the inflamed part, as in gumboils, dental abscesses, &c. 

Figs are chiefly employed as a domestic laxative. They are useful,, 
given in large quantities, when a person has swallowed a hard, sharp, 
substance, by forming a bulky mass which will sheath the substance and 
protect the intestines from injury. In such cases purgatives are to be 
avoided. 

CANNABINEJE. 

Cannabis Indica, U.S.P. and B.P. Indian Hemp. — The flower- 
ing tops of the female plant of Cannabis sativa, grown in the East Indies,, 
U.S.P. The dried flowering tops of the female plants of Cannabis sativa> 
the common hemp. (For medicinal use, that which is grown in India,, 
and from which the resin has not been removed, is alone to be employed, 
B.P.) 

Characters. — Tops consisting of one or more alternate branches,, 
bearing the remains of the flowers and smaller leaves and a few ripe 
fruits, pressed together in masses of a dusky green color and a character- 
istic odor. 

Peepaeations. 

U.S.P. DOSE. 

Extractum Cannabis Indicae Fluidum 5-10 min. 

Tinctura Cannabis Indicae 10-20 min. 

Extractum Cannabis Indicae £ gr. 

B.P. DOSE. 

Extractum Cannabis Indicae ^-1 gr. or more. 

Tinctura Cannabis Indicae 5-20 min. 

U.S.P. Cannabis Americana. American Cannabis. — Can- 
nabis sativa, grown in the Southern United States and collected while, 
flowering. 



880 VEGETABLE MATERIA MEDICA. 

Characters. — Stem about six feet (2 metres) long, rough; leaves 
opposite below, alternate above, petiolate, digitate ; the leaflets linear- 
lanceolate, serrate; dioecious, the staminate flowers in pedunculate 
clusters forming compound racemes ; the pistillate flowers axillary, sessile, 
and bracteate ; odor heavy ; taste bitter, slightly acrid. 

Composition. — The active constituent is a resinoid substance, can- 
nabin. The tops also contain a small quantity of volatile oil. 

Physiological Action. — Its chief effect is on the brain, and is of a 
twofold nature ; it excites a form of delirium and hallucinations, usually 
followed by deep sleep. . . 

Sinall doses give rise to delirium with hallucinations, generally of 
a gay character, causing much merriment ; accompanied by a great incli- 
nation to muscular movement. 

The nature of the hallucinations depends greatly on the character of 
the individual, and people seem to be able to determine their nature, as 
in the case of opium. 

Haschish is an Arabian preparation of Indian hemp, and is the origin 
of the word assassin. An Eastern chief used to dose his fanatic followers 
with Indian hemp, and they became imbued with the idea that they 
would be taken to heaven if killed, and hence were not afraid to encounter 
death. 

The dreams produced by Indian hemp in inhabitants of Eastern 
countries are usually of a sexual character (p. 388), but when taken by 
the more civilized people of Western nations they are not sexual, and are 
often of a disagreeable nature. 

During this stage of hallucination, the person may conduct himself 
rationally and answer clearly any question put to him (Wood). The 
drug produces in some persons a curious loss of sense of time and of 
space. This stage is generally followed by deep sleep. The sensory 
nerves are benumbed, and there is frequently tingling and partial anaes- 
thesia. The pupil is dilated. 

Respiration may be either quickened or slowed. Its action on the 
pulse is very uncertain. Usually it is first quickened, then slowed, 
sometimes vice versa. The temperature rises or sinks according as 
the drug produces muscular movement or sleep. The urine is increased. 
The processes of digestion are less altered by cannabis indica than by 
opium, and the after effects of opium (nausea, headache, &c.) are not 
produced. 

Therapeutics. — As a soporific it is used instead of opium when 
the latter does not agree, or in old opium-eaters ; also in cases of mental 
derangement; in acute and chronic mania it is very useful, especially 
when combined with potassium bromide. 

It has been used in neuralgia to lessen pain ; also in spasmodic coughs, 
asthma, &c. In certain cases of menorrhagia it is useful, but its mode 
of action is unknown. Ringer recommends it in migraine, with or with- 
out nausea. 

U.S. P. Humulus. Hops. — The strobiles of Humulu lupulus. 

Characters. — Ovate, about an inch and a quarter (3 centimetres) 
long, consisting of a thin, hairy, undulated axis, and many obliquely 
ovate, membranous, greenish scales, in the upper part reticulately veined, 



APETALJE. 881 

and toward the base parallel-veined, glandular and surrounding a sub- 
globular achene; odor aromatic; taste bitter, aromatic, and slightly 
astringent. 

B.P. Lupulus. Hop. — The dried strobiles of the female plant ot 
Humulus lupulus. Cultivated in England. 

Characters. — Strobiles of a greenish-yellow color, with minute 
yellow grains (lupuline) adherent to the base of the scales. Odor aro- 
matic, taste bitter. 

U.S. P. Liupulinum. Lupulin. — The glandular powder, sepa- 
rated from the strobiles of Humulus lupulus. 

Characters. — Bright brownish-yellow, becoming yellowish-brown, 
resinous, consisting of minute granules, which, as seen under the micro- 
scope, are subglobular, or rather hood-shaped, and reticulate; aromatic 
and bitter. 

When agitated with water and allowed to stand, no considerable sed- 
iment (sand, &c.) should be deposited. When ignited, lupulin should 
not leave more than 8 per cent, of ash. 

Composition. — The lupulin of hops consists of a bitter principle, 
lupulite, volatile oil, to which the odor of hops is due, and resin. Hops, 
apart from the grains, contain a kind of tannin. 

Dose. — 5-20 grs. or more (-3-1-3 Gm.). 

Peepaeations. 

U.S. P. DOSE. 

Of Humulus — 

Tinctura Humuli 1-3 fl. dr. 

Of Lupulinum — 

Extractum Lupulini Fluidum 10-30 min. 

Oleoresina Lupulini 2-20 gr. 

B.P. DOSE. 

Extractum Lupuli 5-10 gr. 

Infusum Lupuli * 1-2 fl. oz. 

Tinctura Lupuli J-2 fl. dr. 

Action and Use. — Hops are bitter tonic and stomachic, also 
slightly soporific. In the form of bitter beer they are used in some 
cases of atonic dyspepsia ; and a supper of beer and lettuce, with bread 
and butter, is markedly soporific, from the combined effect of the hops 
and lettuce. 

A hop-pillow is sometimes used in sleeplessness of fevers, but its use 
is probably due, not to the action of the volatile principle of the hops, 
but to the mechanical elasticity and softness of the pillow. The crack- 
ling of the leaves in this pillow may be stopped by sprinkling a little 
alcohol on them. 



56 



882 VEGETABLE MATERIA MEDICA. 

CHAPTER XXXV. 
Class EXOGEXS. Division 2-GYMNOSPERMS. 

CONIFERJE. 

Terebinthina Canadensis, U.S. P. and B.P. Canada Tur- 
pentine (Balsam of Fir), U.S. P. ; Canada Balsam, B.P. — A liquid 
oleoresin, obtained from Abies balsamea, U.S. P. The turpentine 
obtained by incision from the stem of Abies balsamea (Pinus balsamea). 
Balm of Gilead Fir, B.P. Canada. 

Characters. — A pale yellow, ductile oleoresin, of the consistence of 
thin honey, with a peculiar, agreeable odor, and a slightly bitter, feebly 
acrid taste. 

Composition. — An essential oil resembling oil of turpentine, and a 
resin. 

Dose. — 10-30 grains. 

Peepaeations. 

u.s.p. B.P. 

Collodium Flexile. Charta Epispastica. 

Collodium Flexile. 

Use. — Used in the preparation of collodion flexile and of charta 
epispastica; also to mount microscopic objects. It may be given inter- 
nally as a stimulant to mucous membranes. 

B.P. Thus Americanuni. Common Frankincense. — The con- 
crete turpentine of Pinus Taida and Pinus australis. Southern States 
of North America. 

Characters. — A softish bright yellow, opaque solid, resinous, but 
tough, having the odor of American turpentine. 

Peepaeation. 
u.s.p. B.P. 

None. Emplastrum Picis. 

Use. — Applied externally is a slight stimulant. Contained in pitch 
plaster. 

U.S.P. Terebinthina. Turpentine. — A concrete oleoresin, 
obtained from Pinus australis and from other species of Pinus. 

Characters. — In tough, yellowish masses, brittle in the cold, 
crummy-crystalline in the interior, of a terebinthinate odor and taste. 

Dose. — As a stimulant, antispasmodic, or diuretic, 5-30 min. As 
an anthelmintic, 2-4 fl. dr. 

Oleum Terebinthinae, U.S.P. and B.P. Oil of Turpentine. 
— A volatile oil distilled from turpentine, U.S.P. A volatile oil distilled 
from the oleoresin (turpentine) obtained from Pinus palustris (P. aus- 
tralis), Pinus Twda, and sometimes Pinus Pinaster and other species, B.P. 

Characters. — Limpid, colorless, with a strong, peculiar odor, and 
pungent and bitter taste. 

Composition. — A mixture of several hydrocarbons having the com- 
position C 10 H 1G . 



GYMNOSPEKMS. 883 

Peepaeations. 

U.S. P. DOSE. 

Linimentum Cantharidis 1 part in 7. 

Linimentum Terebinthinae (ol. tereb., 35 ; resin cerate, 65) 1 part in 3. 

b.p. dose. 

Confectio Terebinthinae 60-120 gr. 

Enema Terebinthinae 

Linimentum Terebinthinae (ol. tereb., 16; camphor, 1; soft 

soap, 2 

Linimentum Terebinthinae Aceticum (ol. tereb., 1 ; acetic acid, 

1 ; camphor liniment, 1) 

Unguentum Terebinthinae 

Confectio Terebinthinae. CONFECTION OF TURPENTINE. — Oil of turpentine, 1 fl. 
oz. ; liquorice root, 1 oz. ; honey, 2 oz. 

Enema Terebinthinae.— Oil of turpentine, 1 fl. oz. ; mucilage of starch, 15 fl. OZ, 

Physiological Action. — Oil of turpentine when applied to the 
skin acts as an irritant and rubefacient, causing a sensation of burning, 
and if applied for any length of time, especially if evaporation be pre- 
vented, it causes vesication. 

When inhaled, it produces sneezing, tightness across the eyes, and 
difficulty of breathing, caused reflexly by the local irritant action of the 
drug on the nasal mucous membrane. 

Internally it causes burning in the mouth, and reflexly a profuse 
flow of saliva, and in the stomach it gives rise to a sensation either of 
heat or of cold. In large doses it produces gastro-enteritis with vomiting 
and diarrhoea. Ulceration of the intestine has been found after death 
from poisoning with turpentine. 

After absorption it causes a rise and then a fall of blood-pressure, due 
to its first stimulating and afterwards paralyzing the vaso-motor centres. 
Its effect on the pulse is uncertain, sometimes it is slowed and sometimes 
quickened. 

Respiration becomes quickened and spasmodic. The drug is partly 
excreted by the lungs, and acts on the mucous membrane, lessening its 
secretion. 

The temperature sometimes rises and sometimes falls. 

It acts on the nerve centres, lessening first the functions of the 
brain, causing diminution of voluntary movement ; then the functions of 
the cord, lowering reflex action ; and lastly those of the medulla, causing 
dilatation of the vessels, lowered blood-pressure, and slowed respiration. 

It is excreted by the kidneys. In small doses it increases the 
quantity of urine, to which it gives a sweetish odor resembling that 
of violets. In large doses it diminishes the quantity of urine and gives 
rise to pain in the lumbar region, burning in the urethra, painful mictu- 
rition, and even hematuria. Large doses of turpentine have a purgative 
action. 

Therapeutics. — Externally it is used as a rubefacient and counter- 
irritant to relieve pain or inflammation, as in chronic rheumatism affect- 
ing either the joints or muscles, also in inflammations of internal 
organs, as chronic bronchitis (liniment over the chest), pleuritis, and peri- 
tonitis with tympanites (by means of hot turpentine stupes). It is also 
very useful as a local application in sciatica and other neuralgias. It is 



884 VEGETABLE MATERIA MEDICA. 

used as an inhalation (as well as internally) in chronic bronchitis (p. 226) 
with profuse expectoration, and is supposed to be useful in phthisis. 

Internally in haemorrhage and ulceration of the intestine, as in 
typhoid fever, it is very serviceable in doses of 5-10 minims frequently 
repeated ; also in haemorrhage from other organs, as lungs, nose, 
uterus, kidneys ; but in hematuria it must be given in very small doses 
(5 minims), as large ones produce harm. 

As a vermifuge, to destroy tapeworm, it must he given in large 
closes, which are best combined with castor oil, as it then passes through 
the alimentary canal rapidly, and consequently is not absorbed, and pro- 
duces no disagreeable renal symptoms. If moderate doses are given, 
insufficient to produce purgation, the drug may be absorbed, and hema- 
turia, nausea, and vomiting may ensue. 

It is sometimes employed in biliary colic (1 part of oil of turpentine 
with 3 of ether). 

The French oil of turpentine (old and containing ozone) is used in 
phosphorus poisoning. New oil of turpentine, free from ozone, is useless. 
Turpentine is sometimes used as an antispasmodic in hysterical affections. 

Non-officinal. Oleum Pini Sylvestris. Oil of Scotch Fir. Fir 
Wool Oil. — It is a colorless liquid obtained by distilling the leaves of 
the Scotch fir. 

Action. — Somewhat similar to that of oil of turpentine. 

Uses. — It is used as a liniment to rheumatic joints or muscles, and 
is used as an addition to baths in rheumatism (p. 404). As an inhala- 
tion it is useful in sore throats and laryngeal catarrh, 5 min., mixed with 
2 J gr. of light carbonate of magnesia and a drachm of water, being added 
to 1 pint water at 140° F., and the steam inhaled. To get the water 
at this temperature two parts of boiling should be mixed with one part of 
cold. The use of water which is too hot may cause loss of voice. 

Not officinal. Sanitas. — A disinfecting solution obtained by acting 
on oxidized turpentine with water. Its active principle is peroxide of 
hydrogen (p. 458). Its advantages are that it is not poisonous and does 
not stain linen. 

U.S. P. Oleum Succini. Oil of Amber. — A volatile oil obtained 
by the destructive distillation of amber and purified by subsequent rec- 
tification. 

Characters. — A colorless, pale yellow, thin liquid, having an empy- 
reumatic, balsamic odor, a warm, acrid taste, and a neutral or faintly acid 
reaction. Readily soluble in alcohol. 

Action and Uses. — Externally it is stimulant, and may be used 
like oil of turpentine. Internally it is said to be antispasmodic. 

Dose. — 5 to 10 minims in capsule. 

Resina, U.S.P. and B.P. Resin. Colophony. — The residue 
left after distilling off the volatile oil from turpentine, U.S.P. 

Characters. — Translucent, yellowish, brittle, pulverizable ; frac- 
ture shining. 

Composition. — Resin is the portion of turpentine fixed by oxidation. 
The greater part of it consists ofabietic anhydride (C 44 H 62 4 ), this being 



GYMNOSPERMS. 885 

formed by the dehydrating of abietic acid (C u H 64: 5 ) during the distillation 
of the oil. It is again transformed into abietic acid by treating it with 
alcohol. A small proportion of pimaric acid is obtained from resin. 

Peepaeations. 
u.s.p. B.P. 

Ceratum Resinse. Charta Epispastica. 

Emplastrum Resinse. Emplastrum Calefaciens. 

Emplastrum Cantharidis. 

Emplastrum Opii. 

Emplastrum Picis. 

Emplastrum Resinse. 

Emplastrum Saponis. 

Unguentum Resinse. 

Unguentum Terebinthinse. 

Use. — Resin is only used externally as a stimulant application, 
in the form of ointment or plaster. 

B.P. Laricis Cortex. Larch Bark. — The bark, deprived of its 
outer layer, of Larix europcea (JPinus larix), the common larch. 

Characters. — In flat pieces or sometimes large quills, with the inner 
surface yellow and fibrous, and the outer surface reddish-brown under a 
grayish epidermis. Odor faint, resembling turpentine ; taste astringent. 

Composition. — A peculiar tannin, striking olive-green with salts of 
iron, and larixinic acid or larixin. 

Peepaeation. 

U.S.P. B.P. DOSE. 

Not given. Tinctura Laricis 20-30 min. 

Action and Use. — It has the same action as oil of turpentine. It 
is seldom used except as a stimulant expectorant in chronic bronchitis 
with abundant secretion. 

Pix Burg-undica, U.S.P. and B.P. Burgundy Pitch. — A resin- 
ous exudation from the stem of the spruce fir, Abies excelsa. Melted and 
strained. Imported from Switzerland. 

Characters. — Hard and brittle, yet gradually taking the form of 
the vessel in which it is kept ; opaque, varying in color, but generally 
dull reddish-brown ; of a peculiar odor, and aromatic taste, without bit- 
terness. 

Composition. — An amorphous resin, mixed with oil of turpentine 
and other oils isomeric with it, and abietic acid. 

Peepaeations. 

u.s.p. B.P. 

Emplastrum Picis Burgundicse. Emplastrum Ferri. 

Emplastrum Picis cum Cantharide. Emplastrum Picis. 

Use. — It is used as a stimulant in chronic rheumatism and bron- 
chitis in the form of plasters. 

U.S.P. Pix Canadensis. Canada Pitch. Hemlock Pitch. 
— The prepared, resinous exudation of Abies canadensis. 

Characters. — It is somewhat softer than the Burgundy pitch. 



886 VEGETABLE MATERIA MEDICA. 

Peepaeation. 
Emplastrum Picis Canadensis. 

Pix Liquida, U.S. P. and B.P. Tar. — An empyreumatic oleo- 
resin obtained by the destructive distillation of the wood of Pinus palus- 
tris, and of other species of Pinus, U.S. P. A bituminous liquid, obtained 
from the wood of Pinus sylvestris and other pines by destructive distilla- 
tion, B.P. 

Characters. — Thick, viscid, brownish-black, of a well-known, pecu- 
liar, aromatic odor. Slightly soluble in water, soluble in alcohol, fixed or 
volatile oils, and in solution of potassa or of soda. Water agitated with 
it acquires a pale brown color, sharp empyreumatic taste and acid reaction. 

Peepaeations. 

U.S. P. DOSE. 

Syrupus Picis Liquidae J fl. oz. 

Unguentum Picis Liquidse (equal parts of tar and suet) 

B.P. 

Unguentum Picis Liquidse (tar, 5 oz.; yellow wax, 2 oz.).. t 

U.S.P. Syrupus Picis Liquidse. Syeup of Tae. — Pour cold water (12) on tar 
(6), stir frequently for twenty-four hours, and then throw the water away. Pour 
on boiling distilled water (50), stir for fifteen minutes, and then set aside for thirty- 
six hours, stirring occasionally. Decant, filter, and add sugar, 40 parts. 

Composition. — Pyroligenous acid, methyl alcohol, acetic acid, and 
oily bodies, creasote, with toluene, xylene, and other hydrocarbons. 

Dose. — Of tar, 20 minims to 1 drachm and upwards, made into pills 
with flour, or given as tar-water in doses of 1-4 fluid ounces. 

Action and Use. — Tar acts as a stimulant both to the skin and 
to mucous membranes. It is used in chronic scaly skin diseases, such as 
psoriasis and the scaly stages of eczema. In the form of tar-water or of 
vapor, it is useful in chronic bronchitis and phthisis. 

U.S.P. Oleum Picis Liquidse. Oil OF Tar. — A volatile oil 
distilled from tar. 

An almost colorless liquid when freshly distilled, but soon acquiring a 
dark, reddish-brown color, having a strong tarry odor and taste, and an 
acid reaction. Specific gravity about 0*970. It is readily soluble in 
alcohol. 

Use. — It is used, dissolved in water or in alcohol, as an external 
application in skin diseases. 

U.S.P. Thuja. Thuja. Arbor Vit^e. The fresh tops of Thuja 
oecidentalis. 

Characters. — Twigs flattish, two-edged, the scale-like leaves 
appressed and closely imbricate in four rows, rhombic-ovate, obtusely 
pointly, with a roundish gland upon the back ; of a balsamic, somewhat 
terebinthinate odor, and a pungently aromatic, camphoraceous ; and bitter 
taste. 

Dose. — Of a saturated tincture or fluid extract, 1 fluid drachm. 

Action. — The twigs of thuja, like those of savin, may produce 
abortion. They probably have no direct specific action on the uterus 
itself, but cause great gastro-intestinal irritation, and thus act on the 



GYMNOSPERMS. 887 

uterus reflexly. The oil of thuja has an action somewhat like camphor, 
and like it produces epileptiform convulsions in warm-blooded and 
paralysis in cold-blooded animals. Both camphor and oil of thuja have 
only a slight action on the heart. They both produce rhythmical con- 
traction and dilatation of the vessels (as seen in the rabbit's ear). Both 
lessen the temperature (Kohne) (cf. p. 863). 

. Use. — It is diuretic, astringent, and aromatic, and its volatile oil 
has been used as a vermifuge. It has been employed in the form of a 
decoction in coughs, rheumatism, dropsy, and amenorrhoea. 

U.S. P. Juniperus. Juniper. — The fruit of Juniperus com- 
munis. 

Characters. — Nearly globular, about one-third of an inch (8 milli- 
metres) in diameter, dark purplish, with a bluish-gray bloom, a three- 
rayed furrow at the apex, internally pulpy, greenish-brown, containing 
three ovate, somewhat triangular, bony seeds, with several large oil glands 
on the surface ; odor aromatic ; taste sweet, terebinthinate, bitterish and 
slightly acrid. 

Oleum Juniperi, U.S.P. and B.P. Oil of Juniper. — A 
volatile oil distilled from the unripe fruit of Juniperus communis. 

Characters. — Colorless or pale greenish-yellow, of a sweetish odor, 
and warm, aromatic taste. 

Peepaeations. 
u.s.p. DOSE. 

Spiritus Juniperi (3 per cent, in alcohol) 30-60 min. 

Spiritus Juniperi Compositus 2-4 fl. dr. 

B.P. DOSE. 

Spiritus Juniperi (with spirit, 1 volume in 50) 30 min. to 1 fl. dr. 

(of the oil, 2-10 min.) 

U.S.P. Spiritus Juniperi Compositus. COMPOUND SPIEIT OF JUNIPEE.— Oil of 
juniper, 10 ; oil of caraway, 1 ; oil of fennel, 1 ; alcohol, 1000 ; water up to 5000. 

Action and Use. — Oil of juniper is a local stimulant. It is con- 
tained in gin and hollands. It resembles oil of turpentine in its action, 
but has a more powerful effect on the kidneys. It is used chiefly as a 
diuretic in dropsy depending on cardiac, liver, or kidney disease. In 
the last case it must be employed with caution. In a healthy man it 
does not seem to increase the flow of urine. Gin is flavored with juniper 
and is frequently employed as a diuretic. The compound spirit of 
juniper, U.S. P., approximates to gin in strength, and may be used in 
place of it. 

Salbina, U.S.P. ; Sabinae Cacumina, B.P. Savinb, U.S.P. ; 
Savin Tops, B.P. — The (fresh and dried, B.P.) tops of Juniperus Sabina. 

Characters. — Twigs densely covered with minute, imbricated, 
appressed leaves in four rows ; odor strong, peculiar, and unpleasant ; 
taste acrid, bitter, resinous, and disagreeable. 

Composition. — The active principle is a volatile oil. 

Peepaeations. 
u.s.p. DOSE. 

Extractum Sabinae Fluidum 5-15 min. 



888 VEGETABLE MATERIA MEDICA. 

Preparations — (continued ) . 

B.P. DOSE. 

Oleum Sabinae, froni fresh plant 1-5 min. 

Tinctura Sabinae 20 min. to 1 fl. dr. 

• Unguentum Sabinae (8 oz. fresh savin tops, bruised, are 
digested with melted wax, 3 oz., and prepared lard, 
16 oz., for 20 minutes, and strained) of dried tops 4-10 gr. or more. 

Oleum Sabinae, U.S.P. and B.P. — A volatile oil distilled from 
savine. 

Characters. — Colorless or yellowish, becoming darker and thicker 
by age and exposure to air, peculiar odor, pungent, bitterish, and cam- 
phoraceous taste. 

Dose. — 1-2 min. 

Action and Uses. — Savine owes its properties to its oil. 

Externally it is used as an irritant to keep open issues or blisters. 

Internally it produces symptoms of violent gastro-intestinal irritation, 
with either stoppage of the urine or hematuria and difficulty in micturi- 
tion. In women it causes congestion of the pelvic organs, and has been 
used criminally to procure abortion ; in these cases gastro-enteritis and 
death have occurred. Small doses may be used as an emmenagogue 
when menstruation is deficient and the patient is not pregnant. 



CHAPTER XXXVI. 
Class II.— ENDOGENiE. ENDOGENS. 

SMILACE^. 

Sarsaparilla, U.S.P. Sarsse Radix, B.P. (Jamaica, B.P.) 
Sarsaparilla. — The (dried, B.P.) root of Smilax officinalis, Smilax 
medica, and other undetermined species of Smilax. Native of Central 
America, imported from Jamaica. 

Characters. — Roots not thicker than a goose-quill, generally many 
feet in length, reddish-brown, covered with rootlets, and folded in bundles 
about eighteen inches long; scentless. 

Composition. — The active principle is a crystalline body, parillin or 
smilacin. 

PREPARATIONS. 
U.S.P. DOSE. 

Decoctum Sarsaparillae Compositum 4-6 fl. oz. 

Extractum Sarsaparillae Compositum Fluidum 30-60 min. 

Extractum Sarsaparillae Fluidum 30-60 min. 

Syrupus Sarsaparillae Compositus 1-4 fl. dr. 

B.P. DOSE. 

Decoctum Sarsae (2£ oz. ; water, 1£ pint) 2-10 fl. oz. 

Decoctum Sarsae Compositum 2-10 fl. oz. 

Extractum Sarsae Liquidum £-4 fl. dr. 



ENDOGENS. 889 

Decoctum Sarsaparillse Compositum, U.S.P. ; Decoctum Sarsae Compositum, B.P. 

Compound Decoction of Saesapaeilla. — Sarsaparilla, cut and bruised, 10 parts, 
or 2j oz. ; sassafras, guaiacum wood and liquorice root, of each 2 parts, or \ oz. ; 
mezereon, 1 part, or 1 dr. ; boiling water up to 100 parts, or up to 1 pint after 
straining. 

TJ.S.P. Extractum Sarsaparillae Compositum Fluidum. — Sarsaparilla, 75 ; gly- 
cyrrhiza, 12 ; sassafras bark, 10 ; mezereum, 3 ; glycerin, 10 ; alcohol and water, of 
each q.s. to make 100 parts. 

U.S.P. Syrupus Sarsaparillae Compositus. — Sarsaparilla, 150 ; guaiacum wood, 
20 ; pale rose, 12 ; glycyrrhiza, 12 ; senna, 12 ; sassafras, 6 ; anise, 6 ; gualtheria, 6 ; 
sugar, 600 ; diluted alcohol and water, of each q.s. to make 1000 parts. 

Action and Use. — The action of sarsaparilla is very much disputed. 
Some believe it to be diuretic, tonic, and alterative. Others deny 
its beneficial action. It has been used a good deal in syphilis, scrofula,, 
chronic rheumatism, gout, and skin diseases, but probably the good effects 
are due to drugs with which it is used. 

Syrupus sarsaparillae compositus, U.S.P., is a convenient vehicle for 
iodide of potassium. 

OLIACEJE* 

U.S.P. Allium. Garlic. — The bulb of Allium sativum. 

Characters. — Bulb subglobular, compound, consisting of about 
eight compressed, wedge-shaped bulblets, which are arranged in a circle 
around the base of the stem, and covered by several dry, membranaceous 
scales. It has a pungent, disagreeable odor, and a warm, acrid taste. It 
should be preserved in a dry place, and used only in the fresh state. 

Officinal Peepaeation. 
u.s.p. dose. 

Syrupus Allii 1-4 fl. dr. 

Composition. — The bulblets, or cloves as they are commonly termed,, 
owe their strong taste and smell to a volatile oil which is sulphide of ally! 

Action. — Allyl alcohol is a powerful antiseptic (pp. 100 and 105),, 
and it is probable that oil of garlic will have a similar action. Like oil 
of mustard, to which it is allied in chemical composition (p. 727), oil of 
garlic is a powerful irritant, or even vesicant, when applied to the skin. 
In the intestine it acts in small doses as a gastric tonic and carmina- 
tive ; in large doses as an emetic and irritant, causing vomiting, purg- 
ing, headache and fever. After absorption, it quickens the pulse and 
acts as a nervous stimulant. It is partly eliminated by the lungs, 
imparting its peculiar odor to the breath and acting as an expectorant* 
It is diaphoretic or diuretic according as the patient is kept warm or 
cool. It is said to be an emmenagogue. 

Uses. — A mixture of garlic juice and oil, or bruised garlic steeped 
in spirit, is used as a counter-irritant in convulsions or nervous diseases 
in children, and also in skin eruptions. The syrup may be used as a 
gastric tonic in atonic dyspepsia, and to check nervous vomiting. It is 
chiefly employed in nervous coughs of children, and as an expectorant 
in bronchitis after the acute stage has passed. It is used as an 
anthelmintic in cases of ascarides, and is given by the mouth and also as 
an enema. 



890 VEGETABLE MATERIA MEDICA. 

Scilla, U.S.P. and B.P. Squill. — The sliced (and dried, B.P.) 
bulb of Urginea Scilla ( U. maritima). Mediterranean coasts. 

Characters. — Bulb pear-shaped, weighing from half a pound to ten 
pounds ; outer scales membranous, brownish-red or white ; inner scales 
thick, whitish, fleshy, juicy ; taste mucilaginous, intensely and disagree- 
ably bitter, somewhat acrid. The dried slices are white or yellowish- 
white, slightly translucent, scentless, disagreeably bitter, brittle and 
easily pulverizable if very dry. 




Fig. 184.— Cut piece of Squill. 

Composition. — The active principle is a glucoside, scillitoxin or 
scillain. The scillitin of some authors is probably slightly impure 
scillitoxin. 

Peepaeations. 

U.S.P. DOSE. 

Acetum Scillse 15-niin. to 1 fl. dr. 

Extractum Scillae Fhiidum 1-2 min. 

Syrupus Scillse Compositus 10-30 min. 

Tinctura Scillae 8-30 min. 

Syrupus Scillae 2-1 A. dr. 

B.P. DOSE. 

Acetum Scillae 15-40 min. 

Oxymel Scillae J-l fl. dr. 

Pilula Ipecacuanhas cum Scilla 5-10 gr. 

Pilula Scillae Composita 5-10 gr 

Syrupus Scillae \-\ fl. dr. 

Tinctura Scillae 10-20 min. 

(of powdered squills, 1-3 gr.) 

U.S.P. Syrupus Scillse Compositus. Squill, 120; senega, 120; tartrate of anti- 
mony and potassium, 3 ; sugar, 1200 : precipitated phosphate of calcium, 9 ; diluted 
alcohol and water, of each, q.s. to make 2000. 

B.P. Pilula Scillje Composita. Squill, \\ oz. ; ginger, ammoniacum, and hard 
soap, of each, 1 oz. ; treacle, 2 oz. or q.s. 

Action axd Uses. — Squill and its active principle, scillitoxin, act 
like digitalis. 

Internally, in large doses, it causes vomiting and purging. When 
absorbed into the blood it slows the pulse and raises the blood-pressure. 
Like digitalis it acts as a diuretic, and also acts like it on voluntary 
muscle fibre. It is chiefly used as an adjunct to digitalis to produce 
diuresis in cases of cardiac dropsy; also as an expectorant, when, 
although the secretion is profuse, it is difficult to expel. It is of no use 
when the expectoration is dry and deficient; in such cases ipecacuanha 
should first be given and then followed by squill. 

Pilula ipecacuanha cum scilla, 10 grains night and morning, is a 
most useful remedy in chronic bronchitis. 

Aloe, U.S.P,; Aloe Socotrina, B.P. Aloes, U.S.P; Soco- 
trixe Aloes, B.P. — The inspissated juice of the leaf of Aloe socotrina, 
U.S.P. (one or more undetermined species of Aloe, B.P.). Socotra. 



ENDOGENS. 891 

Characters. — In hard, opaque, reddish-brown or yellowish-brown, 
not greenish, masses, translucent at the edges ; breaks with an irregular 
or smooth and resinous fracture ; has a bitter taste, and when breathed 
on has a saffron-like odor; dissolves entirely in proof spirit, and during 
solution exhibits under the microscope numerous minute crystals. 

Peepaeations. 

U.S.P. DOSE. 

Aloes Purificata £-6 gr. 

lExtractum Aloes Aquosum 2~6 gr. 

B.P. DOSE. 

Decoctuin Aloes Compositum (Extract) 4 gr. in 1 fl. oz §-2 fl. oz. 

£nema Aloes 4 gr. in 1 fl. oz 10 fl. oz. 

Extractum Aloes Socotrinae 1 part from 2, nearly...2-6 gr. 

Extractum Colocynthidis Compositum (Extract)..! part in 2, nearly 3-10 gr. 

Pilula Aloes et Assafoetidse 1 part in 4 5-10 gr. 

Pilula Aloes et Myrrhae 1 part in 3 5-10 gr. 

Pilula Aloes Socotrinae 1 part in 2, nearly 5-10 gr. 

Pilula Rhei Composita 1 part in 6 5-10 gr. 

Tinctura Aloes 11 gr. to 1 fl. oz 1-3 fl. dr. 

Tinctura Benzoini Composita 8 gr. to 1 fl. oz h-2 fl. dr. 

Vinum Aloes 16^ gr. to 1 fl. OZ 1-2 fl. dr. 

U.S.P. Extractum Aloes Aquosum. AQUEOUS EXTEACT OF ALOES. — Aloes, 100 ; 
boiling distilled water, 1000. Separate the insoluble matter by subsidence and 
filtration, and evaporate. 

B.P. Decoctum Aloes Compositum. COMPOUND DECOCTION OF ALOES. — Extract 
of Socotrine aloes, 120 gr. ; myrrh, 90 gr. ; saffron, 90 gr. ; carbonate of potash, 60 gr. ; 
extract of liquorice, 1 oz. ; compound tincture of cardamoms, 8 fl. oz. ; distilled water 
up to 30 fl. oz. 

B.P. Enema Aloes.— Aloes (Socotrine or Barbadoes), 40 gr. ; carbonate of potash, 
15 gr. ; mucilage of starch, 10 fl. oz. 

B.P. Extractum Aloes Socotrinae. Treating with boiling water, separating 
insoluble matter by subsidence and filtration, and evaporating the clear solution. 

B.P. Pilula Aloes et Assafcetidee. PlLL OF ALOES AND ASSAFCETIDA. — Equal 

parts of Socotrine aloes, assafoetida, hard soap, and confection of roses. 

B.P. Pilula Aloes et Myrrhee. PlLL OF ALOES AND MYEEH. — Socotrine aloes, 
2 oz. ; myrrh, 1 oz. ; saffron, % oz. ; confection of roses, 2 ^ oz. 

B.P. Pilula Aloes Socotrina. PlLL OF SOCOTEINE ALOES. — Socotrine aloes, 2 

oz. ; hard soap, 1 oz. ; volatile oil of nutmeg, 1 fl. dr. ; confection of roses, 1 oz. 

B.P. Tinctura Aloes. TlNCTUEE OF ALOES.- 
liquorice, 1^ oz. ; proof spirit, to 20 fl. oz. 

B.P. Vinum Aloes. "Wine of Aloes. — Socotrine aloes, 1J oz. ; cardamom seeds 
and ginger, of each, 80 grs. ; sherry, up to 2 pints. 

Composition. — All kinds of aloes contain a bitter substance, aloin, 
to which their activity is due. It has in each kind of aloes a slightly 
-different composition, and has received a name showing its source — 
socaloin from Socotrine aloes, barbaloin from Barbadoes aloes, and 
nataloin from Natal aloes. According to some authors these substances 
are isomeric, according to others they form a homologous series. Besides 
oloin, aloes contain resinous substances and traces of an ethereal oil. 

Barbaloin and nataloin are distinguished from socaloin by giving 
with a drop of nitric acid, on a porcelain slab, a bright crimson color. 
With barbaloin this gradually fades, but is permanent with nataloin. 
Socaloin does not give this reaction. Barbaloin is distinguished from 
nataloin by the latter giving a fine blue color, while the former remains 
unchanged, on adding a minute quantity of each to one or two drops of 



892 VEGETABLE MATERIA MEDICA. 

strong sulphuric acid and then bringing a glass rod dipped in nitric acid 
so near that the vapor shall pass over the surface. 

U.S.P. Aloe Purificata. Purified Aloes. 

Preparation. — By melting aloes 100, adding alcohol 15, straining 
and evaporating. 

Characters. — Purified aloes is in irregular, brittle pieces, of a dull 
brown or reddish-brown color, and having the peculiar aromatic odor of 
Socotrine aloes. It is almost entirely soluble in alcohol. 

Peepaeations. 

U.S.P. DOSE. 

Pilulae Aloes 1 part in 2 1 pill. 

Pilulae Aloes et Asafcetida 1 part in 3 2-5 pills. 

Pilulae Aloes et Ferri 1 part in 3 1 pill. 

PUulae Aloes et Masticlies 2 parts in 3 1 pill. 

PUulae Aloes et Myrrbae 2 parts in 3J 1 pill. 

Pilulae Rhei Compositae 1 part in 3 1-4 pills. 

Extractum Colocynthidis Compositum 1 part in 2, nearly 5-10 gr. 

Pilulae Catharticae Compositae 1 part in 6 1-3 pills. 

Tinctura Aloes 1 part in 10 1-4 fl. dr. 

Tinctura Aloes et Myrrhae 1 part in 10 1-2 fl. dr. 

Tinctura Benzoini Composita 2 fl. dr. to 

1 fl. oz. 

Tinum Aloes 6 parts in 100 1 fl. dr. to 

1 fl. oz. 

U.S.P. Pilulae Aloes. PlLLS OF ALOES. — Aloes and soap, of each, 2 gr. in one 
pill. 

U.S.P. Pilulae Aloes et Asafoetida. PlLLS OF ALOES AND ASAFETIDA.— Each 
pill contains aloes, asafetida, and soap, of each, 1J gr. 

U.S.P. Pilulae Aloes et Ferri. PlLLS OF ALOES AND lEON. — Each pill contains 
aloes, dried sulphate of iron, and aromatic powder, of each, 1 gr., made up with con- 
fection of roses. 

U.S.P. Pilulae Aloes et Mastiches. PlLLS OF ALOES AND MASTIC— Each pill 
contains aloes, 2 gr. ; mastic, § gr. ; red rose, £ gr. 

U.S.P. Pilulae Aloes et Myrrhae. PlLLS OF ALOES AND MYEEH. — Each pill 
contains aloes, 2 gr. ; myrrh, 1 gr. ; aromatic powder, \ gr. Made up with syrup. 

u.s.P. Tinctura Aloes. Tinctuee of Aloes. — Aloes, 10 ; extract of glycyr- 
rhiza, 10 ; diluted alcohol, up to 100. 

U.S.P. Tinctura Aloes et Myrrliae. TlNCTUEE OF ALOES AND MYEEH. — Aloes, 
10 ; myrrh, 10 ; alcohol, to 100. 

U.S.P. Vinum Aloes. Wine of Aloes. — Aloes, 6 ; cardamom, 1; ginger, 1;. 
stronger white wine, up to 100. Dose as stomachic, 1-2 fl. dr. As purgative, \-l 
fl. oz. 

B.P. Aloe Barbadensis. Barbadoes Aloes. — The inspissated 
juice of the leaf of Aloe vulgaris. Barbadoes. 

Characters. — In yellowish-brown or dark -brown opaque masses ; 
breaks with a dull conchoidal fracture ; has a bitter, nauseous taste, and 
a strong disagreeable odor. 

Composition. — Contains barbaloin, resin, and volatile oil. 

Peepaeations. 
b.p. DOSE. 

Enema Aloes {vide supra) 4 gr. in 1 fl. oz 

Extractum Aloes Barbadensis 8 parts from 10, nearly 2-6 gr. 

Pilula Aloes Barbadensis 1 part in 2, nearly 5-10 gr. 

Pilula Aloes et Ferri 1 part in b\ 5-10 gr. 

Pilula Cambogiie Composita 1 part in 6, nearly 5-10 gr. 

Pilula Colocynthidis Composita 1 part in 3, nearly 5-10 gr. 

Pilula Colocynthidis et Hyoscyami 1 part in 41, nearly 5-10 gr. 

(of aloes in powder, 2-6 gr. 



ENDOGENS. 893 

B.P. Extractum Aloes Barbadensis. — Prepared like extract of Socotrine aloes. 

B.P. Pilula Aloes Barbadensis. PlLL OF BARBADOES ALOES. — Barbadoes 
aloes, 2 oz. ; hard soap, 1 oz. ; oil of caraway, 1 fl. dr. ; confection of roses, 1 oz. 

B.P. Pilula Aloes et Ferri. PlLL OF ALOES AND IEON. — Sulphate of iron, 
If oz. ; Barbadoes aloes, 2 oz. ; compound powder of cinnamon, 3 oz. ; confection of 
roses, 4 oz. 

Action and Uses. — It causes a bitter taste in the moutli, and 
reflex salivation. In small doses it seems to have a tonic action like 
simple bitters. It increases peristalsis of the intestines and also intes- 
tinal secretion. Its action is particularly exerted on the large intestines, 
and especially in the rectum. This is shown by the great length of 
time which usually elapses between its administration and its action (ten 
or twelve, sometimes as much as twenty-four, hours), and by the rectal 
irritation which it produces, and which is evidenced by tenesmus, hemor- 
rhoidal swelling, and haemorrhage. It increases the secretion of bile by 
stimulating the liver (Rohrig and Rutherford). It only acts when mixed 
with bile, and is consequently useless in jaundice, where the bile does 
not enter the intestine, as is shown by the whiteness of the stools. It 
may, however, be rendered active by giving it along with ox gall. Aloes 
has little or no purgative action when given alone as an enema, but is 
active if mixed with ox bile. In the enema aloes, B.P., it is mixed with 
carbonate of potash. Aloes appears to cause hyperemia of the uterus 
and other pelvic organs as well as of the rectum. It sometimes has an 
aphrodisiac action, but this is not constant, and probably is due to irri- 
tation caused by hemorrhoids (p. 387). Aloes differs from other purga- 
tives in not causing subsequent constipation, but on the contrary render- 
ing the intestine more sensitive, so that the dose can be gradually 
reduced. As it does not cause subsequent constipation, it is 
a favorite purgative, and is contained in most vegetable purgative pills 
(except pil. scamm. co.). As it acts slowly, it should be given a good 
while before a motion is desired, and a favorite plan is to give it as 
a dinner pill just before the last meal of the day, when it usually acts 
next morning after breakfast. I have known people who have taken 
dinner pills regularly every day for thirty years without injury and with 
apparent benefit. As it tends to cause congestion of the rectum, some 
authorities prohibit its use in piles, but in small doses, and if the piles 
are not inflamed, it is often beneficial in these cases, although large doses 
are injurious. From its action in causing congestion of the uterus, it is 
used in amenorrhoea (at the time when the catamenia are expected), but 
must be avoided in pregnancy and rectal inflammation. In these cases 
it is usually combined with iron or myrrh. 

Veratrum Viride, U.S. P. ; Veratri Viridis Radix, B.P. 

American Hellebore, U.S.P. ; Green Hellebore Root, B.P. — 
The rhizome and rootlets of Veratrum viride. United States and 
Canada. 

Characters. — Rhizome two or three inches long, one to two inches 
thick, with numerous shrivelled, light yellowish-brown rootlets. 

Composition. — It contains several alkaloids — jervine, pseudo-jervine, 
cevadine, very little rubijervine, and traces of veratrine and veratralbine. 



894 VEGETABLE MATERIA MEDICA. 

Veratroidine, which was formerly regarded as one of its constituents, is 
probably rubijervine and resin. 




Fig. 185.— Veratrum viride root. 

Pbepaeations. 

U.S. P. DOSE. 

Extractum Veratri Viridis Fluidum 1-4 min. 

Tinctura Veratri Viridis 5-10 min. 

B.P. DOSE. 

Tinctura Veratri Viridis 5-20 min. or more. 

(of the powdered rhizome, 1-3 gr. or more.) 

Action. — In small doses veratrum viride lessens the strength of the- 
pulse in man without at first affecting its rate, but afterwards it renders 
it very slow, soft and compressible, although sometimes moderately full. 
At this stage any exertion at once renders the slow pulse rapid, feeble, 
small, and even imperceptible. The depression of the circulation is- 
accompanied by muscular weakness, and frequently, though not always, 
by nausea and vomiting. When the dose is large these symptoms 
become increased, and a state of collapse comes on with an exceedingly 
rapid, almost imperceptible pulse, cold, clammy skin, constant nausea 
and retching, intense muscular weakness, giddiness, loss of vision, and. 
partial unconsciousness. 

The action of veratrum viride is due to the jervine and other alkaloids 
which it contains. It has been mentioned already that veratroidine is not 
a pure alkaloid, but as no further investigations have been made on the 
alkaloids of veratrum since those of Professor H. C. Wood, I give his 
results. 

Jervine lessens the functions of the spinal cord, both in frogs and 
mammals, and of the medulla (especially the vaso-motor centre), and of 
the cardiac ganglia, and at the same time irritates the motor centres 
in the l>rain, producing convulsions. Thus the symptoms produced are 
muscular weakness, loss of reflex action, followed by tremors, lowered 
blood-pressure, and slow pulse. 

Respiration ceases before the heart, and death ensues from asphyxia. 
There is invariably salivation, but no vomiting nor purging. It has no- 
action on the vagus, and the slow pulse is due to an action on the cardiac 
muscle or its ganglia. Voluntary muscles and motor nerves are- 
little, if at all, affected by it. 



ENDOGENS. 895 

Veratroidine differs from jervine in always causing vomiting and 

purging, and in producing less violent convulsions. It stimulates the 
vagus centre and paralyzes the vag-us ends. It depresses the spinal 
cord and paralyzes the respiratory centre, but increases the excita- 
bility of the vaso -motor centre. At first it slows the pulse and lowers 
the blood-pressure. Next the pulsations become very powerful, 
though still slow, and the blood-pressure rises to normal. Then the 
pulse becomes very rapid, and the pressure rises greatly. This rise is, 
however, not due to the direct action of the drug, but to stimulation of 
the vaso-motor centre by asphyxial blood from paralysis of the respira- 
tion. If artificial respiration be kept up veratroidine steadily lessens 
both pulse rate and blood-pressure. 

Therapeutics. — Veratrum viride has been used as a cardiac depres- 
sant in inflammations, but not generally. 

B.P. Sabadilla. Cevadilla. — The dried fruit of Asagrcea offi- 
cinalis. Mexico. 

Characters. — Fruit about half an inch long, consisting of three 
light brown papyraceous follicles, each containing from one to three 
seeds, which are about a quarter of an inch long, blackish-brown, shining, 
slightly winged, possessing an intensely acrid, bitter taste. 

Peepaeation. 
Veratria. 

Composition. — Three alkaloids, the first, veratria, being the active 
principle. The remaining alkaloids, sabadillina and sabatrina, occur in 
very small quantities, and are of little importance in pharmacy. 

Veratrina, U.S.P.; Veratria, B.P. Veratrlne, U.S.P. ; Vera- 
tria, B.P. — An alkaloid or mixture of alkaloids prepared from the seeds 
of Asagrcea officinalis, U.S.P. An alkaloid obtained from cevadilla; 
not quite pure, B.P. 

Preparation. — A concentrated tincture of the seeds is poured into, 
cold water in order to precipitate albumen. From the filtered solution 
veratria is precipitated by ammonia, and purified by resolution in dilute 
hydrochloric acid, decolorization by animal charcoal, and reprecipitation 
by ammonia. 

Characters. — Pale gray, amorphous, without smell, but, even in 
the most minute quantity, powerfully irritating the nostrils ; strongly and 
persistently bitter, and highly acrid ; insoluble in water ; soluble in spirit, 
in ether, and in diluted acids, leaving traces of an insoluble brown resin- 
oid matter. An active poison. 

Impurities. — Mineral matter, and sometimes traces of the other 
alkaloids of cevadilla. 

Test. — Heated with access of air it melts into a yellow liquid, and 
at length burns away, leaving no residue. 

Dose. — jL— §- S r - 

Peepaeations. 

U S.P. 

Oleatum Veratrinae 1 part in 50 

Unguentum Veratrinee 1 part in 25 

B.P. 

Unguentum Veratrise (8 gr. to 1 oz.) for external use. 



896 VEGETABLE MATERIA MEDICA. 

Physiological Actiox. — Large doses of veratrine cause violent 
sneezing, and great gastro-intestinal irritation, vomiting, purging, and 
symptoms of collapse, the pulse being rapid, small, and irregular ; and 
often involuntary muscular tremors come on. A peculiar creeping and 
prickling sensation in the skin generally accompanies these symptoms. 

Externally, applied to the unbroken skin, it has no marked action, 
but if rubbed in with some fat it passes through the epidermis and acts 
on the true skin, and causes first irritation and then paralysis of the ends 
of the sensory nerves, producing a prickling and creeping sensation, suc- 
ceeded by numbness. It is somewhat like aconitine in this respect. 
This effect is produced whether applied locally or taken internally. 

Its irritating action on the sensory nerves is also observed if it be 
inhaled into the nose, when it causes violent sneezing, which also occurs 
after absorption from the stomach. 

Internally. — It has no marked action on the brain. It has prob- 
ably no action on the spinal cord. By some experimenters it is stated 
that convulsions are produced in frogs, but, from numerous experiments 
which I performed, I doubt the accuracy of this statement. 

Muscles. — The contractile power is increased, but the elasticity very 
much diminished. The period of contraction is very much prolonged, 
but neither the latent period nor the ascent of the curve are affected in 
character ; the height of the curve is slightly increased, and the descent 
of the curve very much prolonged, so that it does not reach the abscissa 
for several revolutions of the cylinder. This contraction is not a state 
of partial rigor, since during its continuance the development of heat is 
increased to a marked degree; neither is it a true tetanus, since the rheo- 
scopic frog only gives a single contraction when its nerve is laid on the 
poisoned muscle. It is a prolonged contraction. To this alteration 
in the muscles is due the peculiar behavior of frogs when poisoned by 
veratria. The frog jumps readily on stimulation, but after its spring it 
lies on the table with legs extended for a long time ; then it draws the 
limbs up slowly, for both the flexors and extensors are contracted, and 
the contraction has to pass off from the extensors before the flexors can 
act. When it has drawn its limbs up, it remains still for a time, to allow 
the contraction to pass off from the flexors, after which it springs again. 
Thus the frog performs the normal movements with very long intervals 
between them. These movements have probably been mistaken for con- 
vulsions. Temperature affects the veratria curve in a remarkable manner. 
As you cool the muscle down, the curve becomes more and more like 
the normal, and if the temperature be much raised (keeping below the 
heat of rigor calo?'is), the effect also disappears; thus extremes of heat 
and cold remove the veratrine effect on the muscle-curve. The effect of 
veratrine on the muscle is also removed by potash (p. 127). 

Muscles previously exhausted by over-exertion have their powers 
restored by veratrine. 

Motor nerves have their excitability increased at first; afterwards 
their peripheral ends are paralyzed. Sensory nerves have their peri- 
pheral ends first stimulated (causing pricking, &c), and then paralyzed 
(cf. aconite, p. 69!>). 

Circulation. — The effect of veratrine on the heart-muscle of the 
frog is very similar to that on voluntary muscle; hence the contractions 



ENDOGENS. 897 

of the heart become slower, and each systole lasts for a length of time, 
till finally the heart stops in complete systole. The effect of veratrine 
on the heart is also removed by heat and by potash (Ringer). In mam- 
mals, small doses injected into the circulation quicken the pulse and 
raise the blood-pressure; moderate and large doses slow the heart and 
lower the blood-pressure. Small doses quicken the respiration; 
large ones slow it, producing long pauses like those which occur after 
section of the vagi, and finally paralyze it. These effects are probably 
due to stimulation at first, and afterwards to paralysis of the ends of the 
vagus in the lung, and to paralysis of the respiratory centre. The tem- 
perature is lowered. 

Therapeutics. — Locally, it is used like aconitine for neuralgia, in 
the form of the ointment rubbed over the affected part. 

Internally, it is sometimes used in rheumatic arthritis, and in sthenic 
febrile affections, as pneumonia, but its action is uncertain, and its use 
dangerous; hence it is seldom employed. Possibly one cause of the 
uncertainty of its action is the high temperature accompanying febrile 
affections, by which its action is altered. A similar reason may hold 
good for aconite, which varies considerably in its action on febrile dis- 
orders (cf. digitalis, pp. 848 and 849). 

Colchici Radix, U.S.P. ; Colcliici Cormus, B.P. Colchicum 
Root, U.S.P. ; Colchicum Corm, B.P.— The (fresh, B.P.) corm of 
Colchicum autumnale (collected about the end of June; and the same 
stripped of its coats, sliced transversely, and dried at a temperature not 
exceeding 150°, B.P.). 




Fig. 186. — Colchicum : transverse section. 

Characters. — Fresh corm about the size of a chestnut ; furnished 
with an outer brown and an inner yellow coat ; internally white, solid, 
and fleshy. Dried slices about a line thick, moderately indented on one, 
rarely on both sides ; firm, flat, whitish, amylaceous. 

Composition. — Colchicine, and traces of veratrine; also starch, 
tannin, and fatty oil. They lose their odor by drying. 

Peepaeations. 

U.S.P. 

Colchici Eadix. dose. 

Extraction Colchici Eadicis ..J-2 gr. 

Extractum Colchici Eadicis Fluidum 2-5 min. 

Vinum Colchici Eadicis 8 min. 

B.P. dose. 

Extractum Colchici £-2 gr. 

Extractum Colchici Aceticum £-2 gr. 

Vinum Colchici 88 gr. to 1 fl. oz 10-30 min. 

57 



898 VEGETABLE MATERIA MEDICA. 

Colchici Semen, U.S. P. ; Colchici Semina, B.P. Colchicum 
Seed, U.S.P.; Colchicum Seeds, B.P. — The seed of Colchicum 
autumnale, U.S. P. The fully ripe seeds of Colchicum autumnale, B.P. 




Fig. 187.— Colchicum Seed: a, natural size; 6, section magnified. 

Characters. — About the size of white mustard seed, very hard, of 
a reddish-brown color, and pitted. 

Composition. — Colchicine, generally regarded as an alkaloid, soluble 
in water and alcohol. Traces of veratrine — in combination with gallic 
acid — and a fixed oil are found. 

Peepaeations. 

U.S.P. DOSE. 

Extractuni Colchici Seminis Fluidum 2-10 min. 

Tinctura Colchici Seminis 15-30 min. 

Vinum Colchici Seminis 15-30 min. 

B.P. DOSE. 

Tinctura Colchici Seminum 54£ gr. to 1 fl. oz 10-30 min. 

General Action. — The action of colchicum does not vary in pro- 
portion to the dose, since, when a certain (fairly large) dose is given, an 
increased dose does not seem to produce a more marked effect. It acts 
as a poison both to cold and warm-blooded animals, but its effect is least 
marked on cold-blooded animals, and more marked on Carnivora than 
Herbivora. It has the same effect on the alimentary canal, whether 
swallowed or subcutaneously injected. 

When given in continued non-poisonous doses it causes an acrid taste, 
with reflex flow of saliva, and symptoms of gastro -intestinal disturb- 
ance, viz., irritation of the fauces, loaded tongue, loss of appetite, 
flatulence, uneasiness, or pain in the stomach and intestines, and diar- 
rhoea. The pulse is slowed, and there is a tendency to muscular weak- 
ness. 

A single large dose, or moderate doses long- continued, may 
produce symptoms of acute gastro-intestinal inflammation, viz., violent 
vomiting (vomited matter being first bilious and then bloody), and 
purging (the stools being first serous, then mucous, then bloody). 
Marked symptoms of collapse supervene, the pulse becomes small, 
rapid, and thready, the skin cold and bedewed with sweat, respiration 
slow and painful. Death ensues from collapse, the brain remaining 
clear to the last. 

Sometimes nervous symptoms occur, such as flying pains over the 
body, numbness, and occasionally, though rarely, convulsions. 

Special Action. — When applied to the skin it is an irritant, 
causing redness, prickling, and smarting, and if taken into the nose 
causes sneezing and running at the eyes. 

Internally. — Its action on the brain, if any, is not well marked. 



ENDOGENS. 899 

In frogs the spinal cord is paralyzed, the paralysis being preceded 
by excitement, sometimes giving rise to convulsions. In the higher 
animals there is no excitement, the cord being paralyzed from the first. 
The sensory nerves are more or less paralyzed. The motor nerves 
and muscles are unaffected. The circulation is affected, but the action 
is to a great extent reflex, since, if injected directly into the circulation, 
both the heart and the blood-pressure are only slightly altered. Very 
large doses are required to paralyze the inhibitory fibres of the vagus, 
but ultimately they are paralyzed. 

The Secretion of Urine. — Some authorities affirm that the total 
solids (both inorganic and organic) are increased, and also the quantity 
of water. Some say that only the urea is increased, others that the 
uric acid is increased, while others, again, contradict both these state- 
ments. 

The probable explanation of these conflicting statements is that the 
observers have conducted experiments with different diets. 

Therapeutics. — Its chief use is in gout, in the form of vinum or 
tincture, either in large doses during the fit, or in small ones continued for 
a length of time. It seems to act best when the bowels are previously 
freely acted on, hence a very old and useful mixture is colchicum, mag- 
nesia, and sulphate of magnesia. 

In rheumatic arthritis 10 min. of tincture with 10 gr. of potassium 
iodide often prove useful. 

In subacute rheumatism it is of very much less service. 

In acute rheumatism it is hardly ever used, salicylate of soda being 
more frequently employed. 

Treatment in Poisoning'. — Evacuate the stomach by an emetic, if 
vomiting is not induced by the drug itself; give tannic acid in large 
quantities (which acts as a chemical antidote) ; white of egg diluted with 
water may be given freely ; or, if pulse is very depressed, give stimulants 
and keep the patient warm. 



ORCHIDACEiE. 

U.S. P. Vanilla. Vanilla. — The fruit of Vanilla planifolia. 

Characters. — From six to ten inches (15 to 25 centimetres) long, 
linear, narrowed and bent or hooked at the base, rather oblique at the 
apex, wrinkled, somewhat warty, dark brown, glossy-leathery, one-celled, 
and containing a blackish-brown pulp, with numerous minute seeds, and 
more or less acicular crystals ; odor and taste peculiar, fragrant. 

Peepaeation. 

dose. 
Tinctura Vanillse A few drops as a flavoring. 

Uses. — It is used chiefly as a flavoring* and a perfume. It is also 
an aromatic stimulant in hysteria and low fevers. 

U.S.P. Cypripedium. Cypripedium. Ladies' Slipper. — The 
rhizome and rootlets of Cypripedium pubeseens, and of Cypripedium 
parviflorum. 



900 VEGETABLE MATERIA MEDICA. 

Characters. — Horizontal, bent, four inches (10 centimetres) or less 
long ; about one-eighth of an inch (3 millimetres) thick ; on the upper 
side beset with numerous circular, cup-shaped scars ; closely covered 
below with simple, wiry rootlets varying from four to twenty inches (10 
to 50 centimetres) in length ; brittle, dark brown, or orange-brown ; 
fracture short, white ; odor faint but heavy ; taste sweetish, bitter and 
somewhat pungent. 

Preparation. 

dose. 
Extractum Cypripedii Fluidum 15 min. 

Use. — It has an antispasmodic action similar to that of valerian, 
but it is less powerful. 

ZINGIBERACEiE. 



Zingiber, U.S. P. and B.P. Ginger. — The (scraped and dried, 
B.P.) rhizome of Zingiber officinale. West Indies, India, and other 
countries. 

Characters. — Irregular lobed decorticated pieces, three or four 
inches long, yellowish-white, but not chalky on the surface, with a 
short, mealy fracture, hot taste, and agreeable aroma. Powder yellowish- 
white. 

Preparations, 
u.s.p. DOSE. 

Extractum Zingiberis Fluidum 10-30 Ulin. 

Oleoresina Zingiberis 1-2 min. 

Pulvis Aromaticus 10-30 gr. 

Tinctura Zingiberis 15-75 Dlin. 

Pulvis Khei Compositus 30-60 gr. 

Syrupus Zingiberis 1 fl. dr. 

Vinuni Aloes 1-2 fl. dr. 

B.P. DOSE. 

Confectio Opii 5-20 gr. 

Confectio Scammonii 10-30 gr. 

Infusurn Sennse 1-2 fl. oz. 

Pilula Scillae Composita 5-10 gr. 

Pulvis Cinnamomi Compositus 30-60 gr. 

Pulvis Jalapae Compositus 20-60 gr. 

Pulvis Opii Compositus 2-5 gr. 

Pulvis Rhei Compositus 20-60 gr. 

Pulvis Scammonii Compositus 10-20 gr. 

Syrupus Rhamni 1 fl. dr. 

Syrupus Zingiberis £-1 fl. dr. 

Tinctura Zingiberis 15 min. to 1 fl. dr. 

Tinctura Zingiberis Fortior 5-20 min. 

Vinum Aloes 1-2 fl. dr. 

Composition. — A yellow volatile oil and a resin, the former having 
the odor, and the latter the taste, of the drug. 

Action. — Ginger causes a feeling of warmth in the mouth, and 
reflexly stimulates the secretion of saliva. It has a stimulant action on 
the stomach, producing warmth at the epigastrium. It promotes the 
expulsion of flatus. 

Uses. — It is used in atonic dyspepsia, also to relieve flatulence, and 
as an adjunct to purgatives to lessen griping. It is also used as a masti- 
catory to increase secretion of saliva, and in relaxed conditions of the 
throat. Also used as a carminative in colic. 



ENDOGENS. 901 

B.P. Turmeric. — The rhizome of Curcuma longa. 

Solution of Turmeric, U.S.P.; Turmeric Tincture, B.P. — A 

solution prepared by macerating 1 part bruised turmeric in 6 parts diluted 
alcohol, U.S. P., or rectified spirit, B.P., in a closed vessel for 7 days 
and filtering. 

Turmeric Paper, U.S.P. and B.P. — Unsized white paper, col- 
ored by steeping in tincture of turmeric and drying by exposure to the 
air without heat. 

Action and Uses. — Turmeric acts similarly to ginger. Chiefly 
used as a condiment. Turmeric paper is used as a test for alkalis, 
which turn it brown. 

Cardamomum, U.S.P. and B.P. Cardamoms. — The fruit, 
U.S.P. (dried capsules, B.P.), of Elettaria Cardamomum. Malabar. 
The seeds are best kept in their pericarps, from which they should be 
separated when required for use, the pericarpial coats being rejected. 



Fig. 188.— Cardamoms. 

Characters. — Seeds obtusely angular, corrugated, reddish-brown, 
internally white, with a warm, aromatic, agreeable taste, contained in 
ovate-oblong, triangular, pale brown, coriaceous pericarps. 

Pkeparations. 

U.S.P. DOSE. 

Pulvis Aromaticus 10-30 gr. 

Tinctura Cardamomi 1-2 fl. dr. 

Tinctura Cardamomi Composita 1-2 fl. dr. 

CONTAINED ALSO IN 

Tinctura Bhei 1-8 fl. dr. 

Tinctura Gentianse Composita 1-4 fl. dr. 

Vinum Aloes 1-2 fl. dr. 

Extractum Colocynthidis Compositum 5-20 gr. 

B.P. DOSE. 

Tinctura Cardamomi Composita ...J-2 fl. dr. 

Tinctura Chloroformi Composita 

CONTAINED ALSO IN 

Extractum Colocynthidis Compositum 3-10 gr. 

Pulvis Cinnamomi Compositus 30-60 gr. 

Pulvis Cretae Aromaticus 10-60 gr. 

Tinctura Gentianse Composita %-2 fl. dr. 

Tinctura Rhei 1-8 fl. dr. 

Vinum Aloes 1-2 fl. dr. 

Composition. — Fixed oil and aromatic volatile oil, containing a 
camphor in solution. 

Action and Use. — Cardamoms act similarly to ginger. They are 
stimulant, aromatic, and carminative, and are less pungent than 
ginger. Used chiefly as a carminative in flatulence, and as an adjunct 
to other medicines to lessen griping. 



902 VEGETABLE MATERIA MEDICA. 

IRIDACEJE. 

Crocus, U.S. P. and B.P. Saffron. — The stigmas of Crocus 
sativus, U.S. P. The dried stigma, and part of the style, of Crocus 
sativus, B.P. Spain, France, and Italy. 

Characters. — Thread-like styles, each terminated by three long 
orange-brown stigmas, broadest at the summit. Has a powerful aromatic 
odor. 

Preparations, 
tj.s.p. DOSE. 

Tinctura Croci £-2 fl. dr. 

B.P. DOSE. 

Decoctum Aloes Compositum £-2 fl. oz. 

Pilula Aloes et Myrrhse 5-10 gr. 

Pulvis Cretse Aromaticus 10-60 gr. 

Tinctura Cinchonae Composita £-2 fl. dr. 

Tinctura Croci j-2 fl. dr. 

Tinctura Opii Ammoniata £-1 fl. dr. 

Tinctura Rhei 1-2 fl. dr. (stomachic). 

" " 4-8 fl. dr. (purgative). 

(of dried saffron, 20 gr. upwards.) 

Composition. — The coloring matter of saffron is a glucoside — crocin 
— soluble in water and easily decomposed by dilute acids. A volatile oil 
is obtainable both directly from the drug and by the decomposition of 
crocin. It possesses the odor of saffron. 

Impurities. — Saffron is often adulterated with parts of other plants 
dyed, and with colored chalk. 

Tests. — By throwing saffron on the surface of warm water, the 
peculiar form of the stigma is at once seen, and admixture of other plants 
discovered. The chalk is detected by its immediately rendering the 
water turbid. 

Action and Use. — Saffron has but little action. It is used chiefly 
as a coloring agent, and as a slight carminative. 

U.S.P. Iris. Iris. Blue Flag. — The rhizome and rootlets of 
Iris versicolor. 

Characters. — Rhizome horizontal, consisting of joints, two to four 
inches (5 to 10 centimetres) long, cylindrical in the lower half, flattish 
near the upper extremity, and terminated by a circular scar, annulated 
from the leaf-sheaths, gray-brown; rootlets long, simple, crowded near 
the broad end ; odor slight ; taste acrid, nauseous. 

Preparations. 

dose. 

Extractum Iridis 2-4 gr. 

Extraction Iridis Fluidum 5-10 min. 

Composition. — It owes its medicinal virtues to an oleoresin. 

Action. — It is emetic and cathartic, and has been proved by 
Professor Rutherford to act as a stimulant to the liver and the intes- 
tinal glands (p. 351). 

Uses. — In constipation and biliousness. 



EKDOGENS. 903 

PALMACE^E. 

B.P. Areca. Areca Nut. — The seed of Areca Catechu, the 
betel-nut tree. 

Composition. — Oil, containing an acid in solution, and red tannic 
matter resembling rhatany-red. 

Dose. — As an astringent, 15 to 30 grains. As an anthelmintic, J 
to | oz. 

Use. — It is much used in veterinary practice, and occasionally in 
ordinary practice, as an anthelmintic for tapeworm. It is also 
astringent, and is used as a masticatory (p. 177). 

ARACE^E. 

XJ.S.P. Calamus. Calamus. Sweet Flag. — The rhizome of 
Acorus Calamus. 

Characters. — In sections of various lengths, unpeeled, about three- 
quarters of an inch (2 centimetres) broad, subcylindrical, longitudinally 
wrinkled; on the lower surface marked with the circular scars of the 
rootlets in wavy lines; externally reddish-brown, somewhat annulate 
from remnants of leaf-sheaths; internally whitish, of a spongy texture, 
breaking with a short, corky fracture, showing numerous oil-cells and 
scattered wood-bundles, the latter crowded within the subcircular nucleus- 
sheath. It has an aromatic odor, and a strongly pungent taste. 

Preparation, 
u.s.p. DOSE. 

Extractum Calami Fluidum 15-60 min. 

Composition. — It contains a volatile oil and a bitter principle. 
Uses. — It is used as a feeble aromatic, stomachic, and stimulant. 

GKAMINACE^E. 

B.P. Farina Tritici. Wheaten Flour. — The grain of wheat, 
Triticum vulgare, ground and sifted. 

Preparation. 
Cataplasma Fermenti. 

Composition. — Starch and gluten. 
Use. — Chiefly as an article of food. 

B.P. Mica Panis. Crumb of Bread. — The soft part of bread 
made with wheat flour. 

Preparation. 
Cataplasma Carbonis (p. 459). 

Use. — It is used as a cataplasm, both alone and in cataplasma car- 
bonis. It is also used as a basis for pills, and especially for making up 
croton oil into pill. Occasionally pills made of it alone are given as a 
placebo. 



904 VEGETABLE MATERIA MEDICA. 

Amylum, U.S.P. and B.P. Starch. — The fecula of the seed of 
Triticum vulgar e, U.S.P. The starch procured from the seeds of com- 
mon wheat, Triticum vulgar 'e, B.P. 

Characters and Tests. — In white, columnar or irregular angular 
masses, white, inodorous, and tasteless. Insoluble in alcohol, ether, or 
cold water. Easily powdered, and when rubbed in a Wedgwood mortar 
with a little cold distilled water, it is neither acid nor alkaline to test- 
paper, and the filtered liquid does not become blue on the addition of 
solution of iodine. Mixed with boiling water and cooled, it gives a deep 
blue color with iodine. 

Peepaeations. 

U.S.P. 

Amylum Iodatum (starch, 95 parts; iodine, 5 parts) 

Glyceritum Amyli (starch, 10 parts; glycerine, 90 parts) 

B.P. DOSE. 

Glycerinum Amyli 1 part in 11 by weight 

Mucilago Amyli 12 gr. to 1 fl. oz 

Pulvis Tragacanthae Compositus 1 part in 6 20-60 gr. 

Uses. — The glycerine of starch forms a soothing application for 
chilblains and chapped hands. Amylum iodatum is really a preparation 
of iodine, q.v. Starch is also used as a vehicle for enemata. Bandages 
saturated with it are used in surgery. 

U.S.P. Triticum. Triticum. Couch-Grass. — The rhizome of 
Triticum repens, gathered in the spring and deprived of the rootlets. 

Characters. — Very long, but, as met with in the shops, cut into 
sections about two-fifths of an inch (1 centimetre) long, and about one- 
twelfth of an inch (2 millimetres) thick ; creeping, smooth, hollow in the 
centre, straw-yellow, inodorous, and of a sweet taste. 

Peepaeation. 

dose. 

Extractum Tritici Fluidum 1 fl. dr. to 1 oz. 

Uses. — It is used as a demulcent and diluent, more particularly in 
cystitis and irritation of the urinary passages. 

It probably owes its diuretic effect to its sugar, and is best given in 
the form of an infusion or decoction, which may be freely used. 

B.P. Hordeum Decorticatum. Pearl Barley. — The husked 
seeds of Hordeum distichon. Britain. 

Characters. — White, rounded, retaining a trace of the longitudinal 
furrow. 

Composition. — Starch, albuminous matter, cellulose, and a small 
quantity of fixed oil. 

Peepaeation. 
Decoctum Hordei. Baeley Watee. — Pearl barley, 2 oz. ; boiling water, 30 fl. 
oz. ; the barley is first washed well in cold water, which is thrown away, and then 
the barley is boiled for twenty minutes and strained. 

Use. — The decoction is used as a demulcent drink. 



ENDOGENS. 905 

U.S.P. Maltum. Malt. — The seed of Hordeum distichum, 
caused to enter the incipient stage of germination by artificial means, 
and dried. 

Characters. — Malt should be fresh, of a color not darker than pale 
amber, and should have an agreeable odor and a sweet taste. 

Peeparation. 

dose. 
Extractum Malti 4 fl. dr. 

U.S.P. Extractum Malti. Extract of Malt. 

Preparation. — Upon malt in coarse powder, not finer than No. 12, 
100 parts, contained in a suitable vessel, pour 100 parts of water, and 
macerate for six hours. Then add 400 parts of water, heated to about 
30° C. (86° F.), and digest for an hour at a temperature not exceecljng 
55° C. (131° F.). Strain the mixture with strong expression. Finally, 
by means of a water-bath, or vacuum apparatus, at a temperature not 
exceeding 55° C. (131° F.), evaporate the strained liquid rapidly to the 
consistence of thick honey. Keep the product in well-closed vessels, in 
a cool place. 

Dose. — 4 fl. drm. 

Action. — This officinal extract of malt is similar to various other 
extracts and foods prepared from malt. It is not only nutritious, but, 
on account of the diastase contained in it, acts as a digestive ferment. 

In large doses it relaxes the bowels. 

Uses. — In cases of imperfect digestion and in phthisis, and in gene- 
ral imperfect nutrition in children or adults. 

Saccharum, U.S.P. ; Saccharum Purificatum, B.P. Sugar, 

U.S.P.; Repined Sugar, B.P. C 12 H 22 O u , or C 24 H 22 12 ; 342.— The 
refined sugar of Saccharum officinarum, U.S.P. Pure cane sugar pre- 
pared from the juice of the stem of Saccharum officinarum. West Indies 
and other tropical countries, B.P. 

Characters. — Compact, crystalline, conical loaves, known in com- 
merce as lump sugar. 

Impurities. — Salts, foreign matters. 

Tests. — U.S.P. White, dry, hard, distinctly crystalline granules, 
permanent in the air, odorless, having a purely sweet taste, and a neutral 
reaction. Soluble in 0*5 part of water, and in 175 parts of alcohol at 
15° C. (59° F.); in 0-2 part of boiling water, and in 28 parts of boiling 
alcohol ; also in 80 parts of boiling, absolute alcohol, but insoluble in 
ether. The aqueous solution, saturated at 15° C. (59° F.), has the 
specific gravity 1*345, and is miscible with alcohol in all proportions. 

Neither an aqueous nor an alcoholic solution of sugar, kept in large, 
well-closed and completely filled bottles, should deposit a sediment on 
prolonged standing (absence of insoluble salts, foreign matters, ultra- 
marine, Prussian blue, &c). If a portion of about 1 gm. of sugar be 
dissolved in 10 c.c. of boiling water, then mixed with 4 or 5 drops of 
test solution of nitrate of silver and about 2 c.c. of water of ammonia, 
and quickly heated nntil the liquid begins to boil, not more than a slight 
coloration, but no black precipitate, should appear in the liquid after 



906 VEGETABLE MATERIA MEDICA. 

standing at rest for five minutes (absence of grape sugar and of more than 
a slight amount of inverted sugar). 

Use. — To mask the taste of disagreeable remedies. It is used as a 
rehicle, corrigent, preservative, and antiseptic. Syrups have the 
advantage of protecting the active ingredients against fermentation, and 
certain ferruginous preparations against oxidation. 

Peepaeatioxs. 

U.S. p. 
Pilulse Ferri Carbonatis. Pulvis Cretae Compositus. 

Pilulae Ferri Iodidi. Pulvis GUycyrrhizae Compositus. 

Ferri Carbonas Saccharatus. Troches, Syrups, Compouud Syrups, &c. 

Mistura Ferri Composita. 

B.P. 

Confectio Kosae Caninae. Mistura Guaiaci. 

Confectio Rosas Gallicae. Pilula Ferri Iodidi. 

• Confectio Sennae. Pulvis Cretae Aromaticus. 

Ferri Carbonas Saccharata. Pulvis Amygdalae Compositus. 

Liquor Calcis Saccharatus. Pulvis Tragacanthae Compositus. 

Mistura Ferri Composita. All the Syrups and Lozenges. 

B.P. Theriaca. Treacle. — The uncrystallized residue of the 
refining of sugar. 

Characters. — A thick, brown, fermentable syrup, very sweet; not 
crystallizing by rest or evaporation. Specific gravity about 1 # 40. 

Test. — Nearly free from empyreumatic odor or flavor. 

Peepaeatioxs. 
b.p. 
Pilula Assafoetidae Composita. Pilula Rhei Composita. 

Pilula Conii Composita. Pilula Scillae Composita. 

Pilula Ipecacuanhae et Scillae. 

Use. — To make up some of the pills of the Pharmacopoeia. "With 
sulphur it is used as a domestic laxative. 

Avenae Farina. Oatmeal. Not officinal. — The meal prepared 
from the seeds of Avena sativa, the common oat. 

Composition. — The seeds contain starch, gluten and gum. The 
pericarp contains an amorphous alkaloid. This alkaloid is soluble in 
alcohol. It is more abundant in dark than in light oats. It probably 
gives to them their bitterish taste. 

Action. — The alkaloid appears to act chiefly as a stimulant of the 
motor ganglia. It increases the excitability of the muscles, and in 
horses causes excitement. 

Uses. — Oatmeal is chiefly used for making gruel or porridge, which, 
in addition to being nutritious, acts as a demulcent in coughs, and as 
a slight laxative. Warm oatmeal porridge at bed time may have a 
soporific action (p. 181), though the exciting action of the alkaloid may 
render panada, Indian corn, or lentils preferable. An infusion, decoc- 
tion, or tincture, has been recommended as a stimulant to replace 
opium in persons addicted to opium eating, in order to help them to 
break off that habit. 



CEYPTOGAMS. 907 

CHAPTER XXXVII. 

Sub-kingdom II.— CRYPTOGAMS. 

FILICES. 

Aspidium, U.S.P. ; Filix Mas, B.P. Male Fern. — The rhizome 
of Aspidium Filix mas and of Aspidium marginale, U.S.P. The dried 
rhizome with the bases of the footstalks and portions of the root fibres of 
Aspidium Filix mas. Collected in summer, B.P. 

Characters. — Tufted, scaly, greenish-brown ; powder greenish- 
yellow, with a disagreeable odor, and a nauseous, bitter, somewhat 
astringent taste. 

Peeparations. 
u.s.p. dose. 

Oleoresina Aspidii 30-60 min. 

B.P. dose. 

Extractum Filicis Liquidum 15 min. to 1 fl. dr. 

(of the powder, 60-180 gr.) 

Composition. — A dark green oil which deposits crystals of filicic 
acid, also traces of volatile oil. The filicic acid is regarded as the chief 
though not the only active principle ; tannin, resin, and sugar have been 
found in the rhizome. 

Physiological Action and Therapeutics. — The liquid extract is 
one of the best anthelmintics against tapeworm, killing the Bothrioee- 
phalus latus, Taenia solum, and T. medioeanellata. Pomegranate root 
bark is said to kill the latter with greater certainty. The dose often 
given is too small, and hence failure is attributed to the drug when it 
really depends on the smallness of the dose. Single doses of 5i-5iss of 
the liquid extract will often cure at once. 

Method of Administration. — Allow the patient to take no food 
after five or six in the evening except a little bread and milk. Just 
before bed give 5i of the liquid extract in 5i of mucilage, and let the 
patient lie down immediately and go to sleep. This often prevents the 
vomiting which sometimes occurs. Next morning administer a purgative, 
and repeat the treatment until the worm comes away. 

Another method is to give a dose of castor oil at night (with the 
same conditions of feeding) and early next morning give a dose of liquid 
extract (5ss-5i), and abstain from food till after the bowels have acted. 

LICHENES. 

Cetraria, U.S.P. and B.P. Iceland Moss. — The entire lichen, 
Oetraria islandica. North of Europe. 

Characters. — Foliaceous, lobed, crisp, cartilaginous, brownish- 
white, paler beneath ; taste bitter and mucilaginous. A strong decoction 
gelatinizes on cooling. 

Preparations, 
u.s.p. DOSE. 

Decoctum Cetrariae 2-4 fl. oz. 

B.P. DOSE. 

Decoctum Cetrariae 1 oz. to 1 pint 1-2 fl. oz. 



908 VEGETABLE MATERIA MEDICA. 

Composition. — Lichenin and cetrarin or cetraric acid. The former 
constitutes 70 per cent, of the moss. It swells in cold and dissolves in 
hot water, gelatinizing on cooling. The latter, which is the bitter prin- 
ciple, is obtained in white acicular crystals, and forms soluble salts with 
alkalis. 

Therapeutics. — It is demulcent, nutritious, and slightly tonic. 

B.P. Litmus. — A blue pigment prepared from various species of 
Roccella. 

Litmus Paper, Blue, U.S. P. and B.P. — Unsized white paper 
steeped in tincture of litmus and dried by exposure to the air. 

Litmus Paper, Red, U.S. P. and B.P. — Unsized white paper 
steeped in tincture of litmus which has been previously reddened by the 
addition of a very minute quantity of sulphuric acid, and dried by 
exposure to the air. 

Solution of Litmus, U.S. P. ; Litmus Tincture, B.P. — A solu- 
tion prepared by macerating 1 part of litmus, in powder, in 10 parts of 
diluted alcohol, U.S. P., or proof spirit, B.P., in a closed vessel for two 
days, and filtering. 

Use. — Red litmus paper is used as a test for alkalis, and blue litmus 
as a test for acids. 

FUNGI. 

Ergota, U.S.P. and B.P. Ergot. Ergot op Rye. — The sclerotium 
(compact mycelium or spawn) of Qlaviceps purpurea, replacing the grain 
of Secale cereale, Nat. Ord. G-raminaceoe, U.S.P. (produced within the 
palese of the common rye, Secale cereale, B.P.). 

Characters. — Somewhat fusiform, subtriangular, curved, with a 
longitudinal furrow on the concave side, obtuse at the ends, about an inch 
long ; purplish black outside, pinkish within ; solid, breaks with a short 
fracture ; odor peculiar, but strong if the powder be triturated with solu- 
tion of potash ; taste oily and disagreeable. 

Peepaeations. 

U.S.P. DOSE. 

Extractum Ergotae Fluidum 100 Gm. in 100 c.c 30-60 min. 

Vinum Ergotse 2-4 fl. dr. 

Extractum Ergotse 3-12 gr. 

B.P. DOSE. 

Extractum Ergotse Liquidum 1 oz. to 1 fl. oz 10-30 min. 

Infusum Ergotae 11 gr. to 1 fl. oz 1-2 fl. oz. 

Tinctura Ergotse 109 gr. to 1 fl. oz 10 min. to 1 fl. dr. 

Composition. — The chemical composition of ergot is still very 
imperfectly known, and the active principle (or principles) to which its 
most important action, that of causing contraction of the uterus, is due, 
has not been satisfactorily isolated. The active principles were formerly 
said to be ergotin and ecbolin, but these do not seem to be pure sub- 
stances. The term ergotin has been applied to several substances. The 
preparation known commercially as Bonjean's ergotin is an alcoholic 



CRYPTOGAMS. 909 

extract of a watery extract of ergot. According to Schmiedeberg, two 
pure principles have been isolated — ergotinic acid and an alkaloid, ergo- 
tinine. According to Dragendorff and Podwyssotzki, the active princi- 
ples are sclerotinic acid and a colloid substance, scleromucin. Sclerotinic 
acid is impure ergotinic acid. In addition to ergotinic acid, ergotinin, 
and probably several other principles, ergot contains about 35 per cent, 
of oil, a peculiar sugar (mykose), and two coloring matters, scleroxanthin 
and sclero-erythrin. 

The most recent researches are those of Robert, who states that ergot 
contains three active principles — ergotinic acid, sphacelinic acid, and an 
alkaloid, cornutine. 

General Action. — There is a great difference of opinion as to the 
action of ergot, due to its preparations undergoing change so rapidly, 
and hence not being of the same strength. They become quite inactive 
if kept for any length of time. In certain parts of Germany, where rye 
bread is much used, epidemics of ergotism have occurred. These 
epidemics depend both upon the continued large doses of ergot and upon 
the deficiency of food, the nutritive part of the rye being replaced by the 
fungus. The deficiency of food is probably an important factor, since 
continued therapeutic doses of ergot rarely produce ergotism, though 
occasionally they do so. 

There are two varieties of symptoms seen in ergotism: (1) the 
gangrenous ; (2) the anaesthetic or convulsive. Both begin with 
gastro-intestinal disturbance, causing loss of appetite, nausea, vomiting, 
and diarrhoea. 

The gangrenous symptoms are redness of the skin followed by well- 
marked gangrene in the part. The cause of this gangrene is probably 
stasis due to the great contraction of the small blood-vessels. 

The nervous symptoms are giddiness, with symptoms of irritation 
and paralysis of sensory nerves, the irritation being indicated by a sensa- 
tion as of insects crawling over the skin, flying pains, &c, the paralysis 
by loss of sensation in the hands and feet. Spasms may occur, and even 
convulsions of an epileptic nature, but their cause is unknown. 

Special Action. — Ergotinic acid causes paralysis of the spinal 
cord both in frogs and mammals, with loss of voluntary motion, paralysis 
of the vaso-motor centre, and fall of blood-pressure, while respiration and 
reflex irritability continue. It does not appear to have the power of 
increasing the uterine contractions, and so cannot be regarded as the 
most important constituent of ergot. Ergotinine is also not the active 
principle as it is present in very small quantity in ergot, and is to some 
extent removed by ether without the ergot losing its power. 

Sphacelinic acid causes contraction of the blood-vessels, with rise of 
blood-pressure and symptoms of gangrene. The heart is unaffected. 
The gangrene in fowls appears to be due to occlusion of the smaller arte- 
ries by a hyaline substance. In rabbits, guinea-pigs, and cats, the sub- 
stance is not formed, and no gangrene appears, but their walls degenerate, 
and blood is effused into various organs. Sphacelinic acid causes tetanus 
of the uterus (Robert). Cornutine causes spastic rigidity in frogs, 
lasting many days, even when given in very minute doses {-£% of a milli- 
gramme). In warm-blooded animals half a milligramme causes salivation, 



910 VEGETABLE MATERIA MEDICA. 

vomiting, diarrhoea, and active movements of the uterus, which are clonic 
and not tonic. The vessels are contracted and the blood-pressure raised. 
Sphacelinic acid and cornutine are therefore the principles which cause 
uterine contraction (Kobert). As these active principles have not yet 
found their way into common use, it will be better at present to take the 
results of experiments, not with pure principles isolated from ergot, but 
only of an extract such as Bonjean's ergotin. 

Action of Extract of Ergot. — A solution of Bonjean's ergotin 
injected into animals causes an affection of the nervous system, indi- 
cated by incoordination, anaesthesia, and paralysis ; and death is due to 
paralysis of respiration. 

The muscles are unaffected; the motor nerves are not paralyzed, 
but on the contrary have their power somewhat increased. 

The sensory nerves are paralyzed, but it is uncertain whether the 
action is central or peripheral. The spinal cord is paralyzed. 

Circulation. Heart. — Its action on the frog's heart is not well 
marked; sometimes the injection of ergot produces slowing of the pulse 
rate with stoppage in diastole, and in these cases direct mechanical irri- 
tation immediately after the poisoning does not cause the heart to con- 
tract. 

Slowing and diastolic arrest occur after section of the vagi, but not 
after administration of atropia; hence they are due to the action of the 
ergot on the inhibitory apparatus in the heart itself. 

Yaso-motor System. — The blood-pressure is considerably raised. 
When injected into the jugular vein, the blood-pressure, according to 
Holmes, is first lowered and then raised considerably, which he explains 
by supposing that the ergot passing to the right side of the heart causes 
contraction of the vessels of the lungs (by acting on their muscular walls), 
and hence lessens the supply to the aortic system and causes a fall of 
blood-pressure, but when it reaches the medulla it stimulates the vaso- 
motor centre, and causes contraction of the vessels throughout the body 
and consequent rise of blood-pressure. This explanation is confirmed by 
the fact that if ergot is injected into the femoral artery, instead of a fall 
occurring at first there is a rise due to contraction of vessels in the limb, 
then a fall as soon as the blood reaches the lungs, and lastly a final rise. 

This explanation is not accepted by Wood, who considers that the 
primary fall is due to the sudden introduction of a large quantity of ergot 
into the heart causing temporary paralysis, which will pass off as the drug 
is removed by the circulation. 

The final rise of blood-pressure no doubt is due to the action on the 
medulla, for if the cord be divided very little rise follows the injection of 
ergot. 

One other factor, which usually receives very little attention, must 
be taken into account (as well in this drug as in many others), viz. : the 
effect on the blood-pressure of contraction of the internal viscera, as the 
intestines or uterus, for by contraction their blood will be driven out, and 
a rise of a blood pressure produced without any action on the vessels. 

Respiration is usually slowed from the beginning, but in some ani- 
mals (dogs) it is first quickened and then slowed. Death is due to par- 
alysis of the respiratory centre. 



CRYPTOGAMS. 911 

Secretion. — The urine is increased in quantity, aud the bladder 
tends to contract, due to the effect of the drug on its unstriped fibres. 

Alimentary Canal. — Ergot markedly increases the peristaltic move- 
ments of the intestine. 

Uterus. — Ergot causes contraction of the uterus, especially of the 
pregnant uterus. This contraction is not usually so much rhythmical as 
tetanic in nature, with occasional increases in violence. There is no 
complete relaxation between the spasms, as in the ordinary labor pains. 
This is probably due to an action on the unstriped fibres of the uterus, 
since ergot causes contraction of involuntary fibres throughout the body, 
but it may be due wholly or in part to the uterine centre in the spinal 
cord. 

Therapeutics. — Ergot is chiefly used in medicine for two purposes : 
(1) to cause contraction of the uterus ; (2) to check haemorrhage by 
causing contraction of the vessels. 

It is sometimes used to hasten delivery when the power of the uter- 
ine contractions is not sufficient to expel the foetus. But the tetanic 
nature of the contraction produced by ergot must be borne in mind. It 
does not increase the power of the labor pains, but only the tonic contrac- 
tion of the uterus. It should be carefully avoided if there be any mechani- 
cal obstruction to delivery, such as rigid and undilated os uteri, contracted 
pelvis, or abnormal presentation, for in such cases it may so far interfere 
with the circulation in the uterus and placenta as to asphyxiate the foetus, 
or cause such contraction of the uterus as to produce rupture of its walls. 
After the child is expelled, the tetanic nature of the contraction produced 
by ergot is useful, and hence it is used to prevent post-partum haemor- 
rhage. In these cases, it is administered either in the form of powdered 
ergot in warm water, or the liquid extract, or by subcutaneous injection 
of ergotin. The last method gives the most rapid results, bnt if the 
ergotin is injected just beneath the skin it causes irritation and may lead 
to an abscess, hence it should be injected deep into a muscle, such as the 
gluteus maximus. 

Ergot is also used very largely in the practice of gynaecology, for exam- 
ple, in chronic metritis, in subinvolution of the uterus, after abortions, to 
promote the expulsion of retained membranes, and in all atonic condi- 
tions of the uterus. 

It is also used in certain cases of leucorrhoea, also in atony of the 
bladder and enlarged prostate. 

It is used to check haemorrhage in fibroid tumors of the uterus ; in 
haemoptysis (either internally, 5ss. of liquid extract every two, three or 
four hours, or subcutaneously injected). In haematemesis also it is some- 
times useful. 

In some cases of chronic constipation it is useful, and appears to give 
tone to the bowel. 

U.S.P. Ustilago. Ustilago. Corn Smut. — Ustilago Maydis 
(Nat. Ord., Fungi), grown upon Zea Mays (Nat. Ord., Graminaeece). 

Ustilago should be preserved in a dry place, and should not be kept 
longer than a year. This fungus is a form of smut growing upon 
maize. 



912 VEGETABLE MATERIA MEDICA. 

Characters. — Irregular, globose masses, sometimes six inches (15 
centimetres) thick, consisting of a blackish membrane, inclosing innu- 
merable brownish-black, globular and nodular spores ; odor and taste 
unpleasant. 

Dose.— J-l dr. (1-4 Gm.). 

Action — It resembles ergot in its action, and probably also con- 
tains the same alkaloid. 

B.P. Cerevisise Fermentuni. Beer Yeast. — The ferment 
obtained in brewing beer. 

Characters. — Viscid, semi-fluid, frothy, exhibiting under the micro- 
scope numerous round or oval confervoid cells (p. 90). 

Dose. — J to 1 ounce. 

Peepaeation. 

Cataplasma Fermenti. YEAST Poultice. — Mix beer yeast, 6 fl. oz., with water 
at 100° F., 6 n. oz., stir in wheaten flour, 14 oz., and place the mass near the fire till 
it rises. 

Use. — It has been given internally along with camphor and nitrous 
ether in typhoid fever and dysentery, and to persons suffering from 
boils. The poultice is applied to sloughing sores. It is apt to cause 
much pain. 

ALGcJE. 

U.S. P. Chondrus. Chondrus. Irish Moss. — Chondrus erispus 
and Chondrus mammilosus. 

Characters. — Yellowish or white, horny, translucent; many-forked ; 
when softened in water, cartilaginous ; segments flat, wedge-shaped, or 
linear ; at the apex emarginate or two-lobed ; it has a slight sea-weed 
odor ; and a mucilaginous, somewhat saline taste. One part of it boiled 
for ten minutes with thirty parts of water, yields a solution which gelati- 
nizes on cooling. 

Dose. — 2-4 dr. 

Use. — It is a demulcent, which is useful in bronchial and catarrhal 
affections. 



SECTION VI. 

ANIMAL KINGDOM. 



CHAPTER XXXVIII. 

Class MAMMALIA. ORDER RODENTIA. 

B.P. Castoreum. Castor. — The dried preputial follicles and 
their secretion, obtained from the beaver, Castor fiber, and separated 
from the somewhat shorter and smaller oil-sacs which are frequently 
attached to them. Hudson's Bay Territory. 

Characters. — Follicles in pairs, about three inches long, fig-shaped, 
firm, and heavy, brown, or grayish-black; containing a dry, resinous 
reddish-brown or brown, highly odorous secretion, in great part soluble 
in rectified spirit, and in ether. 

Composition. — Several fats, salicin, a bitter resin, and bitter volatile 

oil. 

Preparation, 
b.p. DOSE. 

Tinctura Castorei 22 gr. to 1 fl. oz |-1 fl. dr. 

(of castor, 5-10 gr.). 

Therapeutics. — Castor is used chiefly as an antispasmodic and 
stimulant. It may be given in hysteria and epilepsy. Its action is 
very like that of musk. 

Order RUMLNTANTIA. 

Moschus, U.S. P. and B.P. Musk. — The inspissated and dried 
secretion from the preputial follicles of Moschus moschiferus. Central 
Asia. 

Characters. — In irregular, reddish-black, rather unctuous grains ; 
having a strong, peculiar, very diffusible odor, and a bitter, aromatic 
taste; contained in a round or slightly oval membranous sac, about two 
inches in diameter, covered on the outer side with stiff, grayish hairs 
arranged in a concentric manner around its central orifice. 

58 • (913) 



914 ANIMAL KINGDOM. 

Composition. — An odoriferous substance not yet isolated, fats, resins, 
and salts. 

Dose. — 5-10 gr. and upwards. 

Officinal Peepaeation. 

U.S. p. DOSE. 

Tinctura Moschi 20-50 min. 

Therapeutical Uses. — Musk is often employed in hysteria, although 
its physiological action has not been investigated. It is more powerful 
in its action than castor. It is used as an antispasmodic and stimu- 
lant. It is a powerful stimulant, and excellent results have been obtained 
in cases of collapse, when due to paralysis of the respiration. It has also 
been given in asthenic pneumonia, bronchitis, fever, and gangrene of the 
lungs on account of its power of stimulating' the respiratory centre 
and covering the disagreeable odor of the sputa. There is a temptation 
to give it in small doses on account of its high price, and probably many 
failures are due to this. In cases where it is prescribed at all it should 
be given freely, and in many instances it seems to be of great service. 

Sevum, U.S. P. ; Sevum Praeparatum, B.P. Suet, U.S. P. ; 
Prepared Suet, B.P. — The internal fat of the abdomen of the sheep > 
Ovis Aries, purified by melting and straining. 

Characters. — White, smooth, almost scentless ; fusible at 103°. 

Composition. — Consists principally of stearin. 

Peepaeations. 
Emplastrum Cantharidis. Unguentum Hydrargyri. 

Use. — Used in the preparation of certain unguenta and emplastra. 

B.P. Sapo Animalis. Curd Soap. — A soap made with soda and 
a purified animal fat, consisting principally of stearine. 

Characters and Tests. — White, or with a very light grayish tint; 
dry ; nearly inodorous ; horny and pulverizable when kept in dry, warm 
air. Easily moulded when heated. Soluble in rectified spirit ; soluble 
also in hot water, the solution being neutral or only slightly alkaline to 
test-paper. It does not impart a greasy stain to paper. 

Peepaeations in which Cued Soap is used. 
Pilula Scammonii Composita. 
Suppositoria Acidi Carbolici cum Sapone. 
" Morphia? cum Sapone. 

" Acidi Tannici cum Sapone. 

This soap may with advantage be substituted for the hard soap made 
with olive oil in preparing the Linimentum Potassii Iodidi cum Sapone. 

B.P. Lac. Milk. — The fresh milk of the cow, Bos Taurus. 

Peepaeatiox in which Milk is used. 
Mistura Scammonii. 

Composition. — Fat (butter), casein, milk, sugar, and water. 

THERAPEUTICS. — Milk is not, strictly speaking, a medicine, but 
rather an article of diet: it however plays an important part in medi- 
cine, as we rely on it to a great extent in cases of fever and dyspepsia. 



ANIMAL KINGDOM. 915 

Great attention ought to be paid to the milk given to infants if they 
are fed from the bottle, for the milk may begin to ferment before it 
reaches the stomach, and, if it does, it is likely to cause vomiting and 
diarrhoea, and may even act as a nervous poison, paralyzing the nerve 
centres. The best way to prevent this is not to have any tubes to the 
bottles, but to have the teat fixed directly to the bottle, and to scald the 
bottle well after every meal. The teats should also be soaked in some 
antiseptic, such as permanganate of potash and water, when not in use. 
When milk is drunk in any quantity, the rennet-ferment in the stomach 
produces large curds, which are sometimes hard like felt, and are very 
indigestible and irritating to the stomach ; hence, in typhoid fever the 
possibility of these curds should be borne in mind. The milk will not 
readily curdle if mixed with its own bulk of water or soda water, or (if 
diarrhoea be present) with lime water. One may often with advantage 
use koumiss, which is made in the steppes of Tartary by fermenting 
mares' milk. Consumption is so rare in Tartary, that Russians suffer- 
ing from phthisis go to the steppes, and numbers have been cured. No 
doubt other factors aided the cure, such as climate and change of air, but 
even in the same conditions of life koumiss often helps to keep the disease 
in check. It can be made artificially from grape sugar and cows' milk, 
which is allowed to ferment. It is a good stimulant, and is useful in 
cases of phthisis. It contains lactic acid, alcohol, casein, and fat thrown 
down in small flakes. 

Milk may be used with ferments, such as pepsin or pancreatin. The 
mixture is allowed to stand for a time, and then boiled to stop the fer- 
mentation. 

Cows' milk diluted with one or more parts of water and a little 
milk-sugar added, forms a good substitute for human milk as food for 
infants. 

Saccharum Lactis, U.S.P. and B.P. Sugar of Milk. — C 12 H 24 
12 or C 2nt H 24 24 ; 360. — A peculiar crystalline sugar, obtained from the 
whey of cows' milk by evaporation and purified by recrystallization. 

Characters. — Usually in cylindrical masses, two inches in diame- 
ter, with a cord or stick in the axis, or in fragments of cakes ; grayish- 
white, crystalline on the surface and in its texture, translucent, hard, 
scentless, faintly sweet, gritty when chewed. Soluble in 7 parts of 
water at 15° C. (59° F.), and in 1 part of boiling water; insoluble in 
alcohol, ether, or chloroform. On adding to a solution of sugar of milk 
in an equal weight of boiling water some solution of soda, the liquid turns 
brownish, and, on farther addition of test solution of sulphate of copper, 
a brick-red precipitate separates. 

Impurity. — Cane sugar. 

Test. — If 1 part of sugar of milk be sprinkled upon 5 parts of sul- 
phuric acid contained in a flat-bottomed capsule, the acid should acquire 
not more than a greenish or reddish, but no brownish or brownish-black 
color within one hour (absence of cane sugar). 

Uses. — Sugar of milk is used as a diluent in the abstracts, denar- 
cotized opium, &c, of the U.S.P. It is harder, less sweet, and less soluble 
than cane sugar, and hence is a better excipient and diluent for pow- 
ders that require trituration. 



916 ANIMAL KINGDOM. 

B.P. Pepsin. Pepsin. — A preparation of the mucous lining of 
a fresh and healthy stomach of the pig, sheep or calf. 

The stomach of one of these animals recently killed having been cut 
open, and laid on a board with the inner surface upwards, any adhering 
portions of food, dirt, or other impurity, are to be removed and the exposed 
surface slightly washed with cold water; the cleansed mucous membrane 
is then to be scraped with a blunt knife or other suitable instrument ; and 
the viscid pulp thus obtained is to be immediately spread over the surface 
of glass or glazed earthenware, and quickly dried at a temperature not 
exceeding 100° Fahr. 

Dose. — Of pepsin, 2-10 gr. given with a meal. 

U.S. P. Pepsiiium Saccharatuin. — Pepsin, the digestive principle 
of the gastric juice, obtained from the mucous membrane of the stomach 
of the hog, and mixed with powdered sugar of milk. 

Saccharated pepsin is a white powder of a slight but not disagreeable 
odor and taste, and a slightly acid reaction. It is not completely soluble 
in water, leaving floccules of pepsin floating in the solution, which, how- 
ever, dissolve on the addition of a small quantity of hydrochloric acid. 
Strong turbidity of the acidulated solution indicates the presence of mucus, 
which also imparts to the saccharated pepsin a disagreeable odor and taste, 
and will eventually impart to it an ammoniacal odor. 

U.S. P. Prepakation. 

dose. 
Liquor Pepsini 2-4 fl. dr. 

Therapeutics. — Pepsin is given as an aid to digestion, when the 
ordinary stimuli do not excite sufficient secretion, and the digestive fer- 
ment is insufficient. Such cases occur during a long illness or during 
recovery from an acute disease, in old people, and in people with atrophy 
of the mucous membrane and glands of the stomach, due to alcoholic 
excesses or long-continued dyspepsia. It may be given either with or 
just after meals. It has no influence on farinaceous foods or fat, but 
only acts on gelatinous and albuminous matter; hence it is no use giving 
it after farinaceous or fatty food. 

In these cases the secretion of acid is usually defective, and a little 
dilute hydrochloric acid given along with pepsin, and again about two 
hours after meals, is very useful. 

In some cases of asthma, dependent on insufficient digestion, pepsin 
is very useful. Pepsin wines and essences usually contain little or no 
pepsin, and have little digestive power, but they contain rennet, and are 
frequently of use in indigestion in children; they also appear service- 
able in adults. 

U.S.P. Fel Bovis. Ox Gall. — The fresh gall of Bos Taurus. 

Characters. — A brownish-green, or dark green, somewhat viscid 
liquid, having a peculiar odor, a disagreeable, bitter taste, and a neutral 
or faintly alkaline reaction. Specific gravity 1-018 to 1*028. A mix- 
ture of 2 drops of qx gall and 10 c.c. of water, when treated first with a 
drop of freshly prepared solution of 1 part of sugar in 4 parts of water, 
and afterwards with sulphuric acid until the precipitate first formed is 



ANIMAL KINGDOM. 917 

redissolved, gradually acquires a cherry-red color, changing successively 
to carmine purple, and violet. 

Peepaeations. 
Fel Bo vis Inspissatum. Fel Bo vis Purificatum. 

U.S.P. Fel Bovis Inspissatum. Inspissated Ox Gall. 

Heat the ox gall to a temperature not exceeding 80° C. (176° F.), 
strain it through muslin, and evaporate the strained liquid, on a water- 
bath, in a porcelain capsule, from 100 parts to 15 parts. 

Fel Bovis Purificatum, U.S.P. ; Fel Bovinum Purificatum, 

B.P. Purified Ox Bile. — The purified gall of the ox, Bos Taurus. 

Peepaeations. 

U.S.P. DOSE. 

Fel Bovis Inspissatum 

Fel Bovis Purificatum 8-15 gr. 

Preparation. — Evaporate ox gall, 3 parts, in a water-bath to 1 
part. Add alcohol 1 part. After twenty-four hours decant, filter, distil 
off the alcohol, and evaporate to apilular consistence, U.S.P. Mix fresh 
ox bile (1 pint) and rectified spirit (2 pints) by agitation in a bottle, and 
set aside for twelve hours until the sediment subsides. Decant the clear 
solution and evaporate it in a porcelain dish by the heat of a water-bath 
until it acquires a suitable consistence for forming pills, B.P. 

Characters and Tests. — A yellowish-green substance, having a 
taste partly sweet and partly bitter, soluble in water and in spirit. A 
solution of one or two grains of it, in about a fluid drachm of water, 
when treated, first with a drop of freshly made syrup consisting of one 
part of sugar and four of water, and then with sulphuric acid cautiously 
added until the precipitate at first formed is redissolved, gradually 
acquires a cherry-red color, which changes in succession to carmine, 
purple, and violet. Its watery solution gives no precipitate on the 
addition of rectified spirit. 

Composition. — Tauro-cholic and glyco-cholic acids, mucus, choles- 
terin, fats, and salts. 

Dose. — Of purified bile, 5-10 gr. or more, formed into pills or given 
in small gelatin capsules. When the object is to affect the intestines 
rather than the stomach, the latter mode is preferable. 

Action and Uses. — Bile precipitates pepsin and interferes with the 
digestion of albuminous substances in the stomach. It seems also to 
irritate the mucous membrane and give rise to headache and vomiting. 
It does not aid the digestion of farinaceous food. It quickens the 
absorption of fats, it prevents to some extent putrefactive changes in the 
intestinal contents, and it quickens peristaltic action. Some purgatives, 
such as aloes and jalap, only act when mixed with bile. It is therefore 
a useful adjunct to them in cases of jaundice with deficiency of bile in 
the intestine. It is sometimes used in dyspepsia with constipation, and 
is given by some along with opium in order to prevent the constipating 
effect of the latter. Its action in preventing putrefactive changes in the 
intestine may sometimes be useful in cases of indigestion where these 
occur (pp. 103 and 463), and where the flatus has consequently a very 



918 ANIMAL KINGDOM. 

disagreeable odor. In order to prevent its local action on the stomach, 
it may be given as pills coated with keratin. 

Keratin. Not officinal. 

Preparation. — Horn turnings are digested with artificial gastric 
juice until all the matter soluble in them has been removed. The} 7 are 
then allowed to lie for some weeks in ammonia or glacial acetic acid, 
which gradually dissolves them. The solvent is then allowed gradually 
to evaporate until a mucilaginous solution is obtained. 

Characters. — The solution resembles gum in appearance, and when 
dry forms yellow or yellowish-brown scales. When dried, keratin is 
absolutely insoluble in gastric juice, but dissolves readily in the juices of 
the intestine. 

Uses. — To coat pills containing any substance which we wish to act 
upon the intestine without acting on the stomach. These are : 

1. Such substances as irritate the gastric mucous membrane when 
long used, e.g., arsenic, all anthelmintics, salicylic acid, creasote, chrysa- 
robin, copaiba, cubebs, digitalis, preparations of iron — and especially the 
iodide and chloride ; preparations of mercury — especially the perchloride 
and periodide ; opium, phosphorus, quinine, tartarated antimony. 

2. Such substances as impair digestion in the stomach by forming 
insoluble precipitates with pepsin and peptones, e.g., tannic acid, alum, 
acetate of lead, subnitrate of bismuth, nitrate of silver, corrosive subli- 
mate. 

3. Such substances as are partly rendered inert by the gastric juice, 
and partly decomposed in an undesired manner, e.g., alkalies, soap, bile, 
calcium sulphide, ferric sulphide, charcoal, nitrate of silver, iodide of iron, 
green and red iodides of mercury, &c. 

4. Medicines which we wish to introduce into the duodenum in as 
concentrated a form as possible, e.g., kousso, extract of male fern, san- 
tonin, nitrate of silver, acetate of lead or tannin, in ulceration of the 
bowels ; bile, charcoal, soaps, and alkalies, &c. 

5. Medicines of which we desire the remote without the local action, 
e.g., iron, quinine, arsenic in gastric catarrh, in anaemia, in cardialgia 
and gastric ulcer. 

Mode of Application. — The medicine is thoroughly mixed with 
marsh-mallow powder, liquorice powder, or charcoal, and a few drops of 
almond oil. It is then made into a pill mass with cacao butter. After 
the pills have been made of the proper size they are covered with a thin 
coating of cacao butter, and then with one, or better still, with two or 
three coats of keratin. 

Usually the solution of keratin in ammonia is employed, but the 
solvent least likely to decompose the medicine may be employed, and thus 
the acetic acid solution may be used for the chloride of iron or mercury, 
or salicylic acid. 

Order PACHYDERMATA. 

Adeps, U.S.P. ; Adeps Praeparatus, B.P. Lard, U.S. P.; 
Prepared Lard, B.P. — The prepared internal fat of the abdomen of 
Sm scrofa purified by washing with water, melting, and straining, 
U.S.P. The purified fat of the hog, Sus scrofa, B.P. 



ANIMAL KINGDOM. 



919 



Impurities. — Rancidity due to acrid, fatty acids, alkalies, common 
salt, starch, water. 

Characters and Tests. — A soft, white, fatty substance, melting at 
about 100°. Has no rancid odor ; dissolves entirely in ether. Distilled 
water in which it has been boiled should not acquire an alkaline reaction 
(absence of alkalies). A portion of the water when cooled and filtered, 
and another portion acidulated with nitric acid, should give no precipi- 
tate with nitrate of silver (absence of salt), and is not rendered blue by 
the addition of solution of iodine (no starch.) When heated for several 
hours on the water-bath, under frequent stirring, lard should not diminish 
sensibly in weight (absence of water). 

Peepaeations. 

U.S. p. 



Adeps Benzoinatus Unguentum Acidi Tannici. 


Ceratum Kesinae. ' 


' Belladonnas. 


Unguentum. ' 


' Chrysarobini. 


Ceratum. ' 


1 Gallae. 


" Camphorae. * 


{ Hydrargyri Ammoniatae 


" Cantharidis. ' 


Iodi. 


" Extracti Cantharidis. * 


' Iodoformi. 


" Plumbi Subacetatis. ' 


' Plumbi Carbonatis. 


Sabinas. 


Iodidi. 


Unguentum Acidi Carbolici. ' 


' Potassii " 


" Hydrargyri. ' 


' Stramonii. 


OxidiFlavi. 


' Sulphuris. 


44 Rubri. 


Alkalinum. 


" Mezerei. ' 


' Veratrinae. 


" Acidi Gallici. « 


' Zinci Oxidi. 


B.P. 

Adeps Benzoatus. Unguei 


ltum Iodi. 


Emplastrum Cantharidis. ' 


' Potassae Sulphuratae. 


Unguentum Aconitiae. 4 


' Potassii Iodidi. 


" Atropiae. ' 


' Sabinae. 


" Belladonnas. ' 


' Simplex. 


" Hydrargyri. ' 


' Sulphuris Iodidi. 


Nitratis. 


' Terebinthinae. 


Subchloridi. 


' Veratriae. 



Adeps Benzoinatus, U.S.P. ; Adeps Benzoatus, B.P. Ben- 

zoated Lard. 

Preparation. — By mixing powdered benzoin (2 parts, U.S.P. ; 2 
drachms, B.P.) with melted lard (100 parts, U.S.P. ; 1 lb. B.P.), and 
straining. The benzoin prevents the lard from becoming rancid. 

Uses. — Lard is emollient. It is used in the preparation of oint- 
ments, and spread upon poultices to prevent them from getting dry or 
sticking to the surface of the body. 



Order CETACEJE. 

Cetaceum, U.S.P. and B.P. Spermaceti. — A peculiar, concrete, 
fatty substance obtained from Physeter maerocephalus, U.S.P. Nearly 
pure cetine, obtained, mixed with oil, from the head of the sperm whale, 
Physeter macrocephalus, inhabiting the Pacific and Indian Oceans. It 
is separated from the oil by filtration and pressure, and afterwards puri- 
fied, B.P. 

Characters and Tests. — Crystalline, pearly white, glistening, 
translucent, with little taste or odor, reducible to powder by the addition 



920 ANIMAL KINGDOM. 

of a little rectified spirit. Scarcely -unctuous to the touch ; does not 
melt under 100°. 

Peepaeatioxs. 

TJ.S.P. B.P. 

Ceratum Cetacei. Charta Epispastica. 

Unguentum Aquse Rosa?. Unguentum Cetacei. 

Use. — It is used as an emollient external application. 

Class AVES. Order GALLING. 

B.P. Albumen Ovi. Egg Albumen. — The liquid white of the 
egg of G-allus banckiva, var. domesticus. 

Characters. — Transparent, viscid, soluble in water, coagulable on 
heating to 160° F. When coagulated it is opaque and insoluble in 
water. It is coagulated by ether. 

U.S. P. Test Solution or Albumen. — A solution recently pre- 
pared by triturating the white of one egg with 100 cubic centimetres of 
distilled water and filtering through cotton moistened with distilled water. 

ViteUus, U.S.P. ; Ovi Vitellus, B.P. Yolk of Egg.— The 
yolk of the egg of G-allus banckiva, var. domesticus. 

Peepaeatioxs. 

U.S.P. B.P. 

Glyceritum Vitelli. Mistura Spiritus Vini Gallici. 

Properties. — Yellow, coagulated on heating, contains vitellin, also 
cholesterin, and fats, together with salts of lime, &c. 

B.P. Mistura Spiritus Vini Gallici. — Is prepared by rubbing up 
the yolk of an egg with \ oz. of fine sugar, then adding one wineglassful (2 
fl. oz.) of brandy and another of cinnamon water, and beating them all up 
together. 

Therapeutics. — White of egg forms insoluble albuminates with 
a number of metals, and hence is employed as an antidote in cases of 
poisoning (especially in the cases of corrosive sublimate and sulphate 
of copper) ; in these cases the albuminates generally dissolve readily 
enough in the gastric juice, and therefore you must give an emetic at once. 

The white and yolk of egg are useful as nutritious articles of diet, 
and in the form of egg flip (mistura spiritus vini gallici) is much used in 
exhausted conditions of the system. One case in which eggs are very 
useful is cancer of the rectum, since being entirely absorbed in the ali- 
mentary canal, disturbance in the rectum is avoided. A good mixture 
is the white of three eggs, the yoke of two, and a quarter of a pint of 
beef tea ; beat up separately and then together, put in hot water until set 
and given in two or three portions. 

Eggs are often mixed with a little pancreatin, and administered as 
enemata. 

Class PISCES. ORDER STURIONES. 

Iclithyocolla, U.S.P.; Isinglass, B.P. — The swimming-bladder 
or sound of Acipemer huso, and other species of Acipenser. 

PROPERTIES. — In separate sheets, &c, U.S.P. ; in fine shreds, B.P. 



ANIMAL KINGDOM. 921 

Composition. — It consists of gelatine, which is precipitated by tan- 
nic acid. 

Peepaeations. 
u.s.p. B.P. 

Emplastrum Ichthyocollse (Court Plaster). Solution of gelatine. 

Order teleoste^e. Fam. GADID^e. 

Oleum Morrhuse, U.S.P. and B.P. Cod-Liver Oil. — A fixed 
oil extracted from the fresh livers of the cod, G-adiis morrhua, B.P. (or 
of other species of Gadus, U.S. P.), by the application of a heat not 
exceeding 180°. 

Characters and Test. — Pale yellow, with a slight fishy odor, and 
bland, fishy taste. A drop of sulphuric acid added to a few drops of the 
oil on a porcelain slab develops a violet color, which soon passes to a yel- 
lowish or brownish-red. 

Composition. — Contains olein (7 per cent.), palmitin (25 per cent.), 
and some stearin, also minute traces of iodides, and a peculiar substance 
probably allied to biliary acids. 

Dose. — From 1 to 8 fl. dr. 

Physiological Action. — Cod-liver oil is rather a food than a medi- 
cine, and its therapeutical use depends on two properties, viz., its ready 
absorption and its ready assimilation. 

Its ready absorption is probably partly due to the presence of bil- 
iary matters in the oil, since oil passes more readily through a membrane 
when it is moistened with bile. If you take two loops of intestine and 
fill one with ordinary oil and the other with cod-liver oil, and replace 
them, the one with cod-liver oil will lose more in the same time than that 
containing ordinary oil. 

It is readily assimilated, and hence it is used in all diseases where 
nutrition is slow, as in enlarged glands, catarrhal pneumonia, bronchitis, 
&c. By means of its property of stimulating nutrition, cod-liver oil 
improves all the functions of the body, but has no specific action on any 
of the organs themselves. When large quantities of the oil are taken 
into the stomach, they cause vomiting, but if the oil be finely divided 
previously, it can be taken without discomfort. Hence it is advisable, when 
giving it in any quantity, to make it into an emulsion. Potash is some- 
times used, but in the stomach the potash is probably neutralized, the 
emulsion decomposed, and the oil liberated. A better method is to mix 
it with an equal volume of mucilage of acacia and a few drops of oil of 
lemon ; this emulsion is not decomposed by the acid of the stomach. 
The oil can also be mixed with isinglass and taken as jelly. Some peo- 
ple take it best by putting a little salt on the tongue before, and eating 
a piece of bread after the oil. It is often digested if taken with a little 
ether, for the ether stimulates the pancreatic secretion. 

The oil must not be pressed if it causes nausea or diarrhoea, — for it 
is a food and not a medicine, and must not be given if detrimental to the 
appetite. 

It can sometimes be taken in a single dose at bed-time, when it cannot 
be retained during the day. It is rarely well borne when taken on an 
empty stomach, but is best retained when given not immediately after, 



922 ANIMAL KINGDOM. 

but from half an hour to two hours after a meal. Probably the partially 
digested food then forms it into an emulsion. 

Therapeutics. — Cod-liver oil is used in all diseases arising from 
defective nutrition and in all scrofulous conditions, and as a food during 
chronic illnesses and in convalescence from acute diseases. 

In children emaciated with diarrhoea, a useful mixture is vinum ferri 
and cod-liver oil ; it must not be given in such quantities as to increase 
the diarrhoea. Often it will also relieve constipation in children. 

Its nutritive properties are especially directed to glandular tissues ; 
hence it is used in all cases of enlarged glands, as in tabes mesenterica. 

In malnutrition of the heart, and defective circulation, it improves 
the condition of the heart, increases the red corpuscles, and to some 
extent also the white corpuscles ; hence it is useful in old people with 
giddiness and a tendency to syncope. 

It is also used in chronic rheumatism and tertiary syphilis. 

It is also a tonic to the nervous system, and is of great service in 
cases of nervous debility consequent on hard work, worry, or acute dis- 
ease. It is used in neuralgia with iron and port wine. In hysteria in 
middle-aged persons, it is often serviceable. 

In rickets it may be given alone or in combination with phosphate of 
lime. 

In inflammations, as bronchitis, newly developed cells are present in 
great abundance, but nutrition is so defective that they cannot take on 
the character and functions of mucous cells, and hence, in order to allow 
them to form a new mucous membrane, they must be supplied with a 
readily assimilable nutritive material; this is probably the explanation 
of the benefit obtained by the use of cod-liver oil in bronchitis and other 
diseases dependent on malnutrition. 

In chronic bronchitis, with violent cough and abundant sweetish 
expectoration, it gives great relief. 

In phthisis it is of great service, and is used in all stages of the dis- 
ease except when the temperature is very high ; especially is it useful in 
the first stage where there is little consolidation. Under its use the 
patient gains flesh, keeps the disease in check, and even sometimes 
becomes cured. 

In catarrhal conditions of other mucous membranes besides those of 
respiration it is very useful, as in ozeena in children recovering from 
measles, and in otitis after scarlet fever. 

Class INSECTA. Order HYMENOPTERA. 

Mel, U.S. P. and B.P. Honey. — A saccharine secretion deposited 
in the honeycomb by Apis mellifica, the hive bee. 

Characters. — When recently separated from the honeycomb, it is 
a viscid translucent liquid, of a brownish-yellow color, which gradually 
becomes partially crystalline and opaque. It has a peculiar heavy odor, 
and a very sweet taste. 

Composition. — Chiefly glucose and levulose. 

Impurities. — Starch, common salt, sulphates, grape sugar, and other 
foreign substances. 



ANIMAL KINGDOM. 923 

Test. — Water boiled with it for five minutes and allowed to cool does 
not become blue or green with the solution of iodine (absence of starch). 
If 1 part of honey be dissolved in 4 parts of water, a clear solution 
should result, which should not be rendered more than faintly opalescent 
by a few drops of test solution of nitrate of silver (chloride), or of nitrate 
of barium (sulphate). If a small portion of honey be diluted with 1 
volume of water and then gradually mixed with 5 volumes of absolute 
alcohol, it should not become more than faintly opalescent, and should 
neither become opaque nor deposit a slimy substance at the bottom and 
along the sides of the test-tube. When incinerated in small portions at 
a time, in a platinum crucible, it should not leave more than 0*2 per 
cent, of ash (any larger percentage of ash and failure to respond to the 
preceding tests indicating the presence of glucose or other foreign admix- 
tures). 

Officinal Peepaeations. 
u.s.p. 

Mel Despumatum (warmed and strained) 

Confectio Rosae 

Mel Rosae 

B.P. DOSE. 

Mel Depuratum (melted and strained) Ad lib. 

Of Mel Depuratum — 

Oxymel (honey, 40; acetic acid, 5; water, 5) 1 fl. dr. to 1 fl. oz. 

Mel Boracis 

Oxymel Scillse 

Confectio Piperis 

" Scammonii 

Terebinthinae 

Use. — It is slightly laxative — chiefly used as a vehicle. Oxymel 
is the old-fashioned household remedy of honey and vinegar, and is used 
for colds and sore throats. 

Cera Flava, U.S.P. and B.P. Yellow Wax. — A peculiar con- 
crete substance prepared by Apis mellifica, U.S.P. The prepared 
honeycomb of the hive bee, Apis mellifica, B.P. 

Characters. — Yellowish, or yellowish-brown, solid, firm, breaking 
with a granular fracture, having an agreeable honey-like odor. 

Composition. — Cerin and myricin. 

Impurities. — Fats, fatty acids, Japan wax, resin, soap, and paraffin. 

Tests. — U.S.P. If 1 Gm. of wax be boiled for half an hour with 40 
Gm. of solution of soda (specific gravity 1*180), the volume being preserved 
by the occasional addition of water, the wax should separate, on cooling, 
without rendering the liquid opaque, and no precipitate should be pro- 
duced in the filtered liquid by hydrochloric acid (absence of fats or fatty 
acids, Japan wax, resin) ; nor should the same reagent produce a pre- 
cipitate in water which has been boiled with a portion of the wax (absence 
of soap). If 5 Gm. of wax be heated in a flask for fifteen minutes, with 
25 Gm. of sulphuric acid to 160° C. (320° F.), and the mixture diluted 
with water, no solid wax-like body should separate (absence of paraffin). 

B.P. Not unctuous to the touch ; does not melt under 140° (absence 
of fats) ; yields nothing to cold rectified spirit (absence of resin), but is 
entirely soluble in oil of turpentine. Boiling water in which it has 



924 ANIMAL KINGDOM. 

been agitated, when cooled, is not rendered blue by iodine (absence of 
starch). 

Officinal Preparations. 
U.S. p. b.p. 

Ceratuni Resinse. Eniplastrurn Calefaciens. 

Cantharidis. " Cantharidis. 

Extracti Cantharidis. " Cerati Saponis. 

" Sabinae. " Galbani. 

Unguentum— u pi c i s . 

Acidi Carbolici. Unguentum Cantharidis. 

Mezerei. " Hydrargyri Compositum. 

Oxidi Rubri. 
Picis Liquidse. 
Besinse. 
Sabinse. 
Terebinthinse. 

Use. — To give proper consistence to ointments. 

Cera Alba, TJ.S.P. and B.P. White Wax. — Yellow wax 
bleached by exposure to moisture, air, and light. 

Characters. — Hard, nearly white, translucent. Not unctuous to 
the touch; does not melt under 150°. 

Officinal Preparations, 
u.s.p. b.p. 

Ceratum. Charta Epispastica. 

Compound Cerates— Suppositoria Acidi Tannici. 

Ceratum Camphorge. " Hydrargyri. 

Cetacei. " Morphia?. 

Plumbi Subacetatis. " Plumbi Composita. 

Unguentum Aquae Rosae. Unguentum Cetacei. 

Plumbi Subacetatis Com- 
positum. 
Simplex. 

Use. — In the preparation of the above ointments and supposi- 
tories. 

Order HEMIPTERA. 

Coccus, Cochineal, TJ.S.P. and B.P. — The dried female of 
Coccus cacti. Mexico and TenerifFe. 

Characters. — Ovate, plano-convex, about one-fifth of an inch (5 
millimetres) long ; wrinkled, of a purplish-gray or purplish-black color ; 
easily pulverizable, yielding a dark-red powder. Odor faint ; taste 
slightly bitter. It contains a red coloring matter soluble in water, 
alcohol, or water of ammonia, slightly soluble in ether, insoluble in fixed 
and volatile oils. On macerating cochineal in water, the insect swells 
up, but no insoluble powder should be separated. The grayish-white 
insect quickly becomes black when warmed before the fire. 

USES. — It has little medicinal value; it is used to give an attractive 
color to various liquid preparations. 

Preparations, 
b.p. DOSE. 

Tlnctnra Cocci (2J oz. in 1 pint) Ad lib. 

Cardamom i Composita 

Cinch onae Composi ta 



ANIMAL KINGDOM. 925 

Order COLEOPTERA. 

Cantliaris, TJ.S.P. and B.P. Cantharides. Spanish Flies. 
— Cantliaris vesicatoria. The beetle, dried. Hungary. 

Characters. — From eight to ten lines long, furnished with two 
wing-covers of a shining metallic-green color, under which are two 
membranous transparent wings ; odor strong and disagreeable ; powder 
grayish-brown, containing shining green particles. Free from mites. 

Composition. — Cantharidin, a tasteless, inodorous substance, which 
may be crystallized from an alcoholic extract. It is insoluble in water 
and cold alcohol, although it may be extracted from the cantharides by 
both when in conjunction with the yellow coloring-matter. The other 
ingredients are unimportant. 

Peepaeations. 
u.s.p. 

Ceratum Cantharidis 

Ceratum Extracti Cantharidis 

Charta Cantharidis 

Collodion cum Cantharide 

Lininientum Cantharidis 

Tinctura Cantharidis 



B.P. • DOSE. 

Acetum Cantharidis 2 oz. to 1 pint 

Charta Epispastica 

Emplastruni Calefaciens 1 part in 24, nearly 

Eniplastrum Cantharidis 1 part in 3 

Liquor Epispasticus 1 oz. to 2£ fl. oz — 

Tinctura Cantharidis 5£ gr. to 1 fl. oz 5-20 min. 

Unguentum Cantharidis 1 part to 7, nearly 

Action. — Externally the preparations of cantharides produce, 
when applied to the skin, tingling, redness, and vesication ; if the action 
is prolonged, the vesicles coalesce into a large bleb filled with serum, and 
if left on too long the true skin becomes irritated, and suppuration, 
ulceration, and even sloughing occur. 

Internally the drug causes irritation of the alimentary canal, with a 
feeling of warmth in the mouth, oesophagus, and stomach, loss of appetite, 
and (if its use be prolonged, or if a single large dose be given) burning 
and pain in the stomach (increased by pressure), nausea, vomiting, and 
diarrhoea (the vomited and ejected matters often being mixed with blood). 

It affects the kidneys and urinary passages, causing pain in the loins, 
burning in the bladder and along the urethra, irritation of the glans 
penis, and sometimes increased sexual appetite. If continued for a long 
time, it causes great pain in the kidneys, painful erections of the penis, 
difficulty of micturition or suppression of urine, the latter often contain- 
ing albumen or blood. 

The nervous system is usually not affected by small doses, but large 
doses cause headache and quickened pulse and respiration. 

Very large doses produce insensibility, paralysis of respiration, 
and death with asphyxial convulsions. 

The salivary glands and the back of the throat become so much 
swollen that swallowing is difficult, and the attempt to swallow may give 
rise to convulsions, like hydrophobia. 



926 ANIMAL KINGDOM. 

Urinary Organs. — The inflammation caused by cantharides begins 
in the glomeruli, and not in the straight tubes as is often stated. 

The first condition of the kidneys noticed after the administration of 
cantharides is extravasation of leucocytes into the glomeruli and an 
exudation of a fibrinous matrix ; next, following in order, we notice : — 

(1) The glomeruli and the proximate tubules are filled with a granular 
fluid. 

(2) The cells of the capsule become swollen. 

(3) Cells of collecting tubes are affected, and become swollen. 

(4) The cells of the whole urinary tubule become swollen. 

(5) In the straight collecting tubes the cells become multiplied, and 
are thrown off, so that the lumen becomes full of exuded cells. 

Therapeutics. — It is used externally as an irritant and counter- 
irritant, and internally for its effect on the genito-urinary tract. 
Externally as irritant — 

(1) To increase the supply of blood to a part, and hence improve its 
nutrition, as in chronic ulcers in the leg. 

(2) To cause disappearance of inflammatory products in chronic 
inflamed joints and swellings; also in acutely inflamed joints, as in acute 
rheumatism, in the form of a blister above and below the joint. In 
chronic rheumatism a large and strong blister should be used. 

As counter-irritant it is used in pleurisy and pneumonia, and often 
relieves the pain almost immediately. 

It is also used in acute inflammation of the heart and pericardium. 

It is better not to apply the blister directly over the affected part, 
but a little to one side, since there is a risk of getting the vessels just 
underneath it congested instead of anaemic. 

In affections of other serous membranes, as in meningitis, and often 
in inflammation of the brain itself, the application of a blister is very 
useful. 

When applied to the nape of the neck it often relieves giddiness and 
disturbed cerebral functions dependent on tertiary syphilis, diseases of 
the ear, or of the semicircular canals. 

It is occasionally useful to keep up the irritation by means of savine 
ointment applied to the blistered surface. 

It is also locally applied to the perineum in inflammation of the 
prostate, and over the tender region in inflammation of the ovary. 

Internally, in small doses of 1 or 2 min. of tincture, it checks 
hematuria ; in larger doses it increases the disease. 

In Bright's disease, after the acute stage has passed, but a little 
albumen and blood still remain in the urine, it is very useful in doses of 
1-3 min. every three hours. 

In cystitis, especially where there is inability to retain the urine, and 
also in ordinary incontinence of urine, it is useful ; though in both cases 
atropin generally acts better. 

A drop of tincture three times a day will often relieve chordee. 

Precautions. — (1) Do not use the blisters on debilitated persons 
and children; or do not keep them on long, but just sufficient to start the 
blister, and then, after two or three hours, put on a poultice to make the 
blister rise. 



ANIMAL KINGDOM. 927 

(2) Be careful of its use both externally and internally in Bright's 
disease. 

Treatment in Poisoning". — Evacuate the stomach, give mucilagi- 
nous drinks to lessen gastro-intestinal irritation, but avoid oils or fats, 
which increase the solubility of cantharidin and the dangers arising from 
its absorption. Use opium and sitz baths to relieve the strangury. 

Class ANNELIDA. 

B.P. Hiruclo. The Leech. — (1) Sanguisuga medicinalis, the 
speckled leech ; (2) S. officinalis, the green leech. Collected in Spain, 
France, Italy, and Hungary. 

Characters. — Body elongated, two or three inches long, tapering 
at each end, plano-convex, wrinkled transversely ; back olive green with 
six rusty-red, longitudinal stripes. (1) Belly greenish-yellow, spotted 
with black ; (2) belly olive green, not spotted. 

Action. — At the anterior extremity the leech has a sucking disc, 
in the middle of which is a triradiate mouth furnished with sharp teeth. 
Fixing itself to the surface by its disc, it saws through the skin and sucks 
the blood. This process is facilitated by the power of destroying the 
coagulability of the blood which the secretion from the pharynx of the 
leech possesses (Hay craft). This secretion is probably the cause of the 
ecchymoses which frequently occur at the bites as well as of the persistent 
haemorrhage they sometimes occasion. 

Uses. — Leeches may be employed as a substitute for general blood- 
letting in women and children. They are more generally employed for 
the purpose of local depletion in inflammation. The irritation occasioned 
by the bites has probably a certain counter-irritant action (p. 301), but 
the relief they afford is chiefly due to the depletion. They are useful in 
bruises, fractures, inflamed joints, meningitis, otitis, ophthalmia, persist- 
ent headache, laryngitis, pleurisy, pneumonia, pericarditis, hepatitis, 
orchitis, and haemorrhoids. 

Application. — Each leech draws on an average about 1J fl. dr. of 
blood. By applying fomentations afterwards, as much again, or even 
more, may be withdrawn. Care should be taken that leeches which have 
been applied to any one suffering from an infective disease should not be 
used again, lest they convey the virus. When they are to be applied to 
a mucous membrane, such as the tonsil, they should be put in a leech- 
glass. This is a small syringe large enough to hold a leech. The head 
of the animal is introduced first, and the body gently pushed down with 
a piston. The nozzle of the leech-glass is large enough to allow the head 
of the animal to protrude, but not to allow the body to follow. 

Leeches may be applied to the skin by simply confining them to the spot 
with a pill-box ; or a piece of blotting-paper, with holes in it at the points 
where we wish the leeches to fix, may be laid on the skin, and the leeches 
kept over this by a wine-glass or tumbler. It is sometimes difficult to 
make leeches bite. The skin should be carefully washed, and thoroughly 
dried and warmed, and, if necessary, shaved. The room should be well 
ventilated and free from tobacco smoke, and from the fumes of vinegar 
or disinfectants. Leeches should be dried in a soft, warm cloth and then 



928 ANIMAL KINGDOM. 

applied. If a single one is to be used, the body may simply be held in 
the cloth, and the head allowed to reach the skin. A slight movement 
of withdrawal being now made, the leech will probaly fix. Care should 
be taken not to withdraw it so strongly as to tear it from its hold. When 
difficulty is still experienced in making the leeches bite, a little warm 
milk sweetened with sugar may be rubbed over the skin, or a drop 
of blood extracted from the finger by a needle may be used for the same 
purpose. Usually leeches fall off when they are full, but if they do not 
they can be detached by sprinkling salt over them. If it is desirable to 
encourage the bleeding, warm fomentations, poultices, or cupping-glasses 
may be employed. The bleeding may be stopped by applying a small 
piece of absorbent cotton-wool, or of lint rolled into a hard cone and fixed 
over the bite with a compress and bandage. Cobwebs used in the same 
manner are very efficacious. If these are insufficient, a piece of absorbent 
cotton-wool dipped in strong solution of perchloride of iron and dried, 
or the styptic collodion of the U.S. P. may be applied. When other 
means fail a pointed stick of nitrate of silver may be pushed into the 
bite, or the bite may be transfixed with a needle and a silk thread passed 
in a figure of 8 around it. If possible leeches should not be applied at 
night, especially to feeble individuals or children, unless the patients are 
carefully watched, as, if haemorrhage from the bites should occur, it might 
not be noticed until much blood had been lost. Leeches should not be 
applied over loose cellular tissue, where pressure cannot be applied. In 
inflammation of the eyes they should be applied to the temples, and not 
to the eyelids ; and in inflammation of the testicles to the perineum, and 
not to the scrotum. As the marks of the bites are permanent, care 
should be taken to apply leeches, if possible, where the marks will not 
appear. Thus, in applying them to the temples the hair may be shaved 
off a spot and the leeches applied. When the hair grows the marks will 
be hidden. In applying them to the chest in girls they should, if possi- 
ble, be placed so low down that the marks will not be seen when evening 
dress is worn. 

If leeches should get into any mucous cavity, nose, stomach, or 
rectum, they may be dislodged by the injection of strong brine. 



INDEXES. 



59 



GENERAL INDEX. 



Abdomen, mustard stupes or poultices applied 
to the lower part of the, act as indirect ern- 
menagogues, 390 
Abernethy, Mr., reference to, 585 
Abney and. Festing, reference to, 50 
Abortion, emetics to be avoided where a ten- 
dency to, exists, 328; the twigs of thuja may 
produce, 886 
Abscesses, especially of the liver, caustics em- 
ployed to open, 306 
Absinthe, as a spinal stimulant, 167 ; action of, 

on the brain of dogs, 172 
Absorption and excretion of drugs, diagram 
illustrative of, 56; effects of rapid or de- 
layed, 56 
Abstracts, 428 

Abstractum aconiti, 429, 698 
Belladonna, 429 
Conii, 429, 786 
Digitalis, 429, 844 
Hyoscvami, 429, 840 
Ignatise, 429, 821 
Jalapre, 429, 833 
Nucis Vomicae, 429, 821 
Podophylli, 429, 704 
Senegse, 429, 730 
Valerianae, 429, 805 
Acetate, test for, 496 

Acetate Of aluminium, action of, on enzymes, 86; 
on bacteria, 96 
Ammonia, as a vascular stimulant, 292, 293 
Ethyl, 663 
Lead, 597 
Morphia, 712 
Morphine, 712 
Potash, 510 
Soda, 528 
Zinc, 570 
Acetic acid, action of, on bacteria, 99, 100 ; of the 
vapor of, on the general circulation, 177 ; action 
of, on the mucous membrane, 225; as a vesi- 
cant, 304; as a caustic, 304; as a poison, with 
its antidote, 417; properties and uses of, &c, 
481; preparations containing, 4S2; glacial dit- 
to, 482 
Acetone, action of, on bacteria, 98, 100 
Acetum, 429, 483 

Cantharidis, 429, 482, 925 
Lobeliee, 429, 814 
Opii, 429, 710 
Sauguinarise, 429, 726 
ScillEe, 429, 482, 890 
Acid bath, the, 403 

Dilute nitro-hydrochloric, as a hepatic stimu- 
lant, 351 
Ergotinic, 909 
Hseinatin, 81 

Radicals in metallic salts, general tests for, 
496; list of tests for the different acids, 
496, 497, 498 
Solution of nitrate of mercury, 591 
Sphacelinic, 909 
Tartrate of potash, 512 
Acidity, corrected by antacids, 322 
Acids, action of, on the secretion of the mucous 
membranes, 225, 226; as stimulating expecto- 
rants, 227 ; action of dilute on the frog's heart, 
270; on the capillaries, 282 ; as caustics, 304 ; as 



astringents, 308: as styptics, 309; as siala- 
gogues, 314 ; as artificial digestive substances, 
321 ; action of, as irritant poisons, 346 ; strong, 
may produce death weeks after they have 
been swallowed, 347; as antihydrotics, 381; 
as poisons, with their antidotes, 417 ; general 
characters and properties of, 472-474 ; general 
action of, on the tissues, 475 ; on the skin, 475; 
in the mouth, 475; in the stomach, 476; on 
the bile and liver, 476 ; treatment of poisoning 
by, 478 
Acids, mineral, action of, on albumen, 68 ; on 
protoplasm, 71; on infusoria, 75; as siala- 
gogues, 314 
Acids, physiological action of — 
Arsenic, 51 
Bromic, 51 
Hydriodic, 51 
Hydrochloric, 51 
Iodic, 51 
Phosphoric, 51 
Selenic, 51 
Sulphuric, 51 
Acids, preparation, properties, action, and uses 
of— 
Acetic, 473, 481 

Glacial, 473, 482 
Arsenious, 474 
Benzoic, 474 

Boracic or boric, 473, 486 
Carbolic, 474 
Carbonic, 473, 487 
Chromic, 486 
Citric, 473, 485 

Dilute hyd robromic, 473, 474, 493 
Hvdrocvanic, 473, 489 
Phosphoric, 474, 483 
Gallic, 474, 877 

Hydrochloric, or muriatic, 473, 479 
Lactic, 493 
Nitric, 473, 480 
Nitro-hydrochloric, 481 

Dilute, 481 
Oleic. 474, 494 
Oxalic, 474, 485 
Phosphoric, 483 
Salicylic, 474 
Sulphuric, 474, 477 

Aromatic, 478 
Dilute, 478 
Sulphurous, 474, 478 
Tannic, 474, 875 
Tartaric, 473, 484 
Vinegar, 483 
Acidum Aceticum, 482 

Dilutum, 482 
Glaciale, 482 
Benzoicum, 817 
Gallicum, 875 

Hydrochloricum Dilutum, 479 
Hydrocyanicum Dilutum, 577 
Nitricum Dilutum, 480 
Nitro-hydrochloricum, 479 

Dilutum, 479, 480 
Phosphoricum, 483 
Sulphuricuin aromaticum, 478, 861 

Dilutum, 478 
Tannicum, 875 
Tartaricum, 511 
Aconite leaves, 697 ; and root, 697 



(931) 



932 



GENERAL INDEX. 



Aconitia or Aconitine, action of, on oxidation ; 
79; effects of, on muscle, 146; as a sedative, 
146; as an anodyne, 183, 184; action of, on the 
respiratory centre, 209,215; on the vagus 
roots, 260;" on the vagus centre, 279; on the 
heart, 300; Einger's mode of using, 300; as a 
poison, with its antidote, 418; antagonism of, 
to other drugs, 422-425; preparation, char- 
acters and tests of, 698; general action of, in 
frogs, 699; in man, 699; on the heart, 699; 
action of, on individual organs, 699; on the 
muscles, motor and sensory nerves, 699; on 
the spinal cord, brain, and vaso-motor 
centre, 700; on the heart and respiration, 700; 
on the temperature, the stomach, and the 
secretion of the salivary gland, 700; on the 
pupil of the eye and the tissue-, 700; thera- 
peutic use of, locally, 701 ; for the stomach, in 
lebnle conditions, "in cardiac dis-ease, and on 
the nervous system, 701; mode of application, 
701 

Aconitum, properties, composition, and prepara- 
tions of, 697 

Actual cautery, as a styptic, 309 

Adeps benzoatus, 817, 919 
Benzoiuatus, 817, 919 

Adonidin, as a cardiac tonic, 294 

Adonis vernalis, as a cardiac tonic, 294; as a re- 
frigerant diuretic, 374; composition, action, 
and use of, 703 

Aeby, reference to, 128 

iEther purus, 661 

Agaricus albus, as an antihydrotic, 381 

Ague, utility of quinine in, 33; produced by the 
bacillus malaria?, 103 ; importance of emetics 
and purgatives in aiding the action of anti- 
periodics in the cure of, 108, 109; value of 
emetics in, before the administration of qui- 
nine, 327; sometimes cured by emetics alone, 
without quinine, 327 ; action of opium in, 725 ; 
brought on by strychnine, 824 

Air baths, 404 

Air passages, value of emetics in removing ob- 
structions from the, 327 

Albertoni, reference to, 171 

Albumen, nature of, and action of drugs on, 68; 
effects of acids and organic alkaloids on, 69 ; 
action of quinine on, 799 ; test solution of, 920 ; 
albumen of eggs, 920 

Albuminous solutions, action of alcohol on, 6. 

Albuminuria, action of drugs on, 375 ; how far 
caused in apparently healthy persons by mer- 
curials, 565 

Alehemilla. action of, on the bladder, 384 

Alcohol, effects of, on the blood, 82; change un- 
dergone by, when boiled with sulphuric acid, 
82; action'of, on enzymes, 86 ; on bacteria, 96, 
98, 100 ; appears to arrest the action of zymotic 
diseases, 105 ; and preserves animal matter, 105 ; 
action of, on medusae, 112 ; on annulosa, 115; 
on muscles, 124-144 ; on the brain of the lower 
animals, 172; on psychical processes, 175; a 
typical stimulant on" the action of the brain, 
178; different action of, in different doses, on 
the brain, 178 : has both stimulant and narcotic 
action on the brain, 182; as an antispasmodic, 
191: action of, on frogs, 196; on the respiratory 
centre, 215; on the vaso-motor centre, 251 ; on 
the motor ganglia, 280 ; as a cardiac stimulant, 
291 : as a vascular stimulant, 292 ; as a rubefa- 
cient, 304 : as an astringent, 308; as a local seda- 
tive, 328; as an antipyretic, 364; as a stimulant 
diuretic, 373 ; as an aphrodisiac, 388 ; as a poison, 
with its antidote, 418; antagonism of, to strych- 
nine, 122- 125 

Alcohol, 657 

Absolute, 657 
Amylic, 659 
Diluted, 658 
Proof spirit. 658 

tified spirit, 658 
Red wine. 659 
Sherry, 658 

Spirit of French wine, 

White wine, 658; stronger, 659 

Alcohol, ethyl, 'general source and preparation of, 
649; Impurities and teste of, 649,650; general 



action of, 650 ; on albuminous solutions, 650; on 
the skin, mouth, stomach, intestine, and blood, 
650 ; and tissues, 650 ; dispute as to whether it 
can be regarded as a food, 650; its action on 
the circulation and temperature, 651 ; on the 
nervous system, 652; and cranial circulation, 
652; on the nervous tissues, on the judgment 
and emotions, 652 ; on the motor centres, the 
the speech, and the cerebellum, 652; on the 
spinal cord, the respiratory centre, the vaso- 
motor centre, and the heart, 652, 653; impor- 
tance of a proper diagnosis of drunkenness 
from effects of opium and apoplexy, 653 ; effect 
of impurities on the action of, 653; effect3 of 
chronic poisoning by, 653; on the bowels, skin, 
liver, kidneys, and nervous system, 653, 654; 
nature and effects of delirium tremens, 654; 
and treatment of, 654; causes of chronic alco- 
holism, 654; uses of, 655; its weakness as a 
stimulant compared with beef tea, 656 ; action 
of, as a stimulant, 656 ; and on the urine, 657 

Alcohol, methyl, preparation, characters, and 
uses of, 649 

Alcoholism, causes of chronic, 654 

Alcohols, list of the principal, with their respec- 
tive toxic powers, 647-649; action of, on the 
general system, 648, 649 

Aldehydes/properties, action, and uses of— ethyl 
aldehyde, 660; and paraldehyde, 660 

Alder, black, 754 

Ale, intoxicating effects of a single glass of, when 
sucked through a stiaw, 178 

Algae, 912 

Alimentary canal, action of drugs on the, 310 ; of 
quinine on the, 801 ; of sulphate of strychnine 
on the, 823 ; of tobacco, 843 ; of extract of 
ergot, 911 

Alkalies, action of, on protoplasm, 71 ; on infuso- 
ria, 75 ; on muscles, 130 et seq.; on the secre- 
tions of mucus from the trachea, 224; on the 
amount and nature of moist rales in the lungs, 
225; as stimulating expectorants, 227; dilute, 
on the frog's heart, 270 ; on the capillaries, 282 ; 
as caustics, 304; as sialagogues, 314; arrest 
secretion of saliva, 318; dilute, increase the 
action of the gastric juice, 320; strong, may 
produce death weeks after it has been swal- 
lowed, 347; as poisons, with their antidotes, 
417-421 

Alkalies, metals cf the, 498; (1) alkaline salts, 
general characters and reactions of the, 499 ; 
physiological action, 499; and general action, 
499 ; on the skin, as caustics, rubefacients, and 
vesicants, 499,500; in the mouth, 500; in the 
stomach, 500; on the gastric juice, 501 : as anti- 
dotes in poisoning by acids, metals, and alka- 
loids, 501; their action on the blood, 501; as 
alteratives, diuretics, and antacids, 501, 502; 
(2) general action of the group of chlorides, 502; 
on the stomach and other parts oi the body, 
502, 503 ; (3) general action of the sub-group of 
sulphates, 504 ; comparative action oi the alka- 
line metals, 504 

Alkaline hath, 403 

Bromides, as antispasmodics, 195 

Hsematin, 81 

Sulphur ointment, constituents of, 462 

Alkaloids, action of, on the general system, 50, I | 
on albumen, 69 ; onprotoplasni, 71 ; on bacte- 
ria, 93; formed by putrefaction ,103; Albertoni 'a 
investigations as to the action of the coto, 337 ; 
objection to the extremely small doses of, 
required to produce marked physiological 
action, 122; antagonistic action of certain, to 
morphine, 421, 425; nature and action of, 429; 
and of opium, 721 

Alkaloids, cinchona, and their salts, 799; of 
opium, action of the, 721 

Allspice and oil, as carminatives, 330 
Oil of, 779 

All yl alcohol, action of, on bacteria, 100 ; extra- 
ordinary enecj of, 105 ; vide also 889 

Almond, bitter, 775 

Oil of, 776 

Oil, as a demulcent, :;07 ; nature of, 776 

Oil of, expressed, 776 
Aloes, as a purgative, 839; as a cholagogue, 340 



GENERAL INDEX. 



933 



Aloes, as a hepatic stimulant, 531 ; characters, pre- 
parations containing, and composition of, 
890-892 
Barhadoes, 892 ; action of, in the mouth, the 
intestines, and the rectum, 893 ; on the 
bile and the uterus, 893; as an aphrodisiac 
and a purgative, 893 
Aloes, Purificata, 891 
Purified, 892 
Socotrine, 890 
Aloin, nature and action of, 891 
Alteratives, nature of, 35S ; list of the principal, 
358 ; action of, 35S-361 ; uses of, 361 ; alkalies as, 
501 ; lappa as, 813 ; solanine as, 835 ; rumex as, 
859 ; Phytolacca root as, 859 ; stillingia as, 867 ; 
sarsaparilla as, 889 
Althaea (rnarshmallow), characters, composition, 

and uses of, 736 ; a useful demulcent, 736 
Alum, action of, on bacteria, 98 ; on the mucous 
membranes, 308 ; as a caustic, 304; as an astrin- 
gent, 308; as a styptic, 809; as a local emetic, 
326 ; as a local sedative, 328 ; as a vermicide, 
355 ; action of, on the skin, 556 ; as an astrin- 
gent, 556 ; as a styptic, 556 ; a caustic, and an 
emetic, 556 ; properties, action, and uses of, 555- 
557 ; of dried, ditto, 557 
Aluminium, symbol and atomic weight of, 35; 
physiological action of, 51; action of, on the 
mouth and stomach, 475, 476 ; general sources, 
reactions, &c., of the salts of, 555 ; hydrate of, 
557 ; sulphate of, 558 
Amanita muscaria, as an antihydrotic, 381 
Amber, oil of, action and uses of, S84 
American cannabis, 879, 880 

Wormseed. See Chenopodium 
Ammonia, nature of, and changes it undergoes, 
41 ; physiological action of, 51 ; action of, on 
bacteria, 98 ; on the muscles, 124 et seq. ; as a 
spinal stimulant, 167 ; stimulating effects of the 
vapor of strong, and of carbonate of, on the gene- 
ral circulation, 177 ; action of, on the ear, 205 ; 
on the respiratory centre, 214 ; and movements, 
218 ; of strong liquor of, on the secretion of the 
mucous membranes, 225 ; as a stimulating ex- 
pectorant, 227 ; carbonate of, as an emetic in 
chronic bronchitis, 22S ; action of, on the vagus 
centre, 279 ; on the accelerating centre, 279 ; 
action of salts of, on the vaso-motor centre, 
279 ; as a cardiac stimulant, 291, 292 ; as a 
rubefacient, 304 ; aromatic spirit of, as a direct 
antacid, 322 ; action of, on the uterus, 391 ; va- 
por of, as a poison, with its antidote, 416 
Ammonia, character, action, and uses of— 
Acetate of, 544 
Aromatic spirit of, 543 
Bromide of, 544 
Benzoate of, 545 
Carbonate of, 542 
Chloride of, 540 
Citrate of, 544 
Iodide of, 545 
Kitrate of, 545 
Phosphate of, 544 
Solution of, 545 
Solution of acetate of, 544 
Solution of citrate of, 544 
Spirit of, 542 
Strong solution of, 541 
Sulphate of, 545 
Sulphide of, 546 
Valerianate of, 545 
Water of, 542 ; stronger, 541 
Ammoniac, 7S8 

Ammoniacum, as an antispasmodic, 195 ; charac- 
ters and uses of, 788 
Ammoniae benzoas, 817 

Phosphas, 541 
Ammoniated mercury, 590 
Amnion ii benzoas, 817 

lodidum, 470 
Ammonio-ferric sulphate, or amnionio-ferric 

alum, 637 
Ammonium, sulphate of iron and, 637 
Benzoate, as a hepatic stimulant, 351 
Bromide, action of, on the spinal cord, 159 
Carbonate, as a cardiac stimulant, 291; as a 
direct antacid, 322 ; as a local emetic, 326 



Ammonium — 

Chloride, action of, on bacteria, 9S ; on mus- 
cle, 125 et seq. ; on the ear, 205 ; as a stimu- 
lating expectorant, 227 ; antagonism of, to 
chloral, 334-337 ; character, action, and 
uses of, 540 ; on the liver, 540 
Salts, characteristics of, 536 ; sources, reac- 
tions, and preparations of, 537 ; impurities , 
tests, and actions of, 539 ; figure showing 
the paralyzing action of ammonium sul- 
phate on muscle, 539 
Sulphide, action of, on bacteria, 99 

Amoeba?, nature of, action of drugs on, and 
method of experimenting on, 70 et seq. ; an, 
figured at two different periods during move- 
ment, 83 ; struggle for life between the, and ba- 
cilli, 92 ; the protoplasm of, contracts in any di- 
rection, 116; anaesthetics act as poisons to, 187 

Amphioxus, mechanism of respiration in the, 
207 ; diagram of an, 208 

Amyl nitris, 660 

Amyl, nitrite of, use of, in diminishing tension 
and removing pain in angina pectoris, 34; dif- 
ference of action of, in different animals, 66 ; 
blood treated with, and alcohol, SI ; action of, 
on medusse, 90 ; on psychical processes, 175 ; on 
the dog and rabbit, 252 ; as a poison, with its 
antidote, 420; antagonism of, to strychnine, 
422-125; preparation, characters, and tests of, 664, 
665; physiological action of, 665; on the blood, 
blood-pressure, respiration, and pulse, 665 ; on 
the muscles and motor nerves, 666 ; on the ner- 
vous system and urine, 666 ; uses of, 666 ; as a 
remedy in spasmodic conditions, 667 ; in angina 
pectoris, headache, &c, 666, 667 ; pulse-tracings 
illustrative of the action of, in angina pectoris, 
666, 667 ; considerations regarding the admin- 
istration of, 667 

Amylum iodatum, 904 

Ainyridaceae, 756 

Anacardiae, 754 

Anaemia, causes functional inactivity of the 
cerebro-spinal system, 179; loss of albumen 
through the kidneys, and deficiency of fatty 
food cause, 358; a deficiency of iron in the 
blood in, 358 

Anaesthesia, various modes of inducing, 1S6, 187 ; 
may be caused by the direct action of drugs on 
the nerve cells, 187 ; dangers arising from the 
efforts to induce, 189; action of, and mode of 
using in animals, 190, 191 ; history of the dis- 
covery of, 192 

Anaesthetics, nature and uses of, 146, 185 ; action 
of, on the motor centres of the brain, 172 ; dif- 
ference between anodynes and, 185; divided 
into local and general, 186; chief local and 
general, 186; usual action of general anaesthet- 
ics, 186-188; the action of, divided into four 
stages— the stimulant, 188; the narcotic, 188; 
the anaesthetic, 188 ; and the paralytic stage, 
188; uses of, 189 ; dangers of, 189, 190 ; mode of 
administering, 190 ; action of on, and mode of 
using in, animals, 191 ; history of the discovery 
of the uses of, 192 ; action of, on the eye, 198 ; 
may obstruct respiration, 212 ; fallacies from, in 
ascertaining the action of drugs on the circu- 
lation, 235 ; action of, on the motor ganglia, 
280 ; as poisons, with their antidotes, 417 ; iodide 
of ethyl as an anaesthetic, 669 ; iodoform as, 
682, 683; erythroxylon and cocaine as, 732 

Analgesics. 'See Anodynes 

Anaphrodisiacs, nature and action of, 3S6-390; 
diagram illustrating the action of, 387 ; general 
considerations regarding, 388, 3S9; camphor as 
an, 863 

Anemonin, 702 

Aneurism, emetics to be avoided in persons suf- 
fering from, 328 

Angina pectoris, 34; nitrite of ainyl diminishes 
tension and removes pain in, 34 

Aniline red, 695 

Sulphate, action of, on the cardiac muscle, 
2S1 

Animal charcoal, 460 ; purified. 460 

Animal Kingdom, 913-92S ; class mammalia, order 
rodentia, 913; order ruminantia, 913; order 
pachydermata, 91S; order cetaceae, 919; class 



934 



GENERAL IXDEX. 



aves, order gallinje, 920 ; class pisces, order 
sturiones, 920 ; order teleostese, family gadida?, 
921 ; class insecta, order hynienoptera, 922 ; 
order heiniptera, 924; order coleoptera, 925; 
class annelida, 927 

Animals, utility of, for experiments in medicine, 
65, 67 

Anise, character of, 7S9 ; oil of, 705, 7S9 ; as a car- 
minative, 7S9 

Anise and oil, as carminatives, 330 

Annelida. 927 

Annulosa, action of drugs on, 115, 116 

Anodynes, two classes ot local and general, 183; 
nature, action, and uses of, 183, 184 ; adjuncts 
to, 184, 185 

Antacids, nature and action of, 322; divided into 
direct and indirect, or remote, 322; action of 
alkalies as, 501 ; slaked lime as an antacid, 551 

Antagonistic action of drugs, 422-425 

Anthelmintics, nature of, 355; divided into two 
kinds, 355; list of the chief, 355; adjuncts to, 
355: uses of, 355; benzine as an, 646; azeda- 
raeh as, 747 ; pomegranate root hark as, 782 ; 
pumpkin seed as, 785 ; bryonia as, 785 ; worm- 
wood as, 807 ; tansy as, 807 ; santonin as, SOS ; 
spigelia as an, 828; oleum chenopodii as, 859; 
kamala as, 870; oil of turpentine as, S84; thuja 
as, 8S6 ; areca nut as, 903 : male fern as, 907 

Anthrax, produced by the bacillus anthracis, 103 

Anthrax bacilli. See Bacilli 

Antiarine, action of, on mollusca, 114 ; on the 
frog's heart, 271 ; on the cardiac muscle, 281 ; 
as a cardiac tonic, 294 

Antidotes, alkalies serviceable as, in poisoning 
by acids, metals, and alkaloids, 501 

Antidotes, nature and action of, 416 ; list of the 
more common poisons, with their antidotes, 
416-421 

Antidysenteric, ipecacuanha as an, 804 

Antihydrotics, or anhydrotics, nature, action, 
and uses of, 381-383; on the sweat glands, 3S1 ; 
on the secreting cells and nerves, 381 ; on the 
sweat centres and on the circulation, 381 ; dia- 
gram illustrating the action of, 381 

Antimonial preparations are depressant expec- 
torants. 227 

Antimonii et pota?sii tartras, 617 
Oxidum, 617. 619 
Sulphidum, 617 

Purificatum, 617 
Sulphuratum, 617 

Antimonium nigrum, 617 
Sulphuratum, 617, 618 
Tartaratum, 511, 617 

Antimony, symbol and atomic weight of, 35; its 
relations to other members of a group, 42; 
causes sickness, 50; action of, on muscle, 125 
el seq.; of large doses of, on the lungs, 213; on 
the motor ganglia, 280; on the vaso-motor 
nerve-, 281 ; tartarated, as a pustulant, 304; as 
a caustic, 304 ; destroys the glycogenic function 
of t lie liver, 350; has a special action on tissue 
change, 360; in poisoning by, action of, on the 
urine, 360; employed in diseases of the respira- 
tory organs, 361 ; as a poison, with its antidote. 
U8 ; general sources and reactions of , 613 ; ac- 
tion of, on the skin and stomach, 613; effects 
of poisoning from, 613 ; and mode of treatment, 
613 : account of the dispute that has arisen re- 
garding the mode in which tartar emetic causes 
vomiting, 61 1 ■. action of, on the heart of a frog, 
615; on the circulation, blood-pressure, and 
temperature, 615; on the respiration, spinal 
cord, motor ami sensory nerves and muscles, 
615; produces Gattj degeneration of various 
us, 615; rapidity of its action on the skin 
of frogs, 615: diagram of vertical section i 
epidermis ol a frog poisoned by, 616: how 
eliminated, 616; usee of, 616 ; as an emetic, 616; 
how tolerance of t he drug is produced, 59, 616 ; 
oauseant, 616; a- an expectorant, 617: as 
a diaphoretic, 617; preparations containing, 
617 

Antimony, properties, action, and uses of— 
Black, 617 

de oi, 619 
Purified sulphide of, 617 



Antimony — 

Solution of chloride of, 619 
Sulphurated, 618 
Tartarated, 620 

Tartrate of, and potassium, 620 
• Antineuralgic, peppermint camphor as an, 853 
Antiperiodics, list of the chief, 108; their action, 
uses, and adjuncts, 109; emetics and purgatives 
aid the action of, 109; they rarely succeed 
without them if the functions of the liver are 
disturbed, 109 ; lemon juice as a powerful, 740; 
quinine as, 801 ; sulphate of beberia as, S65 
Antipyretics, or febriluges, divided into two great 
classes, 362 ; their nature, 361 ; action, 362 ; and 
uses, 363; aromatic series as antipyretics, 687 ; 
resorcin as, 692; chinoline as, 695": kairin as, 
695 ; quinine as, 801, 802 ; oil of gaultheria as, 
816 ; salicin as, 873 
Antipyrin, characters, 695; action of, in reducing 
temperature, causing profuse perspiration, and 
slightly increasing the blood-pressure, 696; 
uses of, in febrile diseases generally, 696 
Antiscorbutic, lemon juice as an, 740 
Antiseptic, what is required in an, 94 
Antiseptics, nature and action of, 105 ; uses of, 
106-108 ; externally, 106 ; internally, 107 ; chlo- 
ral hydrate as an antiseptic, 670 ; iodoform as, 
682; the aromatic series of the carbon com- 
pounds as, 687 ; naphthalin as, 694 ; chinoline 
as, 695; cheken as, 779: oil of myrtle as, 780; 
oil of eucalyptus as, 781 ; quinine'as, 799 ; ben- 
zoic acid as, 817 ; peppermint camphor as, 853; 
thymol as, ^55; garlic as, 889 
Antisialics, nature and action of, 318, 319 
Antispasmodics, nature, action, and uses of, 193- 
195 ; action of, and list of, general, 194, 195 ; ad- 
juvants to, 194; acetic ether as an antispas- 
modic, 664 ; iodide of ethyl as, 669 ; caulophyllum 
as. 708; oil of rue as, 747 ; oil of cajuput as, 780 ; 
valerian as, 806; oil of stramonium leaves as, 
842 ; asafcetida as, 788 ; cypripedium as, 900 
Antizymotics, nature and action of, 105 
Aortic regurgitation. See Regurgitation, aortic 
Aortic stenosis. See Stenosis, aortic 
Apetake, 857 

Aphrodisiacs, nature and action of,386-3S9; dia- 
gram illustrating the action of, 387 
Apncea, nature and cause of, 211-215 
Apocynaceas, 828 
Apocynum, characters and action of, 828: as a 

laxative, a cardiac tonic, and a diuretic, 828 
Apomorphia, action of, on the cerebellum, 196; may 
lead to obstruction of the bronchi, 213; action 
of, on the respiratory centre, 215: on the mu- 
cous membraues, 226 ; caution required in the 
administration of, in catarrhal conditions, 22G ; 
as a depressant expectorant, 227; effect of, on 
the frog's heart, 271; on the cardiac muscle, 
281 : as a general emetic, 326 
Apomorphina, 429 

Apomorphine, hydrochlorate of. See Hydro- 
chlorate of apomorphine 
Apoplexy, diagnosis between opium poisoning, 

intoxication, and, 717 
Apples, stewed, as a laxative, 339 
Aqua Ammonia, 291 
Ammonia;, 4:'>l 

Fortior, 431 
Amygdalae amarse, 431, 776 
Anethi, 431, 790 
Anisi, 431, 790 
Aurant ii Boris, 431 
Au rantii florum, 431, 737 
Camphorse, 131, 862, 863 
Carui, 431, 791 
Chlori, 131 
Chloroformi, 431 
Cinnamonii, i:;i, 862 
Cinnamonii, 131 
Creasnti, 131, 691 
Destillata, 131 
lo nindi, 131, 789 
Laurocerasi, 131, 777 
Mentha piperita'. 131, 853 
Mentha? viridis, 431, 854 
Pimentse, 131, 779 
Rose, 131,772 



GENERAL INDEX. 



935 



Aqua— 

Sambuci, 431, 793 

Aqueous solution of ferric nitrate of iron, 636 

Aquifoliacese, 754 

Arbutin, as an astringent, 308 ; action of, on the 
kidneys, 376 

Areca nut, as a vermicide, 355 ; nature of, 903 

Argenti oxidum, 577 

Argenturu. See Silver 
Iodidum, 577 

AristolochiaceaB, 865 

Arnica, as a rubefacient, 304 

Camphor, action of, on the cardiac muscle, 

281 
Flowers, characters, action, and uses of, 881; 
root, 8S1 

Arnstein, reference to, 277rc. 

Arseniate of iron, 638 

Arseniate of soda, and of sodium— properties, ac- 
tion, and uses of, 612 

Arsenic, symbol and atomic weight of, 35 ; effect 
of habit in eating, 58 ; use of a small dose of, for 
gastric neuralgia, 58 ; action of, on bacteria, 9S ; 
as an antiperiodic is sometimes more powerful 
than quinine, 109 ; action of, on muscle, 124 et 
seq. ; on the ends of the vaso-motor nerves, 249 ; 
on the motor ganglia, 280 ; on the vaso-motor 
nerves, 281 ; almost tasteless as a poison, 346 ; 
secondary effects of, as a poison, 347 ; destroys 
the glycogenic function of the liver, 350 ; as an 
alterative, 358 ; has a special action on tissue 
changes, 360 ; in poisoning by, action of, on the 
urine, 360 ; used in nervous debility, 361 ; in 
diseases of the skin, 361 ; in some chronic con- 
ditions of the respiratory organs, 361 ; as a 
poison, with its antidote, 418 ; character and 
general sources, 605; action of, on the skin, 
mouth, stomach, and nervous system, 606; 
treatment in cases of poisoning by, 606 ; how 
chronic poisoning by, may occur, 606 ; how the 
system may become habituated to it, as seen in 
the arsenic eaters of Styria, 607 ; action of, on 
the blood, pulse, and heart, 607; on the blood- 
pressure in animals, 607 ; causes paralysis, 607 ; 
peculiarity of its action on the skin, 608 ; dia- 
grams illustrating the epidermis of a frog be- 
fore and after poisoning by, 608 ; uses of, in 
various diseases, 608, 609 ; diagram of section of 
lung of a guinea-pig poisoned by arsenious 
acid, 60S ; probable mode of action of, in 
phthisis, 609, 610 ; mode of administration of, 
610 

Arsenic acid, physiological action of, 51 ; effects 
of, on the blood, 82 ; iodide of, nature and use 
of, 612 ; solution of, and mercury, 612 

Arsenici iodidum, 470 

Arsenious acid, effects of, on the blood, 82 ; as a 
local sedative (in minute doses), 382; properties, 
preparations, and uses of, 611 

Arsenious oxide, as a caustic, 304 

Arteries, nature and functions of, 229; blood 
only available for the nutrition of cells while 
in the, 229 ; action of the pressure of the, on the 
circulation of the blood, 229 ; action of the 
heart on the, 230 ; effect of an upright and of 
a horizontal position on the circulation of the 
blood in the, 230 ; arrest of circulation in the, 
cause of fainting and shock, 230, 231 ; schema 
of the circulation from the heart to the veins 
and the, 232, 233 ; action of blood-pressure on 
the, 234; method of ascertaining the blood- 
pressure in the, 234-237 ; causes of alterations 
in blood-pressure of the, 237; how it may be 
raised and lowered, 237 ; relation of blood- 
pressure to pulse rate and the, 237-241 ; effect 
of the, on pulse curves, 240-242 ; investigation 
of the action of drugs on the, 243-246 ; another 
method of ascertaining this, 246-248 

Arterioles, action of the, on the blood-pressure, 
229; effects of rapid dilatation of the, 230; 
schema of the circulation in the, 232, 233 ; circu- 
lation in the, in the living body, 233; bLod- 
pressure in the, and method of ascertaining it, 
234-237 ; diagram of the apparatus employed in 
this, 235 ; alterations in blood-pressure in the, 
236 ; relation of pulse rate and the, to blood- 
pressure, 237-240 ; diagrams illustrative of this, 



238-242 ; effect of the, on pulse curves, 240-242 ; 
investigation of the action of drugs on the, 243- 
248 ; two modes of estimating the contraction of 
the, 243 ; the method of direct observation, 
243; the method of measurement by rate of 
flow, 246 ; mode of ascertaining whether a rise 
or fall in blood-pressure is due to the heart or 
to the, 258 ; action of digitalm on the, 846 

Artocarpese, 879 

Asafcetida, as an antispasmodic, 194, 195 ; as a 
carminative, 330 ; characters and uses of, 7S7 ; 
as an antispasmodic, carminative and expecto- 
rant, 788 

Asarum Europseurn or asarabacca, action of, in- 
ternally, 866 

Ascidians, action of drugs on, 114; diagram of an 
ascidian, 208 

Asclepiadacese, 828 

Asclepias, characters and use of, 828 ; as a dia- 
phoretic, or expectorant, 829 

Asparagus, as a stimulant diuretic, 374 

Asphyxial blood, stimulating effects of, on the 
medulla, 262 

Aspidospermine, as a depressant expectorant, 227 

Astringents, action of. on the mucous mem- 
branes, 226 ; sulphate' of copper as an astrin- 
gent, 304, 573; nature, action, audusesof, 308, 309, 
slaked lime as an astringent, 550 ; alum as, 556 ; 
salts of zinc as, 568 ; geranium as, 730; rhatany 
root as, 731 ; prinosas, 754; rhus glabra (sumach) 
as, 755 ; myrrh as, 756 ; kino as, 759 ; logwood 
as, 765 ; catechu as, 770 ; rubus or blackberry 
as, 771 ; pale catechu as, 804 ; bearberry as, 815 ; 
chimaphila as, 815 ; saliva as, S56 ; rhubarb as, 
858 ; rumex as, 859 ; oil of cinnamon as, 862 ; 
the bark of quercus alba as, 875 ; galls or nut- 
galls as, 875 ; elm bark as, 878 

Atheroma, emetics to be avoided in persons suf- 
fering from, 328 

Atomic weight of the elements, 35, 36, 37 ; ar- 
rangement according to, 42 

Atonic dyspepsia, slight stimulants produce ap- 
petite in, 319 

Atropacea?, 835 

Atropia, 429-837 

Atropia, preparation and characters of— 
Liquor, 836 
Sulphas, 837 
Sulphate of, 837 
Sulphatis, liquor, 837 
Unguentum, 837 

Atropina, 429 

Atropine, physiological action of, on the motor or 
efferent nerves, 4S , effect of large and small 
quantities of, on the pulse, 54; action of, on 
oxidation, 79; on rnecb-sse, 112; on annulosa, 
116 ; on muscles, 134, 135, 144, 146 ; as a sedative, 
146 ; action of, on the spinal cord, 150, 158, 160; 
on the brain of the lower animals, 172 ; as 
a local and general anodyne, 183, 184, as a 
mydriatic, 196-198 ; action of, on the respira- 
tory centre, 215 ; on the vagus, 218 ; when 
injected into the jugular vein, 219 ; has a slight 
and uncertain action on the respiratory centre, 
223 ; but a powerful effect in completely arrest- 
ing the secretion from the bronchial tubes, 223 ; 
cases in which it is useful as a pulmonary seda- 
tive when combined with apomorphine, 223; 
diagram of pulse and blood-pressure curve 
caused by the actions of, on the heart, 23S ; on 
the vessels of circulation, 247 ; destroys the in- 
hibitory action of the vagus on the heart in 
dogs and rabbits, 252 ; acts on the heart through 
the vagus roots, 261 ; might be useful in lessen- 
ing pain or palpitation of the heart in persons 
with high blood-pressure, 263 ; with muscarine, 
restores the pulsations in the heart-apex of the 
frog, 270 ; rapid action of, on the heart of the 
frog, 273 ; on the inhibitory power of the vagi, 
274, 275 ; neutralizes the action of muscarine 
on the heart, 277 ; action of, on the vagus-cen- 
tre, 279 ; on the vaso-motor centre, 279 ; as a 
cardiac stimulant, 291 ; effect of, on the secre- 
ting cells of a gland, 313 ; the most powerful of 
all antisialics, 318 ; paralyzing action of, coun- 
teracted by physostigmine, 318 ; as alocal seda- 
tive, 32S ; action of, on the intestines, 333 ; as 



936 



GENERAL IXDEX. 



an antihydrotic, 3S1; strong solutions of, ap- 
plied to the conjunctiva, 409 ; as a poison, with 
its antidote, 418 ; antagonistic action of, to 
other drugs, 422-425; general action of bella- 
donna or, in large and small doses, S37 ; special 
action of, locally applied, S37; on the brain, 
the spinal cord," and the motor nerves, 837 ; 
on the muscles, the eye, and the circula- 
tion, 838; on the urine, 839 ; on the intestines 
in large and small doses, 839 ; and on the tem- 
perature, 839 ; certain animals unsusceptible to 
the action of, S39 ; uses of, 839 ; as an anti- 
dote to opium, 840 

Aurantiacese, 737 

Auricular septum, view of the, in the frog, 264 

Aves, 920 

Azedarach, nature and use of, 746; chiefly as an 
anthelmintic, 747 



B. 



Bacilli, action of drugs on particular species of, 

97 , mode of experimenting on the action of 
drugs on reproduction of, 97 ; power of the 
spores of Anthrax bacilli to resist certain sub- 
stances usually fatal to life, 99 ; action of drugs 
on the development and growth of, 99. See also 
Bacteria 

Bacillus anthracis, nature and action of, 609 

The lactic ferment a, 86 ; treatment for de- 
stroying the tubercle bacillus, 453 

Bacillus tuberculosis, difference between the action 
of, and that of Bacillus anthracis, 609 

Bacteria killed by creasote, 87 ; origin and nature 
of, 88; diagram of the different kinds of, 89, 90; 
diseases caused by, 91 ; importance of a knowl- 
edge of, in relation to disease, 91 ; divided by 
Pasteur into two classes, 91 ; lite history of, 91, 
92 ; struggle for existence between the different 
species of, 91, 92 ; action of drugs on the move- 
ments of, 93 ; and on the reproduction of, in 
general, 93; the most destructive substances 
to, 93; mode of experimenting to test the effects 
of drugs in destroying the germs of, 94; compara- 
tive action of different drugs on, 95, 96 ; action 
of drugs on particular species of, 97 ; mode of 
experimenting on the action of drugs on the 
reproduction of, 97 ; results of Koch's experi- 
ments on, with three groups of disinfectants, 

98, 99 ; action of drugs on the development and 
growth of, 99 ; table showing the strength of 
various disinfectants required to prevent the 
development of, 100: influence of temperature 
on the action of antiseptics on, 101 ; alterations 
in, by heat and soil. 101; possible identity of 
different forms of, 102 ; may be modified by 
cultivation, 102 ; action of, and their products 
on the animal body, 103; list of diseases 
caused by, 103; effect of drugs on the action of, 
in the animal body, 104; decomposition of food 
in the mouth due to, 310; action of salicylic 
acid on, 693 

Bael fruit, beneficial action of, in dysentery, 337 ; 

characters, composition, and uses of, 741 " 
Baker, Morrant, reference to, 720». 
Balm. See Melissa 
Balsam, Canada. 882 
Of Copaiva, 768 
Fir 882 

. as a stimulant expectorant, 227 ; na- 
ture, action, and uses of, 759, 760 
Tolu, as an expectorant, 227, 760 
Baptisin, as a hepatic stimulant 351, 353 
Barbaloin, nature and action of, 89] 
Barium, symbol and atomic weight of, 35; its 
relal ion to other members of a group. 12 ; physi- 
ological action of, ">1 : salts of, action of, on 
muscles, 126, 131, 132.137; cause- contraction of 
the vessels, 246; action of, on the heart of the 
frog, 271; salt- of, action of, on the cardiac 
muscle, 281; and on the capillaries, 282; an- 
tagonism of. to other drugs, 422 125 
Barium chloride, action of, on bacteria, 98 
J'.ark. Angostura, 7J7 
Bebeeru, 866 



Bark— 

Calisaya, 794 
Canella alba, 744 
Casca, 771 
Cascarilla, 866 
Cinchona, Pale, 794 
Bed, 795 
Yellow, 794 
Cinnamon, 861 
Coto, 862 
Cotton root, 734 
Elm, 87S 
Larch, 885 
Oak, S74 

Pale cinchona, 794 
Paracoto, 862 
Pomegranate root, 782 
Quebracho, White, 828 
Bed cinchona, 795 
Sassy, 771 
Soap, 774 

"White quebracho, 828 
Yellow cinchona, 794 
Barley, pearl, 904 

Baryta salts, as a poison, with its antidote, 418 
Basham's mixture, 633 

Baths, cold, as anaphrodisiacs, 389 ; hot foot, hip, 
and mustard, as indirect emmenagogues, 390 ; 
may be either local or general, 395 ; three chief 
kinds, 395, 396; the cold bath, 396, 398; the 
cold pack, 398 ; cold sponging, 398 ; cold douche, 
399; the spinal douche, 399; the ascending 
douche, 399 ; sitz bath, 399, 400 ; cold foot bath, 
400 ; cold compresses, 400 ; tepid baths, 401 ; 
warm baths, 401 ; hot baths, 401 ; hot foot 
bath, 402 ; hot sitz baths, 402 ; poultices, 402 ; 
medicated baths, 403 ; sea bathing, 403 ; acid 
bath, 403; alkaline bath, 403 ; sulphurous bath, 
403; mustard bath, 403 ; pine bath, 404; vapor 
baths, 404; calomel fumigation, 404; air baths, 
404; the Turkish bath, 404; friction and in- 
unction, 405-407 ; carbonic acid baths, 4S7 
Bat's wing, Luchsinger's experiment with a, 133 
Baxt, reference to, 718 
Baxter, B., references to, 72n. 
Beads, jumble, 716 

Praver, 760 
Bean of" St. Ignatius, 821 
Bearberry, and bearberry leaves, 814 
Beaumont, Dr., references to his observations on 

the case of Alexis St. Martin, 321, 354 
Bebeerin, action of, on bacteria, 93; as an anti- 
periodic, 108 
Bebeeru bark, as an antiperiodic, 10S ; characters 

and composition of, 865 
Beberia, sulphate of, properties, action, and uses 

of, 865 
Beef tea versus alcohol, as a stimulant, 656 
Beer yeast, 912 

Belladonna, difference of action of, in men, rab- 
bits, and dogs, 06; as a sedative, 146; action of, 
on frogs, 159; as a spinal stimulant, 167; as a 
narcotic, 182; as a local and general anodyne, 
183j 184; as a mydriatic, 199, action of, on the 
respiratory centre, 223 ; on palpitation of the 
heart, 299; as a local sedative, 32S; as a purga- 
tive, 336 ; as an antihydrotic, 381 ; its action in 
incontinence of urine, 384; as a poison, with 
its antidote, 418; antagonism of, to opium, 424 
Belladonna leaves, 835 

Root, 836. For general action of belladonna, 
see Atropine 
Belladonninc, as a mydriatic, 198 
Bennett, Hughes, reference to, 148 
Benzin, properties and uses of, 646 
Benzoates, test for, 496 
Benzoate of ammonia, 817 
of ammonium, 545 
of Lithium, 535 

of soda, action of, on enzymes, 86 ; on bac- 
teria, Hi), luii; nature of, 531 
Benzoated lard, 919 

Benzoic acid, action of, on enzymes, 86; on bac- 
teria, 96, 99, inn; as a stimulating expectorant, 
227: action of, on the kidneys, 377 ; prepara- 
tion and properties of, 817; action of, a- an 
antiseptic, and a diaphoretic, 817 ; uses of, 818 



GENERAL INDEX. 



937 



Benzoin, as a stimulating expectorant, 227 ; char- 
acters and preparations of, 816; compound 
tincture of, 817 
Benzol, action of, on bacteria, 98 
Benzovltropine, as a mydriatic, 198 
Berberiae sulphas, 429, 865 
Berberidaceae, 708 

Berberine, character and action of, 706 
Bergamot, oil of, characters and uses of, 739 
Bergmann, references to, 10-1 
Bernard, M., references to, 55, and n., 67, 139, 143, 

316, 715 
-Bernstein, references to, 161, 210, 212 
Bert, Paul, reference to, 99 
Beryllium, symbol and atomic weight of, 36; 

physiological action of, 51 
Bezold, Von, references to, 250, 252, 260«. 
Bicarbonates, test for, 496 
Bicarbonate of potash, 510 

of soda, action of, on the gastric juice, 321 ; 
nature of, 526 
Bichloride of ethidene, as a general anaesthetic, 
186 ; of methylene, as a general anaesthetic, 186 ; 
nature of, 673 
Bichromate of potash, as a poison, with its anti- 
dotes, 419 ; nature and uses of, 516 
Biedermann, references to, 129, 130 
Bigelow, Dr., reference to his use of ether, 193 
Bile, utility of emetics to expel, from the gall 
bladder, 327 ; and to remove it from the body 
in cases of biliousness, fevers, and agues, 327 ; 
nature and functions of the, 348-354 ; use of 
cholagogues in removing the, from the body, 
354 ; action of acids on the, 476 ; of pilocarpine, 
750 ; of leptandra, 851 ; of aloes, 893 ; purified 
ox bile, 917 ; its composition, action, and uses, 
917 
Bin-oxalate of potash (salts of lemon or sorrel), 

as a poison, with its antidote, 417 
Binz, Prof, references to the experiments of, 72, 

81, 154, 466, 735 
Birds, action of opium on, 716 
Bismuth, properties, preparation, action, and 
uses of — 
Carbonate of, 621, 623 
Citrate of, 623 

and ammonium, 623 
Common, 621, 622 
Oxide of, 621 
Puriried, 622 

Solution of citrate of, and ammonia, 623 
Subcarbonate of, 623 
Subnitrate of, 621, 622 
Bismuth, symbol and atomic weight of, 35; a 
mild irritant to the stomach, 320 ; salts of, as 
a local sedative, 328 
Bismuth subnitrate, as an astringent, 308 
Bismuthi et ammonii eitras, 622 

Citratis liquor, 622 
Carbonas, 622 
Citras, 622 
Subnitras, 622 
Bisulphide, test for, 498 

of carbon, action of, on bacteria, 98 
Bisulphite of soda, 533 
Bitartrate, test for, 498 

Bites of venomous serpents or of rabid dogs, 
utility of caustics in, 306 ; necessity for care in 
cauterizing for dog bites, 306 
Bittersweet. See Dulcamara 
Blackberrv, 771 
Haw, 806 
Pepper, 870 
Wash, 588 
Bladder, diagram to show the effects on the cere- 
bral circulation of rapidly emptying the, 231 ; 
action of drugs on the, 383,384; situation of 
the nerve centre of the, 3S3 ; and of the cere- 
bral, 383; action of vesical sedatives on, 384; 
and vesical tonics, 384 ; urinary sedatives and 
astringents, 385 ; treatment of inflammation of 
the, 385 ; result of distention of the, and of 
stone in the, 389 ; utility of pareira root in 
chronic catarrh of the, 707 ; action of buchu 
leaves on the mucous membrane of the, 748 ; 
of pilocarpine, 749, 750 ; of physostigmine, 764 
Blagdon, Sir Charles, reference to, 3S0 



Blake, reference to, 51 

Blastomycetes, 89 

Blatta orientalis, as a stimulant diuretic, 373; as 

an aphrodisiac, 388 
Bleeding, local, by leeches or by wet cupping, 
usefulness of, in inflammation and fever, 363 ; 
as an anaphrodisiac, 388 

Blisters, probable action of, in inflammation, 303, 
304; various diseases in which they are useful, 
305; as antipyretics, 363 

Blood, red corpuscles of the, effect of heat and 
cold on, 73 ; action of drugs on the, 79 ; effects 
of oxygen and other gases on the, 80, 81 ; vari- 
ous constituents of the— haemoglobin, 80, 81 ; 
oxy haemoglobin, 80, 81 ; haeniatin, 80, 81 ; met- 
haemoglobin, 80, 81; effects of carbonic acid 
on the, 80 ; of hydrocyanic acid, 89 ; of nitrites, 
80 ; alterations effected in the interchange be- 
tween the air and the, 81 ; poisoning of the, 
produced by the bacillus septicaemia?, 103 ; ac- 
tion of, on the brain, 176-182 ; state of the, in 
respiratory complications, 212-215 ; effect of 
excessive venosity of the, on the respiratory 
centres, 211-213 ; condition of the, in suffoca- 
tion, and in nitrite and carbonic oxide poison- 
ing, 214; difference in the quality of, in the 
arteries and in the veins, 229 ; importance of 
the pressure of the arteries and veins on the 
circulation of the, 229 ; action of the heart in 
reference to the, 230; fainting and shock 
caused by the sudden arrest of the supply of, to 
the brain, 230; schema of the circulation of 
the, 232, 233 ; diagram illustrating this, 232 ; 
circulation of the, in the living body, 233 ; na- 
ture of arterial tension, or blood-pressure, 234; 
method of ascertaining the blood-pressure, 235; 
alterations in blood-pressure and their causes, 
236 ; how this pressure may be raised and low- 
ered, 237; relation of pulse rate and arterioles 
to blood-pressure, 237-240 ; diagrams illustra- 
tive of blood-pressure, 238 et seg.; effect of the 
arterioles on blood-pressure and pulse rate, 
240-243; investigation of the action of drugs 
on the blood vessels, 243-246 ; another method 
of ascertaining this, 246-248; venous, causes 
contraction, and oxygenated, dilatation of the 
vessels, 247; action of other parts on blood- 
pressure, 249 ; reflex contraction of blood ves- 
sels, 250 ; action of drugs on this reflex con- 
traction, 251 ; comparative effect of heart and 
vessels on blood-pressure in different animals, 
252 ; influence of nerves on blood-pressure, 
253-256 ; causes of alteration in blood-pressure 
and pulse rate, 257 ; action of the heart on 
blood-pressure, 258 ; action of styptics on the, 
309 ; coagulation of the, caused by alum, lead, 
acetate and ferric chloride, 310 ; action of hae- 
matinics in improving the quality of the, 357 ; 
nature and action of the red corpuscles of the, 
357 ; the various constituents of, 359 ; pressure 
of the, in the -glomeruli, and the composition 
of the, two factors in the rapidity of the secre- 
tion of urine, 369, 372 ; experiment with digi- 
talis on blood-pressure, 372, 373 ; - action of 
hydrocyanic acid on the, 490, 491 ; of caustic 
alkalies injected into the, 501 ; action of the 
metals on the, 564 ; of mercury, 582 ; of salts of 
iron, 628 ; of alcohol, 650 ; of spirit of ether, 
661; of nitrite of amyl, 664; of nitro-glycerine, 
668 ; of chloral hydrate, 671 ; of purified 
chloroform, 675-677 ; of carbolic acid, 688 ; of 
creasote, 690; of antipyrin, 695 ; of caffeine, 
740 ; of Jamaica dogwood, 769 ; of oil of euca- 
lyptus, 781 ; of quinine, 805 ; of oil of valerian, 
806 ; of sulphate of strvchnine, 826 ; of curare, 
826 ; of gelsemium, 827"; of tobacco, 842; of digi- 
talin, 844 ; of thymol, 854 ; of tannic acid, 876 

Blood-letting, as a local anodyne, 183 

Bloodroot. See Sanguinaria 

Blue cohosh, 708 

Bocci, reference to, 349 

Body, remedies acting on the surface of 
the, 301-310. See Remedies, &c. 

Boehm, references to, 122, 219, 249, 278n., 702, 847 

Boerhaave, reference to, 383 

Boisbaudran, L. de, on molecules, 49 

Bon, M. Gustav le, reference to, 106 



938 



GENERAL IXDEX. 



Bones, action of phosphorus on the, 603 

Boracie acid, action of, on bacteria, 99; nature 
and properties of. 486 

Borates, test for, 496 

Borax, action of, on enzymes, So ; on bacteria, 
97, 99 ; as an antiseptic for cleansing the teeth, 
311 ; as an antisialic. 318 : as a direct emmena- 
gogue, 390 ; nature and uses of, 528 ; its deriva- 
tives, glyceriuum, boracis and rnel boracis, 529 

Boric or boracie acid, properties of, &c., 486 

Borneol, action of, on the brain and spinal cord, 
194; on the cardiac muscle, 281 

Boron, symbol and atomic weight of, 35 

Borosalicylate of soda. 96 

Bouchard, reference to, 349 

Bouley. reference to, 322 

Bowditeh, reference to, 268 

Bowels. See Intestines 

Bowman, references to. 365 

Brain, action of drugs on the, 167-196 ; of the 
lower animals, 167 ; of the higher, 168 ; of frogs, 
rabbits, guinea-pies, monkeys, dogs, and cats, 
168-171; diagram of the brain of a monkey, 
170; arrangement of the motor and sensory 
centres of the, in the lower animals, 171; de- 
pressant action of drugs on the motor centres of 
the, 171 ; method of investigating the action of 
drugs on the excitability of the, 171 ; irritant 
action of drugs on the motor centres of the, 
171-174; action of drugs on the sensory and 
psychical centres of the, 175-195 ; effect of drugs 
upon the time required for mental processes, 
175 : drugs which increase the functional ac- 
tivity of the, 176: nerve stimulants, 176; cere- 
bral" stimulants, 176; effects of posture and 
mastication on the action of the, 176 ; stimu- 
lating effects of smoking, sips of alcohol, and 
tea and coffee on the, 177: suction causes an 
increased supply of blood to the, 178; exercise 
causes inci eased' activity in the, 177: sipping a 
powerful stimulant to the, 177: alcohol one of 
the typical stimulants of the, 178; direct action 
of strychnine and caffeine on the, 17 s -: drugs 
which* lessen the functional activity of the, 
178-193; hypnotics or soporifics induce sleep, 
179 : effects of different degrees of sleep on the, 

180; action of hypnotics on the, 17 
of narcotic-, 182; peculiar action of alco- 
hol on the, 182; peculiar physiological condi- 
tion- of the, 182 : action of anaesthetics on the, 
185-191 ; of antispasmodics, 194; of drugs on the 
different kinds of spirits ap- 
pear to affect different parts of the, 195: fainting 
and shock caused by the arrest of the supply 
of Mood I ,230, 231 : action of the, on 

vomiting, 324 ; action of bromide of potassium 
on the, 521 ; of strong solution of ammonia, 
542: of alcohol, 651 ; of spirit of ether, 663; of 
chloral hydrate, 672; of nydrochlorate of apo- 
morphine, 713; of codeine, 714: of opium, 71S: 
of sanguinaria, 725; of caffeine, 743;of oil of 
eucalyptus, 781 ; of confine, 7^7 ; of oil of vale- 
rian, 806 ; of strychnine, v -'4; of belladonna or 
atropine, 837 
Brandy, as a cardiac stimulant, 291 ; nature. &c, 

mill of, 903 
cation of organized ferments, 
89 

d-hydrate, antagonism of, to atropine, 123, 
i m, and use of. .;::; 
Bromicai id, physiological action of. 51 
Brom i or, 196 

Bromide of ammonium as a hypnotic, 181, 182; 
o anaphrodisiac, 389 :* nature of, 51 1 

Calci 

Lithium, 
Potash, 521 
Soda 

/.in.-, 1-1, -".71 

Bromide of potassium, action of, on the motor 

treaof the brain, 172; lessens the functional 

activity of the brain, 178 ; as a hypnotic, 181 ; 

a- an anodyne, 184; a- an antispasmodic, 194; 

action of, aa an antispasmodic, !'.'■"•: on the 

: circulation, 250 ; as an anaphrodisiac, 



3S8 ; uses of, 520-522 ; action of, on the spinal 
cord and the brain, 521; in nervous diseases 
and as a hypnotic, 521 ; allays excitability and 
irritability, 521 ; in epilepsy and sickness, es- 
pecially in pregnancy and. sea-sickness, 522 ; 
as an anaphrodisiac, 522 

Bromide of sodium, as a hypnotic, 1S1 

Bromiue, symbol and atomic weight of, 35 : ac- 
tion of, on infusoria, 75; on enzymes, 87 : on 
bacteria, 93,97,98,99; as a caustic, 304; as a 
poison, with its antidote, 417 : characters, test, 
and uses of, 469 

Bromo-camphor, antispasmodic powers of, 194 

Bromoform, as a general anaesthetic, 186 

Broncnial tubes, atropine completely arrests the 
secretion from the, 223 

Bronchitis, chronic, cod-liver oil affords more 
relief in, than any of the ordinary expecto- 
rants, 217 : importance of an emetic in, 195; 
ipecacuanha, either alone or combined with 
squills, as expectorant in, 208: with great de- 
pression and feeble circulation, carbonate of 
ammonia to be preferred, 228 : importance of 
warmth and moisture in, 22.8; of respirators, 
warm clothing, &c, in, 228; value of certain 
plasters in, 228; tartar emetic ointment and 
croton-oil liniment sometimes of use in, 305 

Bronchitis kettle, nature and use of, 413 ; 

Broom, as a refjigerant diuretic, 374 ; broom and 
broom tops, characters and composition of, 758 ; 
physiological action and therapeutical uses of, 
758" 

Brown-Sequard, reference to, 218n. 

Brucia, effects of, on the blood, 82 

Brucine, as a spinal stimulant, 167 : action of, on 
the respiratory centre, 215: antagonism of, to 
chloral, 420-424 : acts like strychnine, 825 

Brucke, Professor, reference to, 845 

Brunton, Dr. L., references to, 58, 61, 67, 122,126, 
143, 162. 171/?., 205/2., 239. 241//.. 252n., 258n., 
260/2.. 275/2., 332/2., 349/2., 372//., 423, 426, 508, 758 

Bryonia, or bryony, characters and use of, as a 
hydragogue cathartic. 785 

Bubnoff, reference to, 703 

Buchheim, references to, 55, 143 

Buchner, reference to, 102 

Buchu, as a stimulant diuretic, 374: action of, on 
the bladder, 384: buchu leaves, nature, action, 
and use of. 747 

Buckthorn, nature, action, and use of, 753; and 
of buckthorn juice, 753 

Burdock, 813 

Burgundy pitch, 885 

Burnett, Sir W., reference to, 570: his disinfect- 
ing fluid, as a poison, with its antidote, 418 

Burseracese, 756 

Butternut. See Juglans 

Butyl-chloral, as a general anodyne, 183, 184; 
characters, action, and u.-es of, 670 

Butyric acid, action of, on bactei 

Buxine, as a spinal stimulant, 167 

Byttneriacese, 741 



c. 



Cabbage-rose petals, 772 

Cacao butter, 7 (I 

Cadmii iodidum, 470 

Cadmium, iodide ol 

Cadmium, symbol and atomic weight of, 35; its 
relation to other members of a group, 42; phy- 
siological action of, 51 ; effect of, on muscle. 121 

,.■ causes slighl contraction of the \< 
246 ; cadmium sulphate, a- an ast i ingent, 

Csesalpinia . 

Cesium, symbol and atomic weight of, 35; its rela- 
tion to other members of a group, 12; physio- 
logical action of, 51 

Caffeina, 429 

Caffeine, action of, on oxidation, 7:': on m 
112; on annulosa, 115; on muscles, 127; 131 et 

,; on the spinal cord, 148; on the brain 
on the accelerating centre. 279; on the vaso- 
motor centre, 279 ; on tin; cardiac inuscli 
as a cardiac tonic, 293; as a refrigerant diuretic, 



GENERAL INDEX. 



939 



373; antagonism of, to morphine, 420-425; 
(theine) characters of, 742 ; action of, on the 
nerve centres, and on muscular fibre, 743 ; on 
frogs and warni-blooded animals, 743; on the 
brain, medulla, respiration, blood-pressure and 
pulse, 743; on the salivary secretion and the 
intestines, 743; on the temperature, 743; as a 
diuretic, 743 

Cahours, reference to, 143 

Cajuput oil, as a rubefacient, 304; and carmina- 
tives, 330 ; oil of, characters aud uses of, 780 ; as 
a powerful stimulant, antispasmodic and rube- 
facient, 780 

Calabar bean as a myotic, 198 ; as a poison, with 
its antidote, 418; character, composition, and 
preparations of, 761 

Calabarine, as a spinal stimulant, 167 ; antagonism 
of, to chloral, 425 

Calamus, 973 

Calcis hydras, 550 

Calcium, symbol and atomic weight of, 36; its 
relation to other members of a group, 42 ; and 
specially to lithium, 42 ; physiological action of, 
51 ; action of, on the muscles, 130, 137 ; causes 
great contraction of the vessels, 246; salts of, 
and distilled water prolong the beating of the 
frog's heart, 270 

Calcium, characters and uses of— 
Chloride of, 98, 553 
Bromide of, 553 
Precipitated carbonate of, 553 
Phosphate of, 553 
Hypophosphite of, 554 
Sea alsu under Lime 

Calendula (marigold), 812 

Calomel, antiseptic power of, 107; action of, on 
the stomach. 321 ; on the pancreatic juice, 355; 
its action and uses, 587 

Calomel fumigation, 404 

Calumba and Calumba root, characters, compo- 
sition, and preparations of, 706 ; actions and uses 
of, 707 

Calyciflorse (sub-class II.), 753 

Camphor, action of, on bacteria, 100; on ascidians, 
114; and on annulosa, 115; curious exciting 
action of, on the brain and the medulla, 174; 
action of, as an antispasmodic, 194 ; on the ear, 
205; on the vaso-motor centre, 279; on the car- 
diac muscle, 281; as a cardiac stimulant, 291; 
as a popular remedy to cut short coryza or ca- 
tarrh, 293 ; as an anaphrodisiac, 38S r ; charac- 
ters, composition, and preparations of, 862; 
action of, as a stimulant and rubefacient, 864; 
as a diaphoretic and anaphrodisiac, 864; action 
of, on the heart, nerve centres, and the tempe- 
rature, 864; uses of, externally and internally, 
S64 

Camphor, monobromated, characters of, 864; 
action and uses of, S64; as a sedative, 864 

Campylospermas, 785 

Canada balsam, 882 
Pitch, 885 
Turpentine, ditto, 882 

Canadian hemp. See Apocynum 

Canellaceaa, 744 

Canella alba bark, an aromatic bitter and tonic, 
744 

Cannabin, action of, on brain of dogs, 172 

Cannabinea', 879 

Cannabis, American, 879, S80 

Cannabis indica, as a hypnotic, 181 ; as an ano- 
dyne, 184; action of, in producing visions, 204; 
doubtful value of, as an aphrodisiac, 388 ; as a 
poison, wiih its antidote, 418 ; character, action, 
and uses of, 879, 8S0 

Cantharides, as a vesicant, 305; as a stimulant 
diuretic, 373 ; action of, on the kidneys, 376 ; 
produces both albuminuria and hematuria, 
376; its action on the urine, 383; as an aphro- 
disiac, 388; as a direct emmenagogue, 391; as a 
poison, with their antidotes, 418 ; character and 
composition of, 925 ; action of, externally and 
internally, 925 ; on the salivary glands and on 
the urinary organs, 925, 926; uses of, externally 
as an irritant and a counter-irritant, 926; and 
internally, 926 ; precautions, 926 ; treatment in 
poisoning by, 927 



Capillaries, list of drugs by which they are stim- 
ulated, depressed, or paralyzed, 282 ; a certain 
abnormal condition of the, one of the chief 
causes of dropsy, 297 

Caprifoliacese, 793 

Capsicum, 835 ; as a rubefacient, 304 

Fruit, characters and composition of, 835; 
action and uses of, 835 

Caraway, as a carminative, 790 
Fruit, 790 
Oil of, 791 

Caraway and oil, as a carminative, 330 

Carbolic acid, action of, on enzymes, 86 ; on bac- 
teria, 96, 97; as a deodorizer, 105-108; its super- 
iority for removing smell from the hands, 108 ; 
as a sedative and au anaesthetic, 146; oue of the 
chief local anaesthetics, 186 ; action of, on the 
vaso-motor centre, 279 ; as a caustic, 306 ; as an 
astringent for the teeth, 310; liquefied as a 
remedy for toothache, 311 ; as a local sedative, 
328 ; as a poison, with its antidote, 419 ; antag- 
onism of, to chloral, 425 ; characters, tests, and 
preparations of, 687; action of, as a deodorizer 
and disinfectant, 688; on the skin and mucous 
membranes, 688; on the blood, muscle, nerve, 
and medulla oblongata, 688 ; on the spinal cord, 
respiratory and vaso-motor centres, 688; on the 
cerebral, sweat and salivary centres, 689 ; on 
the temperature, 6^9; how excreted, 689; uses 
of, 689-691 

Carbon, symbol and atomic weight of, 36; found 
in three foims, and in various compounds, 40; 
its relation to other members of a group, 42 ; its 
forms, 459-461 

Carbon, bisulphide of, character, action, and uses 
of, 644 

Carbon compounds, fatty series, 643 et seq. ; prop- 
erties and general action of, 644; aromatic 
series, 683-696 ; general characters of, 683 et seq. ; 
action of, 687; the antiseptic and antipyretic 
power, 687. See Hydro-carbons 

Carbon monoxide, as a poison, with its antidote, 
417 

Carbonates, test for, 496 

Carbonate of ammonia, 542 
Bismuth, 623 
Lead, 596 
Lithia, 534 
Magnesia, 560 
Potash, 508 
Soda, 526 
Zinc, 569 

Carbonate of soda, action of, on the ear, 205; on 
the mucus from the trachea, 224 ; as a poison, 
with its antidote, 417 

Carbonic acid, action of, on protoplasm, 71 ; as a 
local anodyne, 183 ; action of, on the blood, 248 ; 
as a refrigerant diuretic, 373 ; as a poison, with 
its antidote, 417 ; as choke damp, with its anti- 
dotes, 417; properties of carbonic acid, 487; 
action aud uses of, 487 ; effects of, in the mouth, 
the stomach, and the intestinal canal, 488 ; poi- 
soning by, 4SS ; has three stages— dyspnoea, con- 
vulsions,'and paralysis, 488; its treatment, 489 

Carbonic oxide, action of, on muscles, 125 et seq.; 
on the vagus centre, 279 ; effects of poisoning by, 
on the color of the blood, 214 

Cardamoms, as carminatives, 330: as stimulants 
and carminatives, 901 

Cardiac muscle, drugs which stimulate or depress, 
281 

Cardiac poisons, action of different kinds of, 271, 
281 

Cardiac sedatives, nature and action of, 299, 300 

Cardiac stimulants, nature and action of, and list 
of the principal, 291 

Cardiac tonics, 223; nature of, and list of the 
principal, 293; conditions and diseases of the 
heart in which they are most useful, 294-297; 
the question as to the use of digitalis in aortic 
regurgitation considered, 296; risks attending 
the administration of digitalis and other car- 
diac tonics, 296; cimicifuga (black snakeroot), 
as a cardiac tonic, 703; apocynin and apocynein 
as, 828 

Carlsbad water, probable cause of its efficacy in 
hepatic diseases, 354 ; nature and uses of, 530 



940 



GEXERAL INDEX 



Carminatives, nature of the action tliev exert on 
the stomach, 329, 330; list of the "chief, 330; 
their principal uses, 330 ; cloves as", 77S ; asafoet- 
ida as, 787; fennel fruit as a, 789 ; oil of anise 
as, 789 ; oil of dill as, 790 ; oil of caraway as, 
790; oil of coriander as, 792; oil of chamomile 
as, 809; oil of rosemary as, 851; oil of lavender 
flowers as, 852 ; oil of peppermint as, S53 ; oil of 
spearmint as, S53 ; hedeoma or pennyroyal, 855 ; 
expressed oil of nutmeg as, 860; oil of cinnamon 
as, 861 ; garlic as, 889 ; cardamoms as, 901 ; saff- 
ron as, 902 

Carolina pink. See Spigelia 

Carron oil, origin, composition, and uses of, 551 

Carrot as a stimulant diuretic, 374 

Casca bark (sassy bark), composition, action, and 
uses of, 771 

Cascara Sagrada as a purgative, 753 

Cascarilla, 866; cascarilla bark as a stimulant, 
tonic, and expectorant, 867 

Cash, Dr., references to, 59, 122, 126, 130, 132, 
137, 14-4, 245, 246, 422, 508, 824 

Cassia, as a laxative, 339; cassia pulp, characters, 
and use, 767 ; purging cassia, 767 

Castanea, characters and uses of, 878 

Castor, antispasmodic action of, 194 ; its charac- 
ters and therapeutics, 913 

Castor oil, nauseous taste of, owing almost en- 
tirely to its odor, 206 ; as a purgative, 339 ; as a 
vermifuge, 355 ; characters and preparations of, 
869 ; composition, action, and uses of, 869 ; as a 
purgative, S69 ; mode of administration, 869 

Cat. easiest mode of anaesthetizing, 191; diagram 
of curve of the pulse and blood-pressure in a, 
after division in the spinal cord and injection 
of erythrophlceum, 239 

Catalysis, effects of, on different substances, 82 

Catap'lasma carbonis, 431, 459,900 
Conii, 431, 786 
Fermenti, 431,903, 912 
Li ni, 431,729, 819 
Sin apis, 431, 726 
Soda? chloratie, 431, 468 

Cataplasms, or poultices, 431 

Catarrh, with copious secretion of mucus, a com- 
bination of morphine and atropine useful in, 
224; camphor a popular remedy in common, 
293 

Catechu, as an astringent, 308 ; for the teeth and 
gums. 311 ; characters, composition, and uses of, 
770, 771 ; pale, 804 

Cathartics. See Purgatives 

Catheter, importance of cleansing and disinfect- 
ing, 107 

Caulophyllum (blue cohosh), character, composi- 
tion, and uses of, 708 

Caustic ammonia, as a poison, with its antidote, 
417; caustic lime, as ditto, 417; caustic 
potash, or soda, as ditto, 417 
Potash, -in!) 
Soda, 526 

Caustics, nature and uses of, 306; general action 
of the alkaline group of metals as, 499; alum as 
a cau-tic, 556 

Celandine. See Chelidonium 

Celastracese, 7.",:; 

Cells, how kept alive, and cause of death of, 229 

Cerates, or ointments, 431 

Ceratum. 431, 920,924 

Cam phone, 431, 862, 863, 920, 924 

Cantharidis, 131, 920, 925 

Cetacei, 431, 920, 924 

Extract! eantharidis, 431, 920, 924, 925 

Plumb] Bubacetatis, 431, 598, 920, 924 

Ceratum Resinse, 131, 885, 920. 924 
Sabinse, 131, 920, 921 

Cerebellum, action of drugs on the, 195 ; different 
kinds of spirits appear to affect different parts 
• .("the 19.".: action of alcohol on the, 652 

Cerebral affections, blisters useful in, 805; cir- 
culation, diagram to show the effects on, of 
rapidly emptying the bladder, 281 ; stimulants, 
nature, and action of, 1 70- 17s ; action of cat- 
holic acid on the cerebral centres, 689 ; tea as a 
powerful stimulant, 7 12 

Cerium oxalate, as a local sedative, 828 j charac- 
ter, use*, Ac, of, 558 



Cerium oxalate — 

Symbol and atomic weight of, 36 ; physio- 
logical anion of, 51 

Cetacean, 919 

Cevadilla, 895 

Chalk, as an astringent, 308 ; as a dentifrice, 310; 
as a direct antacid, 322 

Chalk, prepared, 551 ; officinal preparations of, 552 ; 
mixture of, 552 ; aromatic powder of, 552; com- 
pound powder of, 552 ; lozenges of, 552 ; hydrar- 
gyrum cum creta contains, 552 

Chamomile, characters and uses of, 809 

German, 809 ; a bitter carminative, anthel- 
mintic, 809 ; infusion of, 809 
Oil of, 809 ; a tonic, stomachic, and carmina- 
tive, 809 

Chaperon's experiments on inhibitory paralysis, 
154 

Charcoal, reputed power of, for attracting oxy- 
gen, 82 ; as a deodorizer, or antiseptic, 108 ; as a 
dentifrice, 311 ; action of, on the stomach, 330 ; 
chief action of, 455 

Charcoal, animal, preparation and constituents 
of, 460 
Fumes, as a poison, with its antidote, 417 
Purified, animal, preparation, characters, and 

uses of, 460 
Wood, its prepiration, characters, action, 
and uses, 459 ; poultice of, how to make, 
459 

Charta Cantharidis, 432, 925 

Epispastica, 432, 819, 882, 885, 920, 924, 925 
Potassii nitratis, 432 
Sinapis, 432, 727 

Cheken, composition, action and uses of, 779 

Chelidonium (celandine), characters, composi- 
tion and uses of, 726 

Chemical constitution and physiological action, 
connection between, 50; the most important 
subject in pharmacology, 51 

Chemical reactions, numher and nature of, 47; of 
the metallic elements divided into two groups, 
47, 48 ; which only occur between two bodies 
when a third is present, 82 

Chenopodiaceie, 859 

Chenopodii, oleum, as a vermifuge, S59 

Chenopodium, characters of, 859 

Cherry-laurel water, as a poison, with its anti- 
dote"; 419 ; cherry-laurel leaves, nature, action, 
and use of, 777 

Cherry, wild, as a nervous sedative and tonic, 777 

Chestnut, See Castanea 

Chilies, as carminatives, 330 

Chill, or cold, utility of vascular stimulants in, 
293; action of, on bronchi, 225 

Chimaphila, (pipsissewa), as a stimulant diuretic, 
374; as an astringent and diuretic, 815 

Chinicine, constitution of, 696 

Chinoidin (quinoidin), 799 

Chinoidinum, 430,799 

Chinoline, 695 

Chinoidinse sulphas, 799 

Chiretta, as a bitter tonic, 831 

Chloral, action of, on muscle, 124 et seq.; as a 
sedative, 146; diagram to show the action of, on 
the spinal cord, 151; a useful hypnotic, 181 ; as 
a general anodyne, 183,184; action of, on the 
respiratory centre, 215; on the brain, 218; on 
the vessels and circulation, 247 ; on the vaso- 
motor centre, 251,279; on the motor ganglia, 
280; on the intestines, 337 ; as a poison, with 
its antidotes, 419; antagonistic action of, and 
strychnine and picrotoxine, 423; antagonism 
of, to other drugs, 421-424 

Chloral hydrate, action of, on the nervous sys- 
tem, 186; on the vagus centre, 279; antagonism 
of, to atropine, 421-424; preparation and char- 
acters of, 670; action of, 670-673; as an anti- 
septic, in the mouth, and when injected under 
the skin, 07(1; first introduced into medicine by 
Oscar Liebreich, 670; his speculations regard- 
ing its action, 670 ; its action in the hody, 670 ; 
in frogs and mammals, 671 ; on the tempera- 
ture, respiration, and hlood, 671 ; on the circu- 
lation, 671 : on muscles and motor nerves, 671 ; 
on the spinal cord, 671 ; on the brain, 671; 
treatment o!' poisoning by, 672 ; uses of, 672 



GENERAL INDEX. 



941 



Chlorate of potash, action of, on bacteria, 96, 100 ; 
as a remedy for toothache, 311 ; as an antisialic, 
318 ; action of, on the kidneys, 376 ; characters, 
action, and uses of, 513-515 

Chlorate of soda, 530 

Chlorides, test for, 497 

Chloride of ammonium, 540 
Calcium, 552 
Gold, 640 
Iron, 633 
Soda, 524 
Sodium, 502, 503 
Tin, 600 
Zinc, 569 

Chloride of lime, action of, on enzymes, 86, 87 ; 
on bacteria, 98 

Chloride of sodium, action of, on bacteria, 101 ; 
action of, as compared with bromide of potas- 
sium, 195 ; on the pulsations of the frog's heart, 
269 ; effects of excess of, in t he blood, 358 ; one of 
the mostimportantconstituentsof the body, 359 

Chlorides, general action of the group of, 501-503 

Chlorinated lime, 96 ; characters of, &c, 467 ; so- 
lution of, 468 ; inhalation of, 468 

Chlorinated soda, solution of, 468 ; as a cataplasm 
of, 468 

Chlorine, symbol and atomic weight of, 36 ; its 
relation to other members of a group, 42 ; 
action of, on infusoria, 75 ; on enzymes, 85-87 ; on 
bacteria, 96, 100 ; as a poison, with its antidote, 
416 ; general source, characters, and mode of 
preparation of, 464-466 ; action of, 466 ; chlorine 
water, tests, and uses of, 466 ; chlorinated lime, 
its characters and uses, 467 ; solution of chlori- 
nated lime, 468 ; inhalation of chlorine, 468 ; 
solution of chlorinated soda, 468 ; poultice of 
ditto, 468 ; uses of ditto, 468 

Chlorine water, action of, on bacteria, 98 ; nature, 
action, and uses of, 466, 467 

Chloroform, effects of, on the blood, 82 ; on enzy- 
mes, 86 ; on bacteria, 96, 98 ; on medusse, 112 ; 
on mammals and leeches, 115; on muscle, 124 
et seq. ; as a sedative, 146 ; diagram to show the 
action of, on the spinal cord, 151; action of, 
on psychical processes, 175; action of, as an 
anaesthetic. 185 elseq.; acts directly on the nerve 
cells, 187; dangers arising from the use of, 189 ; 
mode of administering, 190; action of, on the 
respiratory centre, 214 ; on the brain, 218 ; on 
the vagus centre, 279 ; on the vaso-motor cen- 
tre, 279; on the motor ganglia, 280 ; as a cardiac 
stimulant, 291 ; as a rubefacient, 304 ; as a siala- 
gogue, 314; as a local sedative, 328; as a car- 
minative, 330; as a poison, with its antidotes, 
418; antagonism of, to amyl nitrite, 425; puri- 
fied, preparation, 674 ; tests, 674 ; preparations 
of, 675; action of, 675; when mixed with albu- 
men, 675 ; a powerful solvent of protogon, 675 ; 
on the blood and skin, 675 ; on themouth, stom- 
ach, and intestines, 676 ; the nervous system, 
676 ; its action divided into three stages, 676 ; its 
action on the respiration, pulse, heart, and 
blood-pressure, 677 ; on the nervous system, 
677 ; dangers in the administration of, 678 ; 
precautions to be taken, 678-681 ; uses of, and 
various plans for administering, 680, 681. See 
also Anaesthetics. 

Chloropicrin, action of, on bacteria, 99 

Cholagogues, may act as indirect gastric tonics, 
322 ; nature and action of, 340, 349 ; experiments 
with, 351-353 ; adjuncts to, 353; uses of, 354; re- 
move bile from the body, 354 

Cholera, corrosive sublimate in, 589 ; possible use 
of naphthalin in, 694 

Chondrus, 912 

Christison, Sir Eobert, references to, 58, 716, 719, 
849 

Chrome alum, action of, on bacteria, 98 

Chromic acid, action of, on bacteria, 98, 100 ; as a 
caustic, 304; characters and action of, as a dis- 
infectant and caustic, 486 

Chromium, symbols and atomic weight of, 36 

Chrysarobin, characters and uses of, 765 

Chrysarobinum, 430 

Cicutine, as an antisialic, 318 

Cicutoxine, action of, on the accelerating centre, 
279; on the vaso-motor centre, 279 



Cimicifuga (black snakeroot), characters and 
composition of, 703 ; action and uses of, 703 ; as 
a stomachic, a cardiac tonic, and an expecto- 
rant, 704 
Cinchona bark and its alkaloids the chief anti- 
periodics, 108; the former almost a specific in 
intermittent fevers, periodic headaches, neu- 
ralgias, &c, 109 ; cinchona alkaloids and their 
salts, 799 ; action and uses of, 801 
Cinchona, characters, &c, of, 794 
Bark, pale, 794 
Red, 795 
Yellow, 794 
Calisaya bark, yellow, 794 
Properties and composition of the cinchona 
barks, 795 ; physiological action of, 799-801 ; 
uses of, 801 
Cinchonacea, 793, 799 
Cinchonea?, 793 
Cinchonidina, 430, 799 
Cinchonidine, an antiperiodic, 108 ; sulphate of, 

799 
Cinchonina, 430, 799 

Sulphas, 799 
Cinchonine, 798 

Action of, on oxidation, 79 ; on the blood, 81 ; 
as an antiperiodic, 108 ; action of, on mus- 
cle, 125 
Sulphate of, 798 
Cinnamic acid, action of, on bacteria, 99 ; on the 

kidneys, 377 
Cinnamon and oil, as a carminative, 330 
Cinnamon, characters and composition of, 861 
Aromatic powder of, 861 
Bark, 861 

Powder, compound, 861 
Oil of, 861 ; as a carminative and an astrin- 
gent, 862 
Circulation, action of drugs on the, 229-300 ; 
nature of the, in the arteries and veins, 229 ; 
effect of blood-pressure on the, 229; arrest of 
the, causes fainting and shock, 230 ; schema of 
the, 232, 233 ; diagram illustrative of this, 232 ; 
nature of the, in the living body, 233 ; effects of 
variation in blood-pressure on the, 234 ; method 
of ascertaining this, 234; alterations in blood- 
pressure in the, 236 ; relation of pulse rate and 
arterioles to blood-pressure in the, 237-242 ; dia- 
gram of the, 241 ; method for maintaining arti- 
ficial, in the rabbit's ear, 245 ; in the frog, 244 ; 
method of measurement of the, by the rate of 
flow, 246-248 ; action of potash salts on the, 508 ; 
of strong solution of ammonia, 512 ; of the heavy 
metals, 563; of the salts of iron, 564; of anti- 
mony, 615 ; of alcohol, 651 ; and on the cranial, 
652 ; of the spirit of ether, 663 ; of chloral hy- 
drate, 672; of" salicylic acid, 693; of anemonin, 
702; of opium, 719-724; of pilocarpine, 751; of 
strychnine, S22 ; of belladonna or atropine, 837 ; 
of tobacco, 842 ; of veratrine, 897 ; ofcolchicum, 
897 ; of extract of ergot, 910 
Citrate of bismuth, 623; and ammonia, 623 
Iron, 637 

and ammonia, 635 
Ammonium, 635 
Magnesium, 339 
Quinia, 636 
Quinine, 636 
Strychnine, 636 
Lithia, 535 
Potash, 510 
Citrates, test for, 496 
Citric acid, properties of, &c, 4S5 ; syrup of ditto, 

485 
Citrine ointment, 592 
Citro-tartrate of soda (effervescent), 528 
Clover, Mr., his plan of administering chloro- 
form, 681 
Cloves, characters, action, and use of, 778 ; as a 

carminative, 778 ; oil of, 778 
Cloves and oil, as a carminative, 330 
Clysters, injections, or enemas, 433 
Coal gas, as a poison, with its antidotes, 417 
Coats, reference to, 245 

Cobalt, symbol and atomic weight of, 36 ; physio- 
logical action of, 50 ; causes slight contraction 
of the vessels, 246 



942 



GEXEEAL IXDEX. 



Cobra poison, action of, on the infusoria, 75 ; con- 
vulsions caused by, 174 
Coca. See Erythroxylon 

Cocaine, action of, on muscle, 125 ; antagonism of, 
to morphine, 422-424; characters, action, and 
uses of. 732-734: as a local anaesthetic, 732, 733; 
action of. on the nerve centres in man, 733 : is 
said to lessen fatigue, 733 ; on animals, on the 
spinal cord, the respiration, the pulse, blood- 
pressure, and temperature, 733 ; use of, 733 
Coccus, 924 

Cochineal. 024; its characters and uses, 924 
Codeina. 429 

Codeine, action of, on oxidation, 79 ; antagonism 
of. to chloral. 420-425 : characters of, 714 ; action 
of. on the nerves and abdominal viscera, 714; 
on the spinal cord and motor centre in the 
brain. 714: uses of, 715; action and use of, in 
diabetes. 715 
Codeines, artificial. 772 

Cod-liver oil, one of the most efficient expecto- 
rants. 226: great virtue of, in chronic-bronchitis, 
226; a powerful hreniatinic, 358; as an altera- 
tive, 358 ; as an indirect emmenagogue, 391 ; 
character, composition, physiological, and ther- 
apeutic action of, 921-923 
Correct. 802 

Coffee, composition, action and use of, 803 
Colchici radix. 897 
Collodion cum cantharide, 925 
Colchicine, action of, on the respiratory centre, 
215: as a hepatic stimulant, 351, 353; as an 
alterative, 358 ; used in gout, 361 : as a refriger- 
ant diuretic. 374: as a poison, with its antidote, 
419 
Colchicum corm, 897 
Root. 897 
See<l. 897 

Seeds, 897 ; general action of, 898 ; special ac- 
tion of, on the skin, brain, and spinal cord, 
on the sensory and motor nerves and 
the muscles, 899 : on the circulation and the 
secretion of urine, 899; uses of, 899; treat- 
ment in poisoning by, 899 
Cold, effects of, on the action of drugs, 59-62 ; on 
protoplasmic movements, 70; on the action of 
infusoria. 75; on muscle, 117, 121, 133; extreme, 
as an anaesthetic, 146 ; on the action of strych- 
nine. 162, in preventing and inducing sleep, 
1^1 : as a local anodyne, 183; applied to the sur- 
face of a painful part, relieves the pain. 185; 
one of the chief local anesthetics, 186; action 
of. on the respiratory centres, 214; in causing 
congestion, 225 ; apparatus for ascertaining the 
effect of, on the vessels of the frog's lung, 246; 
instrument for showing the action of, on the 
frog's heart, 265; one of the most powerful of 
va-eular and cardiac sedatives. 300; action of, 
on inflammation. 301; diagram to show the 
effects of, in Lessening the pain of inflammation, 
303; as an antipyretic 362, 364 ; local application 
of. 399 
Cold bath, as an anaphrodisiac. 388; various uses 
of. and ri>ks attending, 396-398 
Compresses. 400 
Douche, use-ending, 399 

Spinal 399 
Douches, 399 
I OOt hath, 400 
Pack. 398 
Coleoptera, 925 

Collodion, as a demulcent, 307 : and a styptic, 309 
(olio. hon. characters, action, and uses of, 730 
< antharidal, 736 
Flexible 5 
Btyptic, 736 
Collodion. . B2 
Collodion, . 132, 661 

Cum cantharide, 182, 736 
Flexile, 432, 661, 736, B68, 882 
Stypticum, 132, 786, s;,; 
Colocynth, 782 

■itii a- a drastic purgative. 389; as a hepatic 
stimulant, 851, 853: cofocyntb pulp, composi- 
tion, action, and therapeutics of, 782, 783; a 
powerful cathartic and diuretic. 782, 788 
( oiogne water, tor perfuming, 789 



Colophony, 884 

Coma, condition of the veins and brain during. 
179 B 

Compound radicals, nature of, 47 ; most of them 
possess a paralyzing action on the motor nerves, 
50 

Condurango, characters, action, and uses of, 829 

Confectio opii. 432, 709, 758, 791, 870, 900 
Piperis. 432, 791, 870, 923 
Rosa?, 432, 773, 923 

Caninae, 432, 773, 906 
Gallica?, 402, 773, 906 
Scammonii, 432, 779, 791, 832, 990, 923 
Senna?, 432, 757, 766, 776, 792, 879, 906 
Sulphuris, 432, 461, 511 
Terebinthina?, 432, 751, S83, 923 

Confection of sulphur, mode of preparing, 461 

Confections, electuaries, or conserves, 432 

Congestion of the internal organs arising from 
cold, 224 ; utility of vascular stimulants in, 293 

Conifene. 882 

Confine, effects of, on oxidation, 79 ; action of. on 
the spinal cord, 150 ; as a general anodyne, 183 ; 
on the inhibitory powers of the vagi, 274. See 
Hemlock 

Conium, as a local and general anodyne, 183; the 
vapor of, has a local sedative action on the 
lung, 223 ; as an anaphrodisiac, 388 ; as a poi- 
son, with its antidotes, 419 ; nature, actions, 
and uses of, 786, 787 

Conjunctiva of the eve, action of drugs on the, 
196 

Constipation, the cause of, and remedies for, 335 ; 
diagram to show how ovarian irritation proba- 
bly causes, 336 : action of opium in, 336 ; and of 
small doses of belladonna, 336 

Contraction of the pupil of the eye, origin and 
nature of, 200 

Convallamarin, as a cardiac tonic, 293 

Convallaria majalis, as a cardiae tonic, 293 

Convolvulacete, 831 

Convulsions produced by poisoning, 53: and by 
strychnine and other drugs acting on the 
spinal cord, 158-167 ; by the absence or excess 
of oxygen, 162 ; whether convulsions are caused 
by the action of poison on the brain or the 
spinal cord, 105 ; certain drugs, when taken, 
are the cause of, 172 ; they are usually of spinal 
or cerebral origin, 172 ; asphyxial convulsions, 
173; experiments to ascertain whether they 
are asphyxia! or not, 173: excitement of the 
respiratory centre causes. 212 : asphyxial, only 
occur in warm-blooded animals, 212; carbolic 
acid produces convulsions in frogs, 688 

Copaiba, as a stimulant diuretic, 374 ; value of, in 
inflammation of the bladder, 385 

Copaiva, characters, &c, of, 70S ; balsam of, 768 ; 
oil of, characters, action, and uses of, 769 

Copper, sources, reactions, uses, &c, of, 572 
Acetate of, 574 

Test solution of, 574 
Subacetate of, 573 
Sulphate of, 573 

Anhydrous, 573 

Test 'solution of ammonio-, 573 

Copper sulphate, action of, on enzymes, SO; on 
bacteria, 98 ; on annulosa, 116; as a caustic, 
304, 573: as an astringent, 308; as a local 
emetic, 326; character, action, and uses of, 
573, 574 

Copper, symbol and atomic weight of, 36 ; phys- 
iological action of, 51; action of, on muscle, 
121 etseg.; causes powerful contraction of the 
vessels, 246 ; double salts of, action of, on the 
cardiae muscle, 281; on tin" capillaries. 282; 
as a poison, with its antidote, 419, nature, ac- 
tion and uses of, 572-574 

Coriander and oil, as a carminative, 330 

Coriander, characters of, 792 
Fruit, 792 
on of, a carminative and stimulant, 792 

Cornacea-, 79:; 

Cornea, chief drugs employed in disease of the, 
196 : action of alum on, 190, 557 

Corn smut, 9] ] 

ComUS. characters and action of, 793 

Coroutine, 909 



GENERAL INDEX. 



943 



Corolliflone, 793 

Corrosive chloride of mercury, 589 
Corrosive sublimate, action of, on infusoria, 75; 
on enzymes, 85-87 ; on bacteria, 93, 96, 98, 100 ; 
extraordinary destructive power of, might be 
useful in destroying bacilli, 104 ; owes its cura- 
tive power in cases of infantile dysentery to 
its antiseptic action, 107 ; the only trustworthy 
disinfectant for destroying septic organisms, 
108 ; as a poison, with its antidotes, 419 ; nature 
and uses of, 589 : one of the most powerful 
antiseptics known, 5S9 ; use of, in cholera, 589 ; 
poisoning by, and treatment for, 589 
Coto alkaloids, action of, on the intestines, 337 ; 
Albertoni's investigations regarding the action 
of the, 337 
Coto bark, composition, action, and uses of, 862 ; 

paracoto bark, 862 
Cotoine, action of, on the intestines, 337 
Cotton, gun, preparation and uses of, 735 

Hoot bark, characters, action, and uses of, 

734 
Peed oil, characters and uses of, 734 
Wool, what derived from, 735 
Couch-grass, as a demulcent, 904 
Cough, chest and stomach, cause of, remedies for 
and general treatment of, 220-228 ; diagram of 
the afferent nerves by which it may be ex- 
cited, 221 ; action and use of expectorants in, 
223-227 ; of emetics, 228 ; of warmth and mois- 
ture, 228 ; of respirators, 228 ; of warm clothing, 
friction, liniments, poultices, and plasters, 228; 
action of lactucarium in allaying, 811 
Cowling, Dr., his rule for dosage, 426 
Cramps of the muscles, cause and general treat- 
ment of, 193, 194 
Cranesbill, 730 
Cranial circulation, 176 ; action of| alcohol on 

the, 632 
Cream of tartar, nature and uses of, 511 
Creasote, action of, on infusoria, 75; no effect on 
ptyalin, 85 ; on enzymes, S6, 87 ; on yeast and 
bacteria, 87 ; as a loc;il anodyne, 183 ; as a rem- 
edy for toothache, 311 ; as a local sedative, 328; 
as "a poison, with its antidote, 419 ; characters, 
tests, and preparations of, 690 ; action of, as a 
muscular poison, 691 ; on the blood, skin, and 
mouth, 691; oh the pulse, respiration, and 
urine, 691 ; uses of, 691 
Croix, N. de la, results of his experiments with 

different drugs on bacteria, 95, 96 
Croton chloral, action of, on the vagus centre, 

279; character, action, and uses of, 673 
Croton oil, as a pustulant, 304; as a drastic pur- 
gative, 339 ; as a poison, with its antidote, 419 ; 
action of, externally and internally, 868 ; use 
of, ditto, 868 ; treatment of poisoning by, 868 
Cruciferse, 726 

Crum-Brown, reference to, 143/i., 722«. 
Crumb of bread, 903 
Crvptogams (sub-kingdom II.), 907-912; filices, 

907 ; lichens, 907 ; fungi, 908 ; alga?, 912 
Cubeb. oleoresin of, preparation, action and uses 

of, 872 ; as a stimulant and diuretic, 872 
Cubeha, 871 

Cubebs, as a sialagogue, 314; as a stimulant diu- 
retic, 374 ; characters and composition of, 
871 
Oil of, 871 
Cucumher fruit, squirting, 784 
Cucurbitacete, 782 
Culver's root. See Leptandra 
Cumarin, action of, on the cardiac muscle, as an 

antipyretic. 281 
Cupping, wet, 363 
Cupulifene, 874 

Curare, physiological action of, on the motor of 
efferent nerves, 48 ; when applied externally 
and internally, 52, 53 ; opposite effect of, when 
differently administered, 55 ; effects of, on the 
blood, 82 ; on mollusca, 93 ; on muscle, 114, 125, 
140, 141 ; list of drugs which have a similar 
action to, on the motor nerves, 142, 143; on 
the muscles of respiration, 213 ; on the vaso- 
motor nerves, 249 ; on the inhibitory power of 
the vagi, 274, 275 ; on the vagus ends in the 
heart, 2S0 ; on the nerves of the salivary gland, 



313 ; action of the liver on, 352 ; as a poison, 
with its antidote, 419 ; characters, composition, 
and action of, 826: on the motor nerves, vagus, 
and sensory nerves, 826 ; on the spinal cord, 
muscles, and vessels, 826 ; on the blood-pres- 
sure and on salivation, 826; effects of, on the 
general system, 826 ; uses of, 826 
Curd soap, 914 * 

Cyanide of potassium, action of, on medusae, 112 ; 

as a poison, with its antidote, 419 
Cyanide of silver, 577 ; of mercury, 593 
Cyanogen, action of, on the motor ganglia, 280 
Cydonium, characters and use of, 771 
Cypripedium, characters and use of, as an anti- 
spasmodic, 899 



D. 



Da Costa, Dr., reference to, 300 
Dandelion protoplasm, experiment with, on oxy- 
gen, 78, 79 
Dandelion root, characters and action of, 810 ; on 

the liver, and as a diuretic, 810 
Dastre, reference to, 243, 262 
Daturine, as a mydriatic, 198 ; action of, on the 
vagus centre, 279; on the vaso-motor centre, 
279; on the inhibitory ganglia, 280; antagonism 
of, to morphine, 422-425; nature, action, and 
use of, 842 
Davy, Sir H., split up some supposed elements 
into oxygen and a metal, 37 ; his observation 
on the properties of nitrous oxide, 192 
Decoction of lemon, as an antiperiodic, 740 
Decoctions, 432 

Decoctum, aloes compositum, 432,756, 757, 891,902 
Cetrarise, 432, 907 
Cinchonse flava?, 432, 795 
Granati radicis, 432, 782 
Hsematoxyli, 432, 765, 861 
Hordei, 432, 904 
Papaveris, 432, 708 
Pareira?, 432, 707 
Quercus, 432, 875 
Sarsse, 432, 888 

Sarsse compositum, 432, 745, 757, 864, 88S 
Sarsaparilhe compositum, 432, 745, 864, 889 
Scoparii, 432, 758 
Taraxaci, 432, 810 
Ulmi, 432, 87S 
Delirium tremens, cause, symptoms, and treat- 
ment of, 654, 655 
Delphinine, action of, on the frog's heart, 270; on 
the accelerating centre, 279; on the vaso-motor 
centre, 279 ; nature, action, and use of, 702 
Demulcents, nature, action, and therapeutic uses 
of, 306-308 ; linseed as a demulcent, 729 ; liquor- 
ice root as a demulcent, 757 ; gum, acacia or 
arabica, as a, 770 ; quince seed as a, 771 ; sassa- 
fras pith as a, 865 ; elm as, 878 ; triticum as, 904 ; 
Iceland moss as, 908; chondrus as, 912 
Deodorizers, or deodorants, nature and action of, 
105, 108 ; iodoform as a, 682 ; carbolic acid as a, 
688 
De?mobacteria, 90 
Dew- Smith, 7-eference to, 115ra. 
Diabetes, action of codeine in, 714 
Diaphoretics, action of, on the secretion of sweat, 
370 ; antimony as a diaphoretic, 617 ; eupato- 
riurn as a, 810 ; ipecacuanha as, 803 ; asclepias 
as a, 829; melissa or balm as, 856; origanum as, 
856 ; camphor as, 863 ; oil of sassafras as, 865 ; 
serpentary root as, 866 
Diarrhoea, astringents have a powerful effect in 

checking, 309 
Diastase, 84 

Dickinson, reference to, 851 
Didymum, symbol and atomic weight of, 36 
Diedrich, references to, 720n., T21n. 
Diediilin, reference to, 143 
Digestive system, action of drugs on the, 
310-355 ; on the teeth, 310 ; on the saliva, as 
sialagogues, 311-317 ; on thirst, as refrigerants, 
317 ; on the salivary secretion, as antisialics, 318 ; 
on the appetite, as gastric tonics, 318-322 ; on 
acidity, as antacids. 322 ; on vomiting, as emet- 



944 



GENERAL IXDEX. 



ics, 323-328 : on the stomach, as gastric seda- 
tives, 32S ; on the gases of the stomach, as car- 
niinatives, 329, 330 ; on the intestines, 330-33S ; 
as purgatives, 338-344; as irritant poisons, 344- j 
347 : on the liver, 347-355 ; on the pancreas, ; 
354; on the intestines, as anthelmintics, 355 

Digestive tract, application of drugs to the, 413- ! 
416 : by the mouth and pharynx, 413 ; as nias- 
ticatories, 413 ; as gargles, 413 ; by the stomach, 
414 : by the stomach-pump, 414 ; by the gastric 
syphon, 414 ; to the intestine, 415 ; as enemata, 
415; as suppositories,. 415 ; action of opium on i 
the, 723; action of digitalin on the, 847 

Digestives, when necessary, 357 

Digitaliu, effects of, on medusa?, 112 ; action of, j 
on the vision, 205 ; on the frog's heart, 271 ; on 
the vagus centre, 279 ; on the cardiac muscle, i 
281 ; as a cardiac tonic, 293 ; antagonistic action 
of, 423, 424 : preparation and characters, 844 ; I 
chemistry of, 845 ; general action of, 845 ; spe- 
cial action of, on the muscles, nervous system i 
and spinal cord, S45 ; on the brain, respiration, 
and blood-pressure, 845, S46 ; on the heart and 
arterioles, S46 ; diagram of a pulse-wave before 
and after injection of, in a dog, 846; on the 
vagus roots and ends, 846 ; peculiar action of, | 
on the frog's heart. 84/ ; on the digestive organs 
and the urine, 847 ; effect of temperature on 
the action of, 847 ; diagram showing effects of 
rise of temperature alone, S48 ; ditto, showing 
effects of rise, after injection of, 848 ; ditto, 
showing action of, after temperature, 849 ; ac- 
tion of different preparations of, 849 ; uses of, 
850 ; precautions, 851 : treatment of poisoniDg 
by, 851 

Digitalinum, 430, 844 

Digitalis, effect of varied quantities of, on the 
pulse, 54; cumulative action of, 58; has some- 
times no action on the pulse in pneumonia, 61 ; 
acts differently on the heart of a frog from that 
of mammals, 66; action of, on oxidation, 79; on 
mollusca, 114 : action of, on the brain, 180 ; as a 
cardiac tonic, 223; as a vascular tonic, 226; 
diagram showing the blood-pressure and form 
of the pulse-wave before and after the injection 
of, in the dog, 242 : on the vagus centre, 279 : on 
the cardiac 'muscle, 281; on the capillaries, 
2^2 : on the heart, as a cardiac tonic, 293-295 ; 
the question of the use of, in aortic regurgita- 
tion considered, 295 : caution to be observed in 
the use of, as a cardiac tonic, 297 ; as a vascular 
tonic, 297 ; as a sedative, 300 ; as a styptic acting 
on the blood vessels, 309'; has the power of 
lessening or arresting haemorrhage, 310 ; as a 
general emetic, 326 ; experiment with, on blood 
pressure, 372 ; as a refrigerant diuretic, 374 ; 
as an anaphrodisiac, 388 ; as a direct emmena- 
gogue, 390 ; as a poison, with its antidotes, 419 ; 
antagonism of, to other drugs, 422-425 

Digitalis (foxglove), characters, &c, of, 844 
Leaf, 844 

Digitin, composition of, 8 15 

Digitonin, composition of, 845,849 

Digitoxin, composition or, 845; action of, on the 
cardiac muscle, 2S1 ; as a cardiac tonic, 294. See 
Digitalis 

Dilatation of the pupil of the eye, origin and 
nature of, 199, 200 

Dilator muscle of the iris, nature and functions 
of, 197 

Dill, as a stimulant diuretic, 374 

I 'ill and oil, a> a carminative, 330 

Dill, fruit, characters and use of, as a carmin- 
ative, 790 
Oil of, 790 

Dimethyl-confine, 787 

Diosmese, 747 

Diseases caused by mould fungi, 90; by bacteria, 91 i 

Disinfectants, ELoch's experiments on bacteria 
with, 97-lul: nature and action of, 105, 108; 
super-heated steam the best disinfectant under 
ordinary circumstances. 108; borax as a disin- 
fectant, 529; carbolic acid as a, 688; thymol as, 
354 

Distilled water, action of, on bacteria, 98; and 
calcium salt, on tin; frog's heart, 270; as a 
Uthontriptic, :;77 



Diuretics, nature and mode of action cf, 372 ; list 
of refrigerant and stimulant, 373 ; uses of, 375 ; 
adjuvants to, 375 ; alkalis as, 502 ; iodide of 
ethyl as a diuretic, 669 ; caulophyllum as, 708 ; 
caffeine as a, 743 ; tansy as, 808 ; dandelion root 
as, 810 ; uva ursa as, 815 ; chimaphila as, 815 ; 
benzoic acid as, SIS ; serpentary root as, 866 ; 
thuja as, 8S7 ; oil of juniper as, 887; sarsapa- 
rilla as, 889 ; garlic as, 889 ; squill as, 890 

Dogiel, reference to, 251ra., 259 

Dog-rose, fruit of the, 773 

Dogs, experiments with drugs on, 66, 67; Magen- 
die's series of experiments on the action of 
strychnine on the reflex powers of the spinal 
cord of, 163 et seg. ; easiest way of anesthetizing, 
191 ; diagram of a stopcock by which air or va- 
por, or two kinds of gas may be given to, 191; 
diagram showing the blood-pressure and form 
of the pulse-wave before and after the injection 
of digitalis in, 242; action of the heart in, 252;, 
difference between rabbits and, in this respect, 
253 ; cause of the stoppage of the heart in, 261 ; 
effects of large doses of opium injected into, 
335 ; diagram of a pulse-wave before and after 
injection of digitalis in, 846; action of, on, 847 

Dogwood, 793; dogwood quinine, 793 
Jamaica, action and use of, 769 

Donaldson, reference to, 846 

Donovan's solution, 612 

Dosage, the rules which affect correct, 426 

Dose, nature, size, and effects of a, on the sys- 
tem, 54, 55 ; rules which regulate the amount of 
a, for children and adults, 426 ; Dr. Young's 
rule, 426; Dr. Cowling's, 426; the author's pro- 
posed modification of Dr. Cowling's, 426 

Douche, nasal, diagram of a, 410 

Douches, cold, nature and uses of, 399 ; the spinal, 
399 ; the ascending, 399 

Dover's powder, as a vascular stimulant, 292, 293 ; 
as a sudorific, 364 ; in combination with mer- 
cury, 5S5 ; ten grains of, useful when a cold is 
coming on, 723; will cause diaphoresis, 724 

Dropsy, the pathology of, 297-299; diagram of 
RanVier's experiment on, 298; the principal 
causes of, 297 ; and drugs that are useful in, 
298, 299 ; usefulness of upward friction in, 304 

Drugs, reaction between, and the various parts of 
the body, 34; changes undergone by, in the 
body, 34; physiological action cf, depends 
chiefly upon their power of acting on one 
tissue or organ first, 48; the effects produced 
by large and moderate doses of veratrine on 
the frog an example of this, 48; effect of artifi- 
cially modifying the chemical constitution of, 

50, 51 ; CIRCUMSTANCES WHICH AFFECT THE AC- 
TION of, on the organism, 52-67 ; direct and 
indirect action of, 53 ; local and remote action 
of, 53 ; relation of effect to quantity employed, 
53; the doctrine of homoeopathy in, 54; the 
dose, 55; size, 55 ; and mode of administration 
of, 55 ; difference betwixt venous and subcuta- 
neous injection and absorption by the stomach, 
55-57 ; action of the liver on, 56 ; absorption 
and excretion of, 56, 57 : cumulative action of, 
57; effect of different preparations of, 58; of 
fasting on the action of, 58; of habit, 58; of 
temperature, 59 ; effect oi temperature on the 
action of, on the spinal cord, 61 ; the proper 
definition of the action of, is the reaction be- 
tween them and the various parts of the body 
at a certain temperature, 61 ; effects of climate 
on, 62 ; time of day, 62 ; season, 62 ; and disease, 

63 : use of experiments in the administration 
of, 63 ; effects of idiosyncrasies on the power of, 

64 ; objections to experiments, 05 ; difference in 
the effect of, on men and animals, and on dif- 
ferent animals, 65-67; erroneous deductions 
from, 67 ; ACTION OF, ON PROTOPLASM, BLOOD, 

and low organisms, 68-109 ; on albumen, OS ; 
on protoplasmic movements, 70-73; on infuso- 
ria, 73-75 ; relations of motion and oxidation 
to, 75-7H; action of, on oxidation, 7:> : on the 
blood, 79-82; on enzymes, 85-87 ; on the move- 
ments of bacteria, 93; on the reproduction of 
bacteria in general, 93; and on the destruction 
of the germs, 94; table of the comparative aC- 
Uon of different, on bacteria, 95,96; action of, 



GENEKAL INDEX. 



945 



on particular species of, 97; mode of experi- 
menting on the action of, on the reproduction 
of bacteria, 97 ; Koch's experiments with three 
groups of disinfectants on bacteria, 98, 99; 
action of, on the development and growth of 
bacilli, 99; strength of various disinfectants re- 
quired to prevent the development of anthrax 
bacilli, 100; effect of, on the action of bacteria 
in the animal body, 104; action of, on inver- 
tebrata, 109-116; on the medusae, 109-114; on 
mollusca, 114; on ascidians, 114; on annulosa, 
115 ; on muscle, 116-138 ; on voluntary muscle, 
116 ; as poisons to the muscles, 124-128 ; the ac- 
tion of, on muscle is voluntary, not absolute, 
131; on in voluntary muscular fibre, 132; hypo- 
thetical considerations regarding the action of, 
on . muscles, 136 ; on nerves, 138-147 ; on mo- 
tor nerves, 138 ; on motor nerve-endings, 140 ; 
on the trunks of motor nerves, 144 ; on sen- 
sory nerves, 144 ; on the peripheral ends of sen- 
sory nerves, 147; on the spinal cord, 147- 
167 ; on the conducting power of the cord, 147 ; 
on the reflex action of the cord, 148-151 ; di- 
rect, indirect, and inhibitory paralysis of the 
cord by, 151-158 ; explanation of the action 
of certain drugs on a given hypothesis, 158- 
163 ; stimulating action of, on the reflex pow- 
ers of the cord, 163-167 ; on the brain, 167- 
196 ; depressant action of, on the motor cen- 
tres, 171 ; irritant action of, on motor centres 
in the brain, 172 ; action of, on the sensory and 
psychical centres in the brain, 175-196 ; drugs 
which increase the functional activity of the 
brain, 176 ; nerve stimulants, 176 ; cerebral stim- 
ulants, 176 ; which lessen the functional activity 
of the brain, 178; hypnotics, or soporifics, 179; 
narcotics, 182; anodynes, or analgesics, 183; 
anaesthetics, 185-193; antispasmodics, 193; ac- 
tion of drugs on the cerebellum, 195 ; ON the 
organs of special sense, 196-207 ; on the eye, 
196 ; on the conjunctiva, 196 ; on the lachrymal 
secretion, 196; on the pupil, 197-201; on ac- 
commodation, 201 ; on intra-ocular pressure, 
202 ; on the sensibility of the eye, 204 ; in pro- 
ducing visions, 204 ; on hearing, 205 ; on smell, 
206; on taste, 206; on respiration, 207-228; 
action of, when injected into the jugular veins, 
213 ; on the respiratory centre, 214-218 ; on the 
respiratory nerves, 218-228 ; on the circula- 
tion, .229-300; method of ascertaining the 
action of, on the circulation, 234-236 ; diagrams 
illustrative of this, 238-242; investigation of 
the action of, on the arterioles, 243-246 ; another 
method of ascertaining the action of, on the 
blood vessels, 246-248 ; action of, on the vaso- 
motor and vaso-dilating nerves, 248 ; on reflex 
contraction of vessels, 251 ; as the cause of al- 
teration in blood-pressure and pulse rate, 257 ; 
on the pulse rate, 259 ; on the cardio-inhibitory 
functions of the vagus, 260 ; on the reflex stim- 
ulation of the vagus, 261 ; on vagus roots, 261 ; 
on the heart of the frog, 263-269 ; on the mus- 
cular substance of the heart, 269-273 ; on the 
vagus in the frog, 273 ; on inhibition of the 
heart, 274, 275 ; theories regarding the mode of 
action of, upon the heart, 275-278 ; diagram to 
illustrate the action of, on the various parts of 
the circulatory apparatus, 278 ; on the vagus 
centre, 279; on the accelerating and vaso- 
motor centres, 279 ; on the vagus ends in the 
heart, 280 ; on the inhibitory and. motor ganglia, 
280; on the cardiac muscle, 281; on the vaso- 
motor nerves, 281 ; on the capillaries, 282 ; 
various experiments with, on the heart of a 
frog, 282-291 ; therapeutic use of, acting on the 
circulation, 291-300 ; as cardiac stimulants, 291 ; 
as vascular stimulants, 292; as cardiac tonics, 
293-297; as vascular tonics, 297; as cardiac 
sedatives, 299 ; as vascular sedatives, 300 ; 

ACTION OF, ACTING ON THE SURFACE OF THE 

body, 301-310; as irritants and counter-irri- 
tants, 301-306; as rubefacients, 304,305; as 
vesicants, 305 ; as pustulants and caustics, 305, 
306 ; as emollients and demulcents, 306-308 ; as 
astringents, 308, 309; as styptics, 309, 310; 

ACTION OF, ON THE DIGESTIVE SYSTEM, 310-355 ; 

on the teeth, 310 ; as sialagogues, 311-317 ; as 

60 



refrigerants, 317 ; as antisialics, 318 ; as gastric 
tonics, 318 ; on the secretion of the stomach, 
320 ; on the movements of the stomach, 321 ; 
as antacids, 322 ; as emetics, 323-328 ; as gastric 
sedatives and anti-emetics, 328 ; as carmin- 
atives, 329, 330 ; action of, on the intestines, 
331-355; on absorption from the intestines, 
336 ; as intestinal astringents, 337 ; as purga- 
tives, 338-344; as irritant poisons, 344-847; 
action of, on the liver, 347 ; as hepatic stim- 
ulants, 350 ; as cholagogues, 351-355 ; as hepatic 
depressants, 354; action of, on the pancreas, 
354 ; as anthelmintics, 355 ; ON tissue change, 
356-364 ; as tonics, 356 ; ON excretion, 364- 
385 ; on the kidneys, 364 et seq. ; as diuretics, 
372-375; as albuminuria, 375 ; as lithontripties, 
376 ; on the skin, as diaphoretics and sudorifics, 
377-381 ; as antihydrotics or anhydrotics, 381- 
383; on the bladder, 383-385; on the genera- 
tive syst M, 386-393; as aphrodisiacs and 
anaphrodisiacs, 386-890 ; as emmenagogues 
and ecbolics, 390-392; upon milk, 392, 393; 
methods of administering, 393-416 ; by the 
skin, 393 et seq. ; as baths, 395 ; cold baths, 396- 
401 ; warm baths, 401 ; medicated baths, 403 ; 
vapor baths, 404 ; air baths, 404 ; friction and 
inunction, 405 ; endermic application of, 407 ; 
hypodermic administration of, 407 ; application 
of, to the eye, 409 ; to the ear, 409 ; to the nose, 
410 ; to the larynx, 411 ; to the lungs, 412 ; to 
the digestive tract, 413 ; to the urethra, 415 ; to 
the vagina and uterus, 415 ; as antidotes, 416- 
421 ; antagonistic action of, 422-425 ; table 
showing the antagonism of, 425 

Drunkenness, general effects of, 651 et seq,; causes 
and treatment of, 654 

Dryadese, 771 

Duboisine, action of, as a mydriatic, 198 ; on the 
respiratory centre, 215 ; on the inhibitory gan- 
glia, 280 

Dujardin-Beaumetz, reference to, 874 

Dulcamara, characters, action, and uses of, 834 ; 
action of, on the nervous system, heart, respi- 
ration, and temparature, 835 ; as an alterative, 
835 

Dumas, M., points out a curious relationship 
between the potassium and the lithium group 
of elements, 43 

Dyad metals, 546 et seq. 

Dyspepsia, atonic, slight stimulants produce ap- 
petite in, 319 

Dyspnoea, nature and cause of, 212-214 ; action of 
aconitia on, 699 



E. 



Ear, various diseases of the, and their treatment, 
205 ; action of salicylic acid on the, 693 ; ap- 
plication of drugs to the, 409 ; diagram of a 
vulcanite syringe for injecting solutions into 
the, 410 ; action of pilocarpine on the, 749, 750 

Eau de Cologne, as a cardiac stimulant, 291 ; as a 
general stimulant, 739 ; uses of, in headache, 
fainting, &c, 655 

Ecbolics, nature and action of, 391 ; list of the 
chief, 391 ; uses of, 391 ; adjuncts to 392 

Eckhard, references to, 160ra., 161n., 249rc. 

Egg albumen, 920 
Yolk of, 920 

Elaterin, characters and action of, 784 ; a power- 
ful hydragogue cathartic, 7 5 ; action of, on the 
nervous system, 785 

Elaterium, as a drastic purgative, 340 ; and a 
hydragogue, 340 ; characters and composition 
of, 784 

Elder, characters and uses of, 793 
Flowers, 793 

Elecampane, 813 

Electricity, effects of, on the protoplasmic move- 
ments, 71 ; on the action of infusoria, 74 

Elements composing the earth, list of the, with 
their symbols and atomic weights, 35, 36, 37 ; 
nature of the, 37 ; recent spectroscopic re- 
searches prove them to be compounds, 37 ; 
dissociation of the, 38 ; spectrum analysis of 



946 



GENERAL INDEX. 



the, 38-41 ; evolution of the, 41 ; classification 
of the, 41; according to their atomic weight, 
41, 42 ; in groups, 42 ; iu series, 43 ; Mendel- 
ejeff 's classification, 45 ; differences between 
the even and the uneven series, 46 ; the class- 
ification in series not yet perfect, 46 ; general 
relations of the, 47-52 ; organic radicals, 47 ; 
chemical reactions of the, 47 ; physiological re- 
actions of the, 48 ; the latter divided into groups, 
4S; relation between atomic weight and physi- 
ological action, 49 ; between spectroscopic char- 
acters and physiological action, 49 ; connection 
between chemical constitution and. physiologi- 
cal action, 50 ; relation between isomorphism 
and physiological action, 51 ; Blake's division of 
the, into nine groups, according to their physi- 
ological action, 51 ; his classifications and con- 
clusions cannot be accepted as final, 52 
Elemi, nature and use of, 756 
Elixir aurantii, 433, 738 
Elixirs, 433 

Elm, characters and uses of, 878 ; as a demulcent, 
astringent, and tonic, 878 
Bark, 878 ; characters of, 878 
Embrocations, or liniments, 439 
Emetics, aid the action of antiperiodics, and 
sometimes cure ague without their aid, 109 ; 
powerful adjuncts to expectorants, 228 ; nature 
and action of, 323 ; divided into two classes, 
local and general, 326 ; the various uses of, 326- 
328; in simply emptying the stomach, 326; in 
expelling foreign bodies from it, 326; in re- 
moving the contents of it, 326 ; in removing 
poison from it, 327 ; and bile, 327 ; and obstruc- 
tions from the air passages, 327 ; contra-in- 
dications of, 328 ; anti, 328 ; salt as an emetic, 
525 ; alum as, 557 ; sulphate and acetate of zinc 
as, 568 ; sulphate of copper as, 304, 573 ; sub- 
sulphate of mercury as, 587 ; antimony as, 616; 
hydrochlorate of apomorphine as, 713 ; mustard 
as a prompt and direct, 728 ; ipecacuanha as an, 
804 ; Phytolacca root as, 859 ; iris as, 902 
Emetine, action of, on muscle, 125; as a depress- 
ant expectorant, 227; action of, on the cardiac 
muscle, 281 ; as a general emetic, 326 
Emmenagogues, nature and action of, 390; list of 
indirect and direct, 390, 391; caulophyllum 
as an emmenagogue, 708; oil of rue as an, 747; 
tansy as, 808; hedeoma or pennyroyal as, 855; 
origanum as, 856 
Emollients, nature, action, and therapeutic uses 

of, 306-308 
Emphysema, with copious secretion of mucus, a 
combination of morphine and atropine useful 
in, 223 
Empirical therapeutics, explanation and ex- 
ample of, 35 
Emplastrum Ammoniaci, 433, 789, 819 

cum Hydrargyro, 433, 
583, 597, 789, 819 
Arnica-, 443, 811, 819 
Asaf(X-Lid;e, 433, 597, 787, 788, S19 
Belladonna', 433, 819,836 
Calefaciens, 433, 860, 885, 924, 925 
Cantharidis, 433, S85, 914, 919, 924, 925 
Capsici, 433, 819, 835 
('(•rati saponis, 433, 483, 596, 819, 924 
Ferri, 433, 597, 631, 819, 885 
Galbani, 433, 597, 788, 819, 924 
Ilydrargyri, 433,583, 597, 819 
Icthyocolke, 433 



Opii, 433, 597, 709, 819, 885 
Picis, 133, 819, 



860, 882, 885, 924 
Burgundicse, 133, 885 
Canadensis, 433, 886 
(•mn Cantharide. 433, 885 
Plumbi, 433, 597, 819 

Iodidi, 433, 600 
Resinse, 4:;:;, 597, 819, 885 
Saponis, 133, 597, 819, 885 
Endermic application of drugs, 107 
Endocarditis, ulcerative, micrococci present in, 

103 
Endogense, 888 
Enema Aloes, 134, B91, 892 

Magnesia Bulphal is, 134, 819 
Opii, 134, 709 



Enema — 

Terebinthinae, 434, 883 
Asafcetidie, 434, 787 
Tabaci, 434, 842 
Enema of sulphate of magnesia, 560 
Enemas, injections, or clysters, 433 
Enemata, nature and uses of, 415 
Engelmann, reference to, 133 
Enzymes, nature of, 84 ; action of drugs on, 85 : 
functions of, 85 ; list of the chief, in the animal 
body, 85 ; method of ascertaining the action of 
drugs on, 85 ; table and diagram showing the 
different action of drugs on different, 86 ; meth- 
ods of liberating from zymogens, 87 ; alteratives 
supposed to alter in some way the action of, 358 
Epidermic application of drugs, 349 
Epsom salts, 560 

Erbium, symbol and atomic weight of, 36 
Ergot, action of, on the vaso-motor centre, 279; 
on the motor ganglia, 280 ; as a vascular seda- 
tive, 300 ; as a styptic acting on the blood-vessels, 
309; has the power of lessening or arresting 
haemorrhage, 310 ; as a direct emmenagogue, 
390 ; one of the chief ecbolics, 391 ; as a poison, 
with its antidotes, 419 ; its characters, compo- 
sition, and general action, 908 ; special action, 
909 
Ergot, extract of, its action on the nervous system, 
muscles, and sensory nerves, 910 ; on the circu- 
lation and heart, 910 ; on the vaso-motor system, 
respiration, and secretion, 910 ; on the alimen- 
tary canal and uterus, 911 ; therapeutics, 911 
Ergot of rye, 908 
Ergotinic acid, 909 
Ergotinin, 909 
Ergotism, symptoms of, 909 
Ericaceae, 814 

Erysipelas, caused by micrococci, 103 
Erythrophloein, as a cardiac tonic, 294 
Erythrophloeuui, state of the pulse and blood- 
pressure in a cat after division of ihe spinal 
cord and injection of, 239 ; action of, on the 
vagus roots, 260; on the caidiac muscle, 281; 
as a cardiac tonic, 294; diagram showing the 
effect of, upon the blood-pressure; and secre- 
tion of urine, 371 ; as a refrigerant diuretic, 374 
Erythroxylaceae, 732 

Erythroxylon (coca), characters and composition 
of, 732 ; action of, as a powerful local anaesthetic, 
732; on the nerve centres, respiration, pulse, 
and blood-pressure, 733 ; on mammals, 733 ; on 
the secretion of saline and sweat, 733; on the 
urine and temperature, 733 ; uses of, 733 
Escharotics, acids as, 475 
Esmarch, reference to, 679 
Essences, 434 
Essentia Anisi, 434, 790 

Mentha' piperita', 434, 853 
Ether, action of, on bacteria, 98; on annulosa, 
115; on muscle, 124 et seq.; on psychical pro- 
cesses, 175; nature of narcosis by, 185; first 
used as an amesthetic in dentistry, 192; as an 
antispasmodic, 194 ; action of, on the respiratory 
centre, 215; on the brain, 218; on the vaso- 
motor centre, 279; on the motor ganglia, 280; 
as a cardiac stimulant, 291 ; as a vascular stim- 
ulant, 292 ; as a rubefacient, 304 ; as a sialagogue, 
314; as a local sedative, 328; and acetic acid, as 
a carminative, 330 ; action of, on the vascularity 
of and absorption in the intestines, 336 ; its 
preparation, character and uses, 660; action of, 
on the skin, 662; mouth, stomach, and intes- 
tine, 662 ; cerebral hemispheres, spinal cord, 
and medulla oblongata, 662; muscles, nerves, 
and blood, 662; and heart, 662; dill'crence be- 
tween chloroform and, 663, 664 
Ether, simple and saline — 
Acetic, 661 
Amyl, nitrite of, 66 I 
Compound spirit of, 664 
Nitro-glycenne, glonoine, 668 
Oil of, 668 
Pure, 661 
Spirit of, 662 

Nitrous, 664 
Stronger, 661 
Ether spray as an anaesthetic, 146 



GENERAL INDEX. 



947 



Ethereal oils, action of, on bacteria, 104 

Ethyl, iodide of, preparation and characters of, 
669 ; action and uses of, as an anaesthetic, alter- 
ative, diuretic, antispasmodic, 669 ; mode of 
administration, 670 

Ethyl-atropine, action of, on the motor nerves, 
&c, 839 

Eucalyptol, action of, on bacteria, 100; as a disin- 
fectant, 108 ; and antiperiodic, 108 ; as a vermi- 
cide, 355 

Eucalyptus, character, action, and uses of, 781 ; 
oil of, 781 ; action of, as an antiseptic, 781 ; on 
the blood, spleen, and skin, 781 ; effects of, when 
swallowed, 781 ; action of, on the nerve centres, 
spinal cord, brain, medulla, and heart, 781 ; on 
the temperature, 781 ; how excreted, and uses 
of, 781 

Eucalyptus oil, action of, on enzymes, 86 ; on bac- 
teria, 96 ; use in blood-poisoning, 108, 781 

Eulenberg, references to, 57, 185 

Euonymin, as a cholagogue, 340; as a hepatic 
stimulant, 351 

Euonymus, wahoo, nature and action of, 753 ; acts 
as a hepatic stimulant, &c, 754 

Eupatorium, characters and use of, 810 ; as atonic, 
diaphoretic, emetic, and cathartic, 810 

Euphorbia, action of, on the nose, 219 

Euphorbiacese, 866 

Euphorbium, as a vesicant, 304 

Eustachian tube, the, some diseases of, and their 
treatment, 205 

Evolution of species and of elements, 41 

Ewald, A., reference to, 163 

Ewers, references to, 219, 260ra. 

Excretion, action of drugs on, 364-385 

Exogense, exogens, 697 et seq., 753 etseg., 882 etseq. 

Expectorants, nature and action of, 223-228 ; 
action of, on the secretions of the air passages 
and the mucous membranes, 224 ; on the expul- 
sive mechanism, 227; list of depressant, 227; 
of stimulating, 227; adjuncts to, 228; antimony 
as an expectorant, 617 ; cimicifuga (black snake- 
root) as an, 703; senega root as a stimulating, 
730; myrrh as, 756; balsam of Peru as, 760; 
balsam of Tolu as, 760 ; cheken as, 779 ; galba- 
num and ammoniacum as, 788 ; ipecacuanha as, 
802; benzoic acid as, 817; marrubium as, 855; 
cascarilla bark as, 866 ; garlic as, 889 ; squill as, 890 

Experiments, use of, 63 ; objections to, answered, 
65-67 ; erroneous deductions from, 67 ; mode of 
conducting, for examining the action of drugs 
on infusoria, 73; for testing the power of pro- 
toplasm over oxygen, 78 ; the action of drugs 
on oxidation, 79; the action of drugs on alco- 
holic fermentation, 88; on the movements of 
bacteria, 93 ; on the destruction of germs, 93 ; 
on the action of drugs on the reproduction of 
bacilli, 97 ; and on the development and growth 
of bacilli, 99 ; for testing the action of drugs on 
the motor nerves, 141 ; on the reflex action of 
the spinal cord, 151 ; on the respiratory centre, 
215 ; on the action of drugs on the circulation, 
231-234; on blood-pressure, 234-237; on the 
action of heat and cold on the frog's lung, 244 ; 
on the action of the heart on blood-pressure, 
258 ; on the heart of the frog, 263-268 ; Stannius's, 
on the action of the various cavities on the 
frog's heart, 282 ; Ranvier's, on dropsy, 298 

Expressed oil of nutmeg, 860 

Extract of ergot, 910 

Extract of malt, 905 

Extracts, 434 ; fluid or liquid extracts, 434; fresh 
or green extract, 437 

Extractum, Aconiti, 434, 437, 697, 698 
Fluidum, 434, 698 
Aloes aquosum, 434, 891 

Barbadensis, 434, 892 
Socotrinse, 434, 891 
Anthemidis, 434, 809 
Arnicse Radicis, 434, 811 

Fluidum, 435, 811 
Aromaticum fluidum, 435 
Aurantii amari, 435, 737 
Belse liquidum, 435, 741 
Belladonna, 835 

Fluidum, 434, 435, 436 
Alcoholicum, 434, 836 



Extractum — 

Brayerae fluidum, 435, 773 
Buchu fluidum, 435, 748 
Calami fluidum, 435, 903 
Calumbse, 706 

Fluidum, 435, 436, 706 
Cannabis Indices, 879 

Fluidum, 435, 436, 879 
Capsici fluidum, 435, 835 
Castanese fluidum, 435, 878 
Cheken fluidum, 780 
Chimaphilse fluidum, 435, 815 
Chiratse fluidum, 435, 831 
Cimicifugse fluidum, 435, 703 
Cinchonse, 795 

Flavse liquidum, 435, 795 
Fluidum, 435, 436, 795 
Colchici, 435, 436, 897 

Aceticum, 435, 436, 482, 897 
Radicis, 897 

Fluidum, 435, 436, 897 
Seminis fluidum, 435, 898 
Colocynthidis, 435, 782 

Compositum, 435, 783, 819, 834, 
891, 892, 901 
Conii, 786 

Alcoholicum, 435, 786 
Fluidum, 435, 436, 438, 786 
Cornus fluidum, 435, 793 
Cubebse fluidum, 435, 871 
Cypripedii fluidum, 435, 900 
Digitalis, 844 

Fluidum, 435, 436, 844 
Dulcamara? fluidum, 435, 834 
Ergot*, 908 

Fluidum, 436, 908 
Liquidum, 436, 908 
Erythroxyli fluidum, 436, 732 
Eucalypti fluidum, 436, 781 
Euonymi, 435, 754 
Eupatorii fluidum, 436, 810 
Filicis liquidum, 436, 907 
Frangulse fluidum, 436, 753 
G-elseniii fluidum, 436, 827 
Gentianse, 830 

Fluidum, 436, 830 
Geranii fluidum, 436, 730 
Glycyrrhizse, 757 

Fluidum, 436, 757 
Liquidum, 436,757 
Purum, 435, 757 
Gossypii radicis fluidum, 436, 734 
Grindelise fluidum, 436, 813 
Guaranse fluidum, 437, 732 
Hsematoxyli, 435, 765 
Hamamelidis fluidum, 436, 874 
Hydrastis fluidum, 436, 705 
Hyoscyami, 841 

Alcoholicum, 405, 841 
Fluidum, 435, 436, 438, 841 
Ipecacuanha? fluidum, 436, 803 
Iridis, 902 

Iridis fluidum, 436, 902 
Jalapse. 435, 834 
Juglandis, 435, 873 
Krameriae, 731 

Fluidum, 435, 731 
Lactucse, 435. 437,811 
Lactucarii fluidum, 436, 811 
Leptandrse, 851 

Fluidum, 435, 436, 851 
Lobelias fluidum, 436, 814 
Lupuli, 435, 881 
Lupulini fluidum, 436, 881 
Malti, 435, 905 
Maticse fluidum, 436, 872 
Mezerei iEthereuin, 436 

Fluidum, 436 
Nucis Vomicae, 822 

Fluidum, 436, 822 
Opii, 435, 709, 710 

Liquidum, 436, 709 
Papaveris, 435, 709 
Pareirse, 707 

Fluidum, 436, 707 
Liquidum, 436, 707 
Physostigmatis, 435, 761 



948 



GENERAL INDEX. 



Extractum — 

Pilocarpi fluidum, 436, 749 

Piscidise erythrinse fluidum, 769 

Podophvlli, 704 

Fluidum, 435, 436, 704 

Pruui virginiana? fluidum, 436, 777 

Quassiae, 752 

Fluidum, 435, 436,752 

Rhei, S57, 858 

Fluidum, 435, 436,857 

Rhois glabrse fluidum, 436, 755 

Rosa? fluidum, 436,773 

Rubi fluidum, 436,772 

Rumicis fluidum, 436,859 

Sabinae fluidum, 436, 887 

Sanguinarire fluidum, 436, 726 

Sarsae liquid urn, 439, 888 

Sarsaparillae fluidum, 436, 888 

Compositum fluidum, 436, 864, 888 

Scillse fluidum, 436, 890 

Scutellariae fluidum, 436, 856 

Senegte fluidum, 434,731, 766 

Senme fluidum, 436 

Serpentarise fluidum, 436, 866 

Spigelian fluidum, 436,828 

Stillingiae fluidum, 436, 867 

Stramonii, 842 

Fluidum, 435, 436, 842 

Taraxaci, 810 

Fluidum, 435, 436, 810 

Tritici fluidum, 436, 904 

Uvse ursi fluidum, 436, 815 

Valerianae fluidum, 436,805 

Veratri viridis fluidum, 436, 894 

Viburui fluidum, 436, 806 

Xanthoxyli fluidum, 436, 749 

Zingiberis fluidum, 436, 900 
Eye, action of drugs on the, 196-205; chief drugs 
"employed in the treatment of disease of the 
cornea, 196; on the conjunctiva, 196; on the lach- 
rymal secretion, 196; projection of the eyeball, 
197; on the pupil, 197; diagram to show the ner- 
vous supply of the, 197; the iris of the, and the 
two muscles of which it consists— the sphincter 
and the dilator, 197; drugs which act on the 
iris — mydriatics and myotics, 198; causes and 
consequences of the dilatation of the pupil of 
the, 199, 200 ; and of the contraction of the, 200 ; 
action of drugs on accommodation, 201; on 
iutra-ocular pressure, 202; uses of mydriatics 
and myotics, 203; action of drugs on the sensi- 
bility of the, 204; in producing visions, 204 
application of drugs to the, 409 ; action of puri 
fied chloroform on the eye, 679; of aconitine, 701 
of opium on the pupil of the, 717; of cocaine. 
732; of pilocarpine, 749-752; of Jamaica dog- 
wood on the pupil of the, 769; of gelsemium, 
827; of belladonna or atropine, 838; of Indian 
hemp or American cannabis, on the pupil of 
the, 800 



Fainting, cause of, 230; effect of emptying the 

bladder on, 231 : treatment of, 231 
Farina lini, 729 

Fasting, rapid effects of drugs when taken, 58 
Fat*, as emollients, 307 

Fatty degeneration, due to a twofold action, 360; 
of the In er, stomach, and kidneys produced by 
phosphorus, 604; what this chiefly depends on, 
604; of the vessels, and its result, 604; of the 
liver and other organs produced by arsenic, 
607 
Febrifuges. See Antipyretics 
Feet, cold, remedy for, 181 
Feitelberg, reference to, 299ft. 
Fel boris insplssatum, 917 
Purificatura, 917 
Fennel, as a carminative, 330; as a stimulanl diu- 
retic. 37 1 : characters, composition, and uses 
of. 789 
Fruit, characters, and usee of, as a stimulanl 
and carminative, 789 



Ferments, inorganic, 82; organic and organized, 
83 ; nature of, 83 ; the process of fermentation 
divided into two kinds, 84; diastatic amylolytic, 
85; inversive, 85; proteolytic, 85; action of 
drugs on, 85-87; yeast and bacteria, 88 etseq.; 
description of the chief oiganized, 88 etseq.; 
Brefeld's classification of, 89; diagram illustrat- 
ing the principal organized, 90. See also Yeasts, 
Mould fungi, Bacteria, Bacillus, &c. 

Fern, male, its characters, physiological action, 
and therapeutics, 907; method of administra- 
tion, 907 

Ferri Arsenias, 528, 611 

Carbonas Saccharata, 906 

et ammonise citras, 631 

et Quiniae citras, 631, 635, 796 

et Quininse citras, 796 

et Strychnime citras, 635, 822 

Iodidum, 469 

Oxidurn magneticum 631 

Peroxidum humidum, 631 

Phosphas, 528 

Sulphas exsiccata, 630 

Ferric chloride, action of, on bacteria, 98; as an 
astringent, 308 ; as a styptic, 309 

Ferrier, Dr., reference to, 160,171,183,195,204,206; 
composition and use of his snuff, 622 

Ferrous salts, physiological action of, 51 

Ferrous sulphate, action of, on bacteria, 98 

Ferrum tartaratum, 511, 631 

Fever, remittent, depends on the presence of a 
spirillum in the blood, 109 

Fibres, efferent and afferent, position and func- 
tions of the, 313, 314 

Fibrin, condition of, when digested with pan- 
creatic juice, 354 

Fibrine, effects of heating, 84; and of pepsin on, 
84 

Fick, A., his kymograph, 235, 75S 

Fick, J., references to, 122 

Figs, as demulcents, 307 ; as laxatives, 339 ; char- 
acters and composition of, 879; uses of, 879 

Filices, 907 

Filix mas, as a vermicide, 355 

Fir wool oil, action and use of, 884 

Fire damp, as a poison, with its antidote, 417 

Fish, mechanism of, respiration in the, 208; dia- 
gram of a, 208 

Flag, blue, 902; as an emetic or cathartic, and a 
stimulant, 902 

Flag, sweet, as a stomachic stimulant, 903 

Flaxseed, 729 ; oil of, 729 

Flies, Spanish, 925; external and internal ac- 
tion of, 925; in very large doses, 925; on the sali- 
vary glands, 925; on the urinary organs, 926; 
external and internal use of, 926; as anirritant 
and counter-irritant, 926; precautious, 926; 
treatment in poisoning by, 927 

Flour, wheaten, 903 

Flourens, reference to, 211 

Flowers of sulphur, its preparation, characters, 
&C., 417 

Fluorine, symbol and atomic weight of, 36; its 
relation to other members of a group, 42 

Fokker, reference to, 104 

Food, discussion as to whether alcohol can be 
deemed a, 650 

Foot baths, warm, utility of, as direct emmena- 
gogues, 390 

Formad, reference to, 103 

Formic acid, action of, on bacteria, 98 

Foster, M., reference to. 114»., 163 

Franck, F., reference to, 171ra., 172». 

Frankincense, common, characters and use of,882 

Fraser, reference to, 143, 158-160, 260»., 422 

Freusberg, references to, 167 

Friars' balsam, 817 

Friction, one of the simplest rubefacients, 304; 
value of friction of the skin, as an adjunct to 
cold baths, 405 

Fritsch, reference to, 171 

Frogs, effects of large and small doses of vera- 
trine on, 19; and of various poisons, when 
modified by heat or cold, 59,60; various experi- 
ments on, 65-67; action of quinine on the 
mesentery of, 72; act ion ofveratrine on, 126; ex- 
periment* on the Bartorius of, 129; rhythmical 



GENERAL INDEX. 



949 



action of the ventricle of the heart of, 133; 
experiment on the leg of, 140 ; explanation and 
diagram of the mode of experimenting on the 
sensory nerves in, 141 ; experiment on the gas- 
trocnemius of, 148-151 ; mode of experiment- 
ing on the action of drugs on the reflex action 
of the spinal cord of, 151 ; on the heart of, 152 ; 
diagram showing the nervous system of, 153; 
experiments with quinine on the spinal cord of, 
153; experiments with, 154-161; on the sarto- 
rius of, 163 ; experiments on the nervous sys- 
tem of the, 168; diagram of the higher nerve 
centres of, 169 ; Pi evost's experiment with chlo- 
roform on the brain of, 187 ; the easiest way of 
anaesthetizing, 190, 191 ; action of alcohol on 
196 ; on convulsions in, 212 ; diagram to illus- 
trate the effects of the horizontal and vertical 
position of the, in shock, 230; experiments on 
the arterioles of, 243 ; as to the effects of drugs 
on the vessels of, 243; and as to the effect of 
heat and cold on the lung of, 244; diagram 
illustrative of this, 244; method of maintain- 
ing artificial circulation in 245; method of 
measurement by the rate of flow, 246; ex- 
periments on the out-flow of blood from 
divided vessels in, while the nervous system 
is intact, 250; heart beats in the, when im- 
perfectly filled, 258; the heart of, 264; diagram 
of the heart of, 264; diagram of the auricular 
septum in, 264 ; action of drugs on the heart of, 
265; instrument for showing the action of 
heat and cold, and of poisons on the heart of, 
265; effect of heat and cold on the action of the 
heart of, 265; Ludwig and Coats's apparatus 
for observing alterations in the pulsations and 
rhythm of the heart of, 266 ; Williams's, 266, 
267; tracings showing changes in the pulsa- 
tions of the apex of the heart of, 269 ; irritation 
of the vagus of, causes still-stand of the heart 
of, 273; actions of two classes of poisons on the 
vagus of, 274; difference between the action of 
the accelerating nerves and the inhibitory 
fibres of the vagus of, 275; Stannius's experi- 
ments on the heart of, 282-285; diagrams illus- 
trative of these, 282-285; Gaskell's experiments 
on, 284; with illustrative diagram, 284; general 
considerations regarding the heart of, 285; 
vagus stimulation on the heart of, divided into 
five classes, 287-289; diagrams illustrative of 
this, 288; hypothesis regarding the action of 
the vagus on the heart of, 288; with illustra- 
tive diagrams, 289 ; inhibition in the heart of, 
290 ; experiments with, as to the antagonism 
of drugs, 422 ; action of chlorides on the nervous 
system of, 504, 547 ; of soda on, 525 ; action of 
barium on, 548 ; of mercury, 582 ; of phosphorus, 
603; of arsenic on the skin of, 608; diagrams of 
the epidermis of, before and after poisoning by 
arsenic, 608 ; action of antimony on the heart 
and skin of, 615, diagram of the vertical sec- 
tion of the epidermis of a, poisoned by anti- 
mony, 616; of solution of perchloride of plati- 
num on, 641; of salts of iron on, when injected 
subcutaneously, 628 ; of the nitrite of amy!, 667 ; 
of chloral hydrate, 670; of iodoform, on the 
heart of, 682 ; carbolic acid produces convul- 
sions in, 6S9; action of resorcin on, 691; of ac- 
onitia, 698; of staphisagrine, 702; of opium, 
715; of caffeine, 740; of quinine, 803; of bella- 
donna or atropine, 837; of nicotine, 843; of 
digitalis on the heart of, 847; of veratrine on 
the heart muscle of the, 897 ; of colchicum on 
the spinal cord of the, 898 ; and of ergotinic 
acid, 909 ; of cornutine, 909 
Fruit, Bael, 741 

Capsicum, 835 

Caraway, 790 

Coriander, 792 

Dill, 790 

Fennel, 789 

Hemlock, 786 

Squirting cucumber, 784 

of the dog-rose, 773 
Fuchsin, 695 

Fuller's earth, as a demulcent, 307 ; nature and 
uses of, 555 



0. 



Gadhxe, 921 

Galbanum, as an antispasmodic, 195 ; characters 
and use of, as a stimulant expectorant, 788 

Gall, ox, inspissated, 917 

Gallic acid, 877 ; properties and uses of, 877 

Gallici, mis tur a spirit us vini, 920 ; its therapeutics, 
920 

Gallinse, 920 

Gallium, symbol and atomic weight of, 36 ; prop- 
erties of, 46 

Galls, as an astringent, 308 ; characters, action, 
and uses of, 875 

Gamboge, as a drastic purgative, 339 ; and a hy- 
dragogue, 340; characters, action, and uses of, 
744 

Gamgee, A., reference to his Physiological Chem- 
istry, Tin. 

Ganglia, motor cardiac, 253; inhibitory, 253; 
diagram to show the supposed relation of mo- 
tor, in the heart to accelerating fibres, 254; 
Kemak's and Bidder's, 264, 268, 272; motor, in- 
hibitory, and quickening, supposed to be pre- 
sent in the nervous system of the frog, 275- 
277 ; inhibitory and motor, of the heart, 280 ; 
functions of the cardiac, 286 

Gargles, method of using, 413 

Garlic, as a stimulating expectorant, 227; action 
of, 889 ; as an antiseptic, irritant, and carmin- 
ative, 889; as a stimulant, expectorant, and 
diuretic, 889 

Gartner, references to, 59 

Gases, action of different, on the frog's heart, 
271; poisonous gases, with their antidotes, 416 

Gasket], references to, 111, 242, 245, 249w., 259, 
271n., 275, 276«., 285, 289 

Gastric juice, action of acids on the, 475 

Sedatives, and anti-emetics, nature, number, 
and uses of, 328; divided into local and 
general, 328 ; adjuvants to, 328 
Stimulants, alkalies as, 501 
Syphon, nature and us?es of, 414 
Tonics, nature and action of, 318 et seq.; 
purgatives and cholagogues may act as in- 
direct, 322 ; states in which they are indi- 
cated, 356 

Gastro-salivary circulation, diagram of, 316 

Gaultheria, oil of, characters, action, and use of, 
816 ; as an antipyretic, 816 

Gelatine, as a demulcent, 307 ; solution of, 921 

Gelsemine, as a spinal stimulant, 167 ; as a local 
and general anodyne, 183 ; as a mydriatic and 
myotic, 198 ; action of, on the respiratory cen- 
tre, 209, 215. See Gelsemium 

Gelsemium, as a poison, with its antidote, 420; 
antagonism of, to opium and atropine, 420-425 ; 
characters and action of, 827; on the eye, the 
spinal cord, the motor centres, 827; on the 
head, the vagus, the blood, pulse, and heart, 
827; uses of, 827 

Geltowsky, references to, 71n. 

Generative system, action of drugs on the, 
386-393; action of the ceiebral and spinal cen- 
tres on the, 386; action of drugs on the, as 
aphrodisiacs, 387 ; as anaphrodisiacs, 388 ; as 
emmenagogues, 390; andasecbolics, 390; action 
of drugs upon milk, 392 

Genito-urinary tract, action of opium on, 724 

Gentian, 830 

Boot, characters, and composition of, 830; 
preparation and use of, 831 

Gentianacese, 830 

Geraniacese, 730 

Geranium, (cranesbill), characters, composition, 
and action of, as an astringent, 730 

Gianuzzi, references to, 213, 829 

Giant cells, action of iodoform on, 683 

Gilbert, reference to, 132 

Gin, as a cardiac stimulant, 291 ; and as a stim- 
ulant diuretic, 373 

Ginger, as a carminative, 330 ; as a sialagogue, 
314, 315 ; characters, action, and uses of, 900 ; as 
a carminative, 900 

Gingerbread, as a laxative, 639 



950 



GENERAL IXDEX. 



Glanders, caused by a species of bacillus, 103 
Glands, poisonous action of tbe heavy metals on 

the, 564 
Glandular system, antagonistic action of drugs 

on the, 423 
Glauber's salt, 529 

Glaucoma, nature of, and mode of treatment, 204 

Glomeruli, the result of arterial presure on the, 
369 ; poisonous action of the heavy metals on 
the, 564 

Glycerine, action of, on enzymes, 86; on bacteria, 
9S : as a demulcent, 307 : characters and uses 
of, '819, 820 

Glycerines, 437 

Glvcerinurn, 437 

" Acidi Carbolici, 437, 6SS, 820 
Gallici, 437, 820, 877 
Tannici, 437, 820, 876 
Amyli, 437. 820, 904 
Boracis, 437, 820 

Glyceritum vitelli, 437, 820, 920 

Glycogen, formed and stored up by the liver, 350; 
glycogenic function of the liver destroyed by 
phosphorus, aisenic, and antimony, 350 

Glycyrrhizinum ammoniatum, 757 

Gold, symbol and atomic weight of, 36; as an al- 
terative, 35S ; properties, action, and uses of, 
free from metallic impurities, 640; solution of 
chloride of, 641 ; cbloride of, and sodium, 641 

Goltz, reference to, 167, 250 

Gonorrhoea, caused by micrococci, 103 

Gout, rheumatic. See Rheumatic gout 

Granville, Mortimer, his proposed mode of re- 
lieving pain, 1S5 

Grass, couch, 904 

Graves, Dr., reference to, 617 

Grawitz, references to, 89 

Griffith's mixture, 630 

Grindelia, characters and uses of, 812 ; in asthma, 
dyspnoea, and as a local application, 812 

Groups, arrangement of the elements in, 42 

Grutzner, reference to, 58 

Guaiac resin and tincture of guaiac, experiments 
with, on oxygen, 7S; as a stimulant diuretic, 374 

Guaiaci, resin a, 445 

Guaiacum, as an alterative, 358; as a direct eni- 
menagogue, 391; guaiacum resin, characters, 
composition, action, and uses of, chiefly in the 
treatment of tonsillitis, 745; guaiacum wood, 
nature and composition of, 745 

Guanidine, action of, destroyed by extremes of 
heat or cold, 60; effect of "temperature on, ex- 
traordinary, 162 ; action of, on the motor gan- 
glia, 280; on the cardiac muscle, 281 

Guarana, characters, composition, and uses of, 
732 

Guareschi, references to, 104, 349 

Gum, as a demulcent, 307 

Gum acacia, characters, &c, and uses of, 770; gum 
arabic, 770 

Gumchi, 760 

Gun cotton, preparation and use of, 735 

Gutta-percha, characters and use of, S16 

Guttifene, 744 

Gymnosperms, 8S2. 



II 



Habit, effect of, on the action of drugs, 58 
Hsematemesis, value of astringents and styptics 

in, 809 
Hainatin, nature and spectrum of, SO 
Hsematinics, or blood tonics, nature, actions and 

084 - "f. 357 

Ha materia, value of astringents and styptics in, 
809 

Hsmodromometer, Marey's, 269 

Hemoglobin, solution of, 78 ; power of, 70; spec- 
troscopic examination of, 81; action of, on the 
frog's ueart,272; treatment to be adopted when 
tlnre is a deficiency of, in tli*- blood, 856; the 
quantity of. Increased by hsematinics, 356 

Ha moptysis, value of astringents and styptics In, 
809 



Haemorrhage, action of astringents and styptics 
in lessening or arresting, 309, 310 ; importance of 
absolute quiet in severe, 310; emetics to be 
avoided in persons suffering from, 328 

Hall, Marshall, reference to, 220 

Halogen elements, the general source, characters 
and mode of preparation of, 464-472 

Haloid Compounds — 

Bichloride of methylene, 673 
Bromal hydrate, 673 
Bromide of ethyl, 669 
Chloral, 670 

Hydrate, 670 
Chloroform, 674 

Purified, 674 
Croton chloral hvdrate, 673 
Hydrate of chloral, 670 
Iodide of ethyl, 670 

Hanramelacea?, 873 

Hamamelis, as a vascular sedative, 300; charac- 
ters and use of, 874 

Harlev, reference to, 82 

Harnack, references to, 117, 125, 143, 260//., 268n. t 
271 

Haywood, Dr., reference to his use of ether, 193 

Head, action of gelsemium on the, 827 

Hearing, action of drugs on, 205 

Heart and vessels, comparative effect of, on blood- 
pi essure in different animals, 252; in dogs and 
rabbits, 252 ; action of the, on blood-pressure, 
258; various modes of estimating the action of 
the, on the circulation, 258; cause of the stop- 
page of the, in rabbits, dogs, and men, 261; 
stimulation of the, by increased blood-pressure, 
262; difference betwixt the tortoise and the 
mammalian heart, 262; palpitation of the, 263; 
the, of the frog, 263 ; diagram of the heart of 
the frog, 264; action of drugs on the, of the 
frog, 265 ; instrument for showing the action of 
heat and cold, and of poisons on the frog's 
heart, 265; diagram of Ludwig and Coats's 
frog-heart apparatus, 266; diagram of Williams's 
apparatus for investigating the action of drugs 
on the heart of the frog, 267 ; action of drugs 
on the muscular substance of the, 269; appara- 
tus for ascertaining the action of drugs on the 
muscular substance of the, 269; tracings show- 
ing changes in the action of the frog's heart, 
269; difference between the heart-apex and the, 
272; diagram to show the difference in the mode 
of experimenting with the heart and with the 
apex alone, 272; diagram showing the periodic 
rhythm of the, 272; tracings of the pulsations 
of a ventricle of the, 273; action of drugs on 
inhibition of the, 274; theories regarding the 
mode of action of drugs upon the, 275 ; hypo- 
thetical view of the nervous system of the, 276, 
278; diagram of the hypothetical nervous appa- 
ratus in the, 276; detailed description of the 
physiology of the, 277-291 ; diagram of the heart 
and vessels to illustrate the action of drugs on 
the circulatory apparatus of the, 278; drugs 
which stimulate, or depress, or paralyze the 
vagus centre of the, 279 ; the accelerating centre, 
279; the vaso-motor centre, 279 ; the vagus ends 
in the, 280; the inhibitory and motor ganglia, 280; 
the cardiac muscle, 281 ; the vaso-motor nerves, 
281 ; the capillaries, 2S2; Stannius'sexperiments 
regarding the action of the various cavities of 
the frog's, 282-286 : diagrams illustrative of this, 
282,283,284; Gaskell's experiments on the same 
subject, 284; diagram to illustrate this, 284; 
general considerations regarding the, 285; reg- 
ulating action of the nervous system of the, 
2S5-2M); diagrams illustrating this, 2SS; hypo- 
tin >is regarding the action of the vagus of the, 

288; illustrative diagrams, 289; inhibiti f 

the, 290; no satisfactory explanation can as yet 
be -liven of the action of drugs on the, 290; 
knowledge in this respect at present in a pro- 
ve state, 290; drugs which act on the 
circulation of the, their divisions and subdi- 
visions, 291 ; cardiac stimulants, 291 : vascular. 
292: cardiac tonics, 293; various conditions and 
diseases of the, in which tonics are most use- 
ful, 293-297 ; the question of the use of digitalis, 
in aortic reguigitation considered, 295; pre- 



GENERAL INDEX. 



951 



cautions as to position of the, during the ad- 
ministration of cardiac tonics, 296; action of 
sedatives on the, 299 ; diagram to show the 
nervous mechanism by which the action of the, 
may be depressed by irritation of the stomach, 
345 ; action of manganese salts on the, 640 ; of 
alcohol, 653 ; of spirit of ether, 662 ; of bromal 
hydrate, 673; of purified chloroform, 676-681: 
of iodoform, 682; of aconitia, 699,700; of sta- 
phisagria, 701; of quillaia (saponin), 774; of 
quinine, 800; of ipecacuanha, 803; ot strych- 
nine, 823; of gelsemium, 827; of solanine, 835; 
of tobacco, 907; of digitalin, 911; of camphor, 
929 ; of extract of ergot, 981 

Heat, effect of, on the power of poisons, 59-63 ; 
power of, to preserve life in narcotic poisoning, 
61 ; effects of, in accelerating death from mus- 
cular and metallic poisoning, 61 ; effect of, on 
protoplasmic movement, 71 ; on the action of 
infusoria, 73; on mould mngi, 90; on bacteria, 
93 ; as a disinfectant, 108 ; effects of, on muscle, 
117, 121, 128, 133; on the action of strychnine, 
162; in inducing sle°p, 180 ; as a local anodyne, 
183; dry, in the form of a poultice, relieves 
pain, 185; action of, on the respiratory centre, 
215; apparatus for ascertaining the effect of, 
on the vessels of the frog's lung, 244 ; instru- 
ment for showing the action of, on the frog's 
heart, 265; the most powerful of all cardiac 
stimulants, 291 ; as a vascular stimulant, 292 ; 
action o r , on inflammation, 301; diagram to 
show the effect of, in lessening the pain of in- 
flammation, 302, as a vesicant, 304; as an emol- 
lient, 307 

Hedeoma, or pennyroyal, characters of, 855; ac- 
tion and uses of, 855; as a carminative, dia- 
phoretic, and eramenagogue, 855, 856 

Heidenhain, originates the name of zymogens, 
88; references to, 352, 366, 368?i. 

Hellebore, American, 893 ; hellebore root, green, 
893 ; action of, on the pulse, S94 

Helleborin, action of, on ascidians, 115; on the 
frog's heart, 271 ; on the cardiac muscle, 281 ; 
as a cardiac tonic, 294 

Hemiptera, 924 

Hemidesmus root, characters, composition, and 
use of, 829 

Hemlock (conium), composition, action, and 
therapeutics of, 786 ; paralyzingpowerof,786 
Fruit, 786 
Leaves, 786 
Pitch, 953 

Hemp, Indian, as a hypnotic, 182; as a narcotic, 
182; character, action, and uses of, 879; on the 
sensory nerves, the pupil, and respiration, 880 ; 
on the pulse, temperature, urine, and digestion, 
880 ; uses of, as a soporific, 880 

Henle's loop, 366, 368, 376 

Hepatic stimulants, nature of, 348 ; action of, 350 ; 
importance of combining intestinal and, 352; 
cholagogues, 353; depressants, 354; resin of 
podophyllum as a, 704; euonymus (wahoo), as 
a, 754; juglans as a, 873 

Hermann, references to, 52, 56, 83, 271n. 

Hernia, emetics to be used with caution in per- 
sons suffering from, 328 

Hipbaths and mustard hip baths, utility of, as in- 
direct emmenagogups, 390 

Hips (fruit of the dog-rose), 773 

Hirt, reference to, 260 

Hitzig, reference to, 171 

Hock, as a stimulant diuretic, 373 

Hoffmann, reference to, 268 

Hoffman's anodyne, 664 

Holmgren, reference to, 244 

Holmium, symbol and atomic weight of, 36 

Homatropine, as a mydriatic, 198 

Homoeopathy, the principle of, 54 

Homolle's digitalin e, 845 

Honey, as a demulcent, 307 ; its characters, com- 
position, &c, 922 

Honeys, 441 

Hoppe-Seyler, references to, 83«. 

Hops, as a hypnotic, 181 ; characters of, 881 

Horehound. See JMarrubium 

Horseradish, as a sialagogue, 314; as a carmina- 
tive, 330 ; as a stimulant diuretic, 374 ; horse- 



radish root, characters, composition, and uses 
of, 728 
Hot baths, 401 ; hot foot baths, 402 ; hot sitz baths, 

402 
Howard's plan of artificial respiration, 680 
Hiifner, reference to, 365 
Humboldt, Alexander von, references to, 59 
Humulus, or hop, 880 
Hunter, John, reference to, 242 
Husemann on lithium, 49 
Hydragogues. See Purgatives 
Hydrargyri Chloridum mite, 583 
Corrosivum, 583 
Cyanidum, 584 
Iodidum rubrum, 469, 584 

^Viride, 470, 584 
Oxidum fiavum, 583 

Rubrum, 583 
Perchloridum, 583, 587 
Subchloridum, 583, 587 
Sulphas, 584 

Flava, 584 
Sulphidum rubrum, 583 
Hydrargyrum, 583 

cum Creta, 552, 583 
Ammoniatum, 584 
Hydrastin, as a hepatic stimulant, 351 
Hydrastis (golden seal), characters, composition, 
and uses of, 705 ; as a hepatic stimulant and as 
an antiperiodic, 705 
Hydrate, bromal, preparation and characters, 
673; action of, 673; irritates the eyes and 
causes running at the nose, 673; has a narcotic 
action like chloral, and a powerful paralyzing 
action on the heart, 673 ; causes salivation and 
profuse secretion from bronchial mucous mem- 
brane, 673 ; uses of, 673 
Hydrate, croton chloral, action, uses, and admin- 
istration of, 673 
of aluminium, 557 

of chloral, action of, on bacteria, 100 
Hydriodic acid, physiological action of, 51 
Hydrobromic acid, action of, on the ear, 205; di- 
lute ditto, properties of, &c, 493, 494 
Hydrocarbons, fatty series, 645 ; chemical nature 
and physical character of the, 645 ; boiling point 
of the, 645 ; physiological action of those belong- 
ing to the marsh gas series, 646. See under the 
different names of the series. 
Hydrochlorate of apomorphine, characters of, 713 ; 
action of, as an emetic, on the motor centres in 
the brain and the respiratory and vomiting 
centres in the medulla, 713, 714; on muscular 
fibre, the pulse, and the secretion of bronchial 
mucus, 714; opium versus, 723 
Hydrochlorate of morphia, 712; of morphine, 712 
Hydrochlorate of pilocarpine, characters and 
composition of, 749 ; action of, on the nerves, 
nerve centres, and muscular fibre, 749, 750 ; and 
on all the secretions of the body, 750 ; on the 
bladder, uterus, and spleen, 750; on the circula- 
tion and vessels, 750; on the respiration and 
temperature, 751 ; on the eye, skin, and throat, 
751 ; its chief use in dropsy, 751 ; contra-indica- 
tions, 752 
Hydrochlorate of rosaniline, preparation, char- 
acters, actions, and uses of, 695 
Hydrochloric acid, physiological action of, 51; 
action of, on the protoplasmic movements, 71 ; 
on enzymes, 86; on bacteria, 98; as a caustic, 
304; arrests secretion of saliva, 318; as a poison, 
with its antidote, 417; properties and uses of, 
479 ; preparations containing free, 479 
Hydrocyanic acid, forms acompound with haemo- 
globin, 80 ; nature and spectrum of this com- 
pound, 80; effects of, on the blood, 82; on 
bacteria, 98; as a local anodyne, 183; action of, 
on the respiratory centre, 209 ; on the muscles 
of respiration, 213 ; effects of poisoning by, on 
the color of the blood, 214; the vapor of, has a 
local sedative action on the lung. 223 ; action of, 
on the vagus centre, 279 ; on the motor ganglia, 
280 ; on palpitation of the heart, 300 ; as a local 
and general sedative, 328 ; as a poison, with its 
antidote, 417; antagonism of, to atropine, 422- 
425 ; preparation, properties, action, and uses of, 
473, 490 et seq.; action of, on the skin, 490; on 



952 



GENERAL IXDEX. 



the blood, 491 ; ou respiration, 491 ; ou the heart, I 
491 ; on the arteries and nerves, 492 ; diagram J 
to show the effect of, when applied locallv, 492; 
uses of, 493 

Hydrogen, symbol and atomic weight of, 36; its i 
preparation and uses, 455 

Hydrogen, peroxide of, rapidly decomposed by : 
finely divided platinum, 82; power of certain 
metals to absorb, S3 ; it? preparation, properties, | 
action, and uses, 458 

Hvdmquinone, characters, action, and uses of, 
692 

Hymenoptera, 922 

Hyoscyainina? sulphas, 429 

Hyoscyaniine, as a general anodyne, 183 ; action 
of, on the vagus centre. 279; on the vaso-motor 
centre, 279 ; and inhibitory ganglia, 280 ; as an 
antihydrotic, 381; as a vesical sedative, 384; as 
a poison, with its antidotes, 420; antagonism of, 
to morphine, 422-425 

Hyoscyamine, sulphate of, characters, action, and 
uses of, 841 

Hyoscyamus, a hypnotic, 181 ; as a narcotic, 182 ; 
as a general anodyne, 183; action of, on the 
vagus centre, 279 ; on the vaso-motor centre, 
279; on the inhibitory ganglia, 280; characters, 
composition, and preparation of, 840 

Hyoscyamus leaves, 840 

Hyphonrycetes, 89, 90 

Hypnotics, or soporifics, nature and action of, on 
the brain, 179-182; list of the chief, 181; bro- 
mide of potassium as a hypnotic, 521 

Hypodermic administration of drugs, 407; advan- 
tages of this method, 407; nature and method 
of the injections, 407; diagram of a syringe for 
hypodermic injection, 408 ; objections to hypo- 
dermic injections, 408; method of obviating 
these, 409 ; account of the syringe employed by 
Koch, 409; injections of acetate of morphia, 439 

Hypophosphite of soda, 530 ; of lime, 554; of iron, 
639 

Hyposulphite, test for, 497 

Hysterical paralysis of the limbs and hysterical 
aphonia, usefulness of blisters in, 305 

Hystozyme, a recently discovered ferment, 85 



I. 



Ice, as an anesthetic, 146; action of, externally, 
on the mucous membrane, 225 ; the most pow- 
erful of local sedatives, 328; as a cardiac seda- 
tive, 300; as an aphrodisiac, 388 
Iceland moss, as a demulcent, 307; composition 

of, 907 
IcMhyocolla, 920 

Idiosyncrasy, effects of, on the action of drugs, 64 
Ignatia, characters and composition of, 821 
Image, Mr., of Bury St. Edmunds, his plan of 

administering chloroform, 680 
Indian hemp, 879, 880 

White, 829; acts like digitalis, 829 
Liquorice, 760 
Indiarubber bag for holding hot water, utility of, 

to invalid travellers, 292 and n._ 
Indigo, preparation and use of, 771 
Indol, action of, on bacteria, 99 
Inflammation, chronic and acute, action of irri- 
tants and counter-irritants in, 301-306; diagrams 
illustrative of the action of irritants in, 302,303; 
of the joints, utility of friction in, 305 
Infusions, 137 

Infusoria, nature of, and action of drugs on, 73 el 
teg.; mode of experimenting on, 74; effects of 
hem, cold, and saline solutions on, 74, 75: of 
acids, alkalies, and other drugs on, 75; oxi- 
dation of, 75-78 
Infusum Anthemidis, 138,809 
Aurantii, 438, ::;s 

Composltum, 438, 788, 789, 778 
Bravene (Cusso), (38, 77:; 
Buchu. 138, 74* 
Calumbe, 438, 706 
Caryophylli, 138, 77s 
Caecarillae, 138, 867 
Catechu, 138, 805, B61 



Infusum — 

Cheken, 7S0 
Chiratae, 43S, 831 
Cinchona?, 43S, 893 

Flava?, 795 
Fluid urn, 438 
Cuspariie, 438, 747 
Cusso, 438, 773 
Didtalis, 438, 844 
Dulcamara, 438, 835 
Ergota?, 438, 908 

Gentian* compositum, 438, 738, 739, 830 
Kranieria?, 438, 731 
Lini, 438, 729, 756 
Lupuli, 438, 881 
Maticae, 438, 872 
Pruni Virginians, 438 

Fluidum, 777 
Quassia?, 438, 752 
Ehei, 438, 858 
Rosa? Acidum, 438, 773 
Senega?, 438, 731 
Senna?, 438, 766, 900 

Compositum, 438, 560, 766, 821 
Serpentaria?. 438, 866 
Uva? ursi, 438, 815 
Valeriana?, 438, 806 
Inhalations, of chlorine, 468 

of vapors for the lungs, 412, 453 
Inhalers for the lungs, 412 
Inhibition, and the action of drugs on inhibitory 

centres, nature of, 154-158 
Injectio morphia? hypodermica, 439, 712 
Injections, enemas, or clysters, 4s3 
Inorganic materia medica, 455 et seq. 
Insect powder, as a poison, with its antidotes, 420 
Insufflator, for applying powders to the larynx, 

diagram of an, 411 
Intestines, difference between the vessels of the, 
and those of the muscles, 242 ; action of drugs 
on the, 331 ; movements and secretion of the, 
331 ; cause of these, 331 ; paralytic secretion of 
the, 331; diagram illustrative of the effect of 
section of the nerves on secretion from the, 331 ; 
certain nerve-centres possess the power of re- 
straining the secretion from the, 331 ; nervous 
arrangements and nerve-centres of the, 332; 
natural and artificial circulation in the, 332; 
diagrams illustrating the effects of artificial cir- 
culation in the, 334; action of peptones, nicotine, 
and atropine, 334; of opium, 334, 335 ; difference 
between the action of soda and potash on the, 
334; effects of morphine on the, 334; and of so- 
dium salts, 334 ; cause of constipation of the, and 
remedies for, 335; diagram to show how ovarian 
irritation probably causes constipation, 336; 
action of opium as a purgative on the, 336; 
small doses of belladonna also act as purgatives 
on the, 336; action of drugs on absorption from 
the, 336; action of astringents on the, in diar- 
rhoea, 337; diagram illustrating diarrho?a de- 
pending on the presence of scybala in the, 338; 
nature and action of various kinds ofpurgatives 
on the, 33S-344; of irritant poisons, 346; dia- 
gram of the liver, stomach, and, 351 ; application 
of drugs to the, 415; as enemata, 415 ; as suppo- 
sitories, 415; action of strong solution of am- 
monia on the, 542 : action of iron on the, 563; 
of copper, 566; of alcohols, 649, 650, 653; of salts 
of iron, 627; of gold, 641; of spirit of ether, 662; 
of purified chloroform, 676; of opium, 719; of 
sanguinaria,725j of caffeine, 743; of pilocarpine 
on the glands ofthe, 749,750; of physostigmine, 
764; ofquillaia (saponin), 774; of ipecacuanha, 
803; of sulphate of strychnine, 822; of bella- 
donna or atropine, 839; of aloes, 893 
Intoxication, diagnosis between opium poisoning, 

apoplexy, and, 717 
Inula (elecampane), characters and uses of, 813 
Inunction ofdrugS, method of employing, 406 
Inunction of the skin, advantage to be derived 

from, 406 
Invertebrata, action of drugs on, 109-116 
1 odlc acid, physiological action of, 51 
Iodide, test for, 497 

Iodide of ammonium, action of, on the ear, 205; 
preparation, character, and uses of, 545 



GENERAL INDEX. 



953 



Iodide of— 

Ethvl-stryclmine, 318 
Lead, 599 
Mercury, green, 592 

Red, 592 
Potassium, 517 
Silver, 577 
Soda, 531 
Sulphur, 470 
Zinc, 571 
Iodide of potassium, action of, on the ear, 205; on 
the sense of smell, 206; on taste, 207; difference 
between large and small doses of, on the secre- 
tion of mucus, 225 ; as an anaphrodisiac, 388 ; 
nature, action, and uses of, 517-520 
Iodides, the, as alteratives, 358 
Iodine, symbol and atomic weight of, 36 ; its rela- 
tion to other members of a group, 42 ; action 
of, on infusoria, 75; on enzymes, 86, 87; on 
bacteria, 93, 96, 98, 100 ; on taste, 207 ; on qui- 
nine, 207 ; and its preparations, as rubefacients, 
304; and its compounds, as a sialagogue, 314; 
as an alterative, 358 ; has little influence on the 
excretion of urea, 360; vapor of, as a poison, 
with its antidote, 416; characters, tests, and 
preparations of, 469; iodide of sulphur, charac- 
ters and uses of, 470 ; ointment of, 470 ; physio- 
logical action of iodine, 470 ; uses of, 471 ; as an 
aphrodisiac, 471 ; as an anaphrodisiac, 471 
Iodine water, action of, on bacteria, 98 
Iodism, symptoms of, 471, 519 
Iodoform, a local anaesthetic, 186; preparation 
and characters of, 681 ; mode of administration, 
682; action of, as an antiseptic, a deodorizer, 
and a local anaesthetic, 682; action of, on the 
heart and nervous system, 682; on giant cells, 
683 ; uses of, 683 
Ipecac, 802 

Ipecacuanha, causes vomiting in man, but not in 
rabbits, 66; action of, on the nose ; 219; one of 
the most useful expectorants in sufficient doses, 
226; as a depressant expectorant, 227; as a local 
emetic, 326, 327; as a hepatic stimulant, 351; 
as an antihydrotic, 381 ; characters, composition, 
and preparations of, 802, 803; physiological 
action of, on frogs, 803 ; locally, 803 ; on the 
stomach and intestine, 803;. on the vessels, 
heart, and lungs, 803; uses of, as an emetic 
and diaphoretic, 804; as an expectorant and 
antidysenteric, S04; precautions, 804 
Ipecacuanha powder, as a sudorific, 361 
Iridin, as a cholagogue, 340; as a hepatic stimu- 
lant, 351 
Iridium, symbol and atomic weight of, 36 ; phy- 
siological action of, 51 
Iris of the eye, structure and action of the, 197 
Iris, the, or blue flag, 902 
Irish moss, 912 

Iron, symbol and atomic weight of, 36 ; effects of 
large and small doses of, on the muscles, 124; 
causes slow contraction of the vessels, 246; 
action of, on the vaso-motor nerves, 281 ; as a 
vascular tonic, 297 ; action of, on the liver, 352 ; 
as a vermicide, 355 ; action of, on the general 
system, 563 ; properties, sources, and reactions 
of 624, 625 ; general preparations of, 625-627 ; 
action of, 627; on the skin, mouth, stomach, 
and intestine, 627, 628; on the blood and 
tissues, 62S ; on the nervous system, 628 ; on 
frogs and mammals, 628 ; how eliminated, 628 ; 
the strong solution of the perchloride of, one 
of the most powerful styptics, 634 ; the liquor 
and tincture of, more often employed than any 
other preparation of, 634 
Iron, properties, preparations, action, and uses 
of— 
Ammonio-ferrie, sulphate of, or alum, 637 
Aqueous solution of ferric citrate of, 636 
Arseniate of, 638 
Citrate of, 636 

and ammonia, 635 
Ammonium, 635 
Quinia, 636 
Quinine. 636 
Strychnine, 636 
Chloride of, 633 
Compound mixture of, 630 



Iron — 

Hydrated oxide of, 631 

with magnesia, 631 
Peroxide of, 632 
Hypophosphite of, 639 
Lactate of, 637 
Magnetic oxide of, 632 
Mixture of acetate of, and ammonium, 633 
Moist peroxide of, 631 
Nitrate of, 634 
Oxalate of, 637 
Phosphate of, 638 
Pyrophosphate of, 639 
Reduced, 632 
Iron, saccharated carbonate of, 630 
Iodide of, 638 
Solution of basic ferric sulphate of, 631 
Chloride of, 633 
Citrate of, and quinine, 636 
Pernitrate of, 634 
Persulphate of, 631 
Subsulphate of, 631 
Tersulphate of, 631 
Strong solution of perchloride of, 633 
Sulphate of, 629 

and ammonium, 637 
Dried, 630 
Granulated, 630 
Precipitated, 630 
Syrup of bromide of, 638 
Tartrate of, and ammonium, 635 

Potassium, 635 
Tartarated, 635 
Tincture of acetate of, 633 
Valerianate of, 639 
Irritants and counter-irritants, 301-306 ; divided 
into four classes, 301 ; diagrams illustrating the 
action of, 302, 303; rubefacients, and their 
action on chronic and acute inflammation, 301- 
305; list of the principal, 304; vesicants and 
their action, 305; pustulants, 305; and caustics, 
306 ; oil of copaiva as an irritant, 769 ; quillaia 
(saponin) as an, 774; oil of myrtle as, 780; 
camphor as, 863 ; garlic as, 889 
Isinglass, as a demulcent, 307 ; nature and prop- 
erties of, 920, 921 
Isomorphism and physiological action, relation 

between, 51 
Ivy, poison, 755 



Jaborandi, as a myotic, 198; as a depressant 
expectorant, 227 ; as a sialagogue, 314, 315 ; as 
an antihydrotic, 381; antagonism of, to atro- 
pine, 422-425 ; characters, action, and uses of, 
749-752 

Jackson, Dr., advises the use of sulphuric ether 
as an anaesthetic, 192 

Jalap, as a drastic purgative, 339 ; as a hepatic 
stimulant, 351 ; as a cholagogue, 353 ; char- 
acter of, 833 
Resin of, characters, action, and uses of, 833 

Jamaica dogwood, action and use of, 769 
Sarsaparilla, 888 

James's powder, 617, 620 

Jankowski, reference to, 299w. 

Jaw, lower, action of phosphorus on the, 603 

Jequirity seeds, character, action, and uses of, 
760 

Jervine, action of, on the spinal cord aud the 
medulla, 894 ; the cardiac ganglia and the brain, 
894 

Joints, inflammation of the, utility of friction in, 
305 ; and of vesicants, 305 ; tartar emetic oint- 
ment and croton-oil liniment sometimes useful 
in, 305 

Jolyet, references to, 143, 318n. 

Juglandacea?, 873 

Juglandin, as a hepatic stimulant, 851 

Juglans, characters and uses of, 873; as a cathartic 
and hepatic stimulant, 873 

Jugular veins, action of poisons when injected 
into the, 164, 213, 218 

Juices, 447 



954 



GENERAL INDEX. 



Jumble beads, 760 

Juniper, as a stimulant diuretic, 374 ; composition 

of, 8S7 ; oil of, 887 ; as a stimulant and diuretic, 

887 



K. 



Kairix, action of, as an antipyretic, and uses of, 
695 

Karnala, as a vermicide, 355 ; characters, action, 
and uses of, 869 ; as an anthelmintic, 870 

Kaolin, or China clay, action of, in inflammation 
of the urethra, 385; nature and uses of, 555 

Kava, as a stimulant diuretic, 374 

Keratin, its preparation, characters, and uses, 
992 ; its mode of application, 993 

Kidneys, precautions to be taken regarding the 
state of the, 356 ; action of drugs on the, 364- 
377 ; the threefold functions of the, 364 ; three 
structures connected with these functions, 364; 
nature and process of secretion in the, 364-377 ; 
diagram' of the urinary tubules in different 
classes of animals, 365 ; diagram of the circula- 
tion in the kidney of the newt, 367; diagram- 
matic sketch of the blood vessels in a mamma- 
lian kidney, 367 ; diagram of the tubules and 
vascular supply of the, 368; circumstances 
modifying the secretion of urine by the, 369 ; 
relation between sweat glands and the, 379 ; 
action of the heavy metals on the, 564 ; the 
possible effect of mercury on the, 565 ; action 
of phosphorus on the, 604; of alcohol, 649, 654; 
of pilocarpine, 750, 751 ; of tannic acid, 876 ; of 
oil of turpentine, 883 

Kiedrowski, reference to, 492 

Kino, as an astringent, 308 ; nature, action, and 
uses of, 759 

Klein, on bacteria, 88 ; reference to, 102 

Knoll, reference to, 218 

Kobert, references to, 124 

Koch, on bacteria, 88; reference to, 94; his 
experiments on bacteria with disinfectants, 97- 
101; references to, 105, 107; account of a 
syringe employed by, 409 

Kohler, F., reference to, 102 

Kolliker, references to, 139, 143 

Koppe, references to, 258n., 422 

Koumiss, nature and use of, 914, 915 

Kousso, as a vermicide, 355 ; nature, action, and 
use of, 773 

Kowalewsky, reference to, 259 

Kraepelin, references to, 175 

Krameria, 731 

Kramerise, 731 

Kratschmer, reference to, 218 

Kronecker, references to, 60, 122, 123, 354 

Krukenberg, reference to his researches on the 
medusa, 112, 115, 116 

Kuhne, Professor, references to, 59, 71n. ; his dis- 
covery of ferment-yielding bodies, 88; refer- 
ences to, 129, 163 

Kunde, references to, 161 

Kiintzer, reference to, 607 

Kymograph, the, for ascertaining blood-pressure, 
description and diagram of, 235, 240 



Laijiat.i:, 851 

Laburnum, as a poison, with its antidote, 420 
Lachrymal secretion, action of drugs on the, 196 
Lac sulphuris, 462 

Lactate of iron, 637 

Lactic acid, action of, on bacteria, 99; a hyp- 
notic, 181 ; properties of, <tc, 493 

Lactocariam, character, action, and use of, 811; 

has a soporific action, and allays cough, 811 

Langendorf. reference to. 216 
Langley, reference to, '>\2n. 
Lanthanum, symbol and atomic weight of, 36 
Lappa, characters and uses of, 813; as an altera- 
tive, and in skin diseases, 818 
Larch hark, 886 



Lard, prepared, 918 

Benzoated, 919; as an emollient, 919 
Larynx, irritation of the, a cause of cough, 220- 
222; application of drugs to the, 411; diagram 
of insufflator for applying powders to the, 411; 
various modes for applying different drugs to, 
411, 412 
Laudanum, use of, in maintaining anaesthesia, 

192 
Lauracete, 861 

Lautenbach, references to, 348, 349n. 
Lavender, characters of, 852 
Oil of, characters of, 852 

Flowers, 852; characters, action, and 
uses of, 852 ; as a stimulant and car- 
minative, 852 
Laxatives. See Purgatives 

Lead, symbol and atomic weight of, 36; action 
of, on the kidneys, 376 ; sources and reactions, 
of, 593, 594; action of, 593; in the mouth, stom- 
ach, and intestine, 594; general sources of lead 
poisoning, 594; treatment for, 595; symptoms 
of chronic poisoning by, 595 ; lead colic and 
cramps, 595 ; paralysis, 595 ; known as wrist- 
drop, 595; action of, on the general system, 596; 
how eliminated, 596; uses, 596 
Lead, acetate of, action of, on bacteria, 99 ; as a 
vascular sedative, 300; as an astringent, 308; 
as a styptic, 309 ; as a poison, with its antidote, 
420 
Lead, acetate of, 597 
Carbonate of, 597 
Iodide of, 599 
Nitrate of, 599 
Oxide of, 596 
Plaster of, 597 

Solution of subacetate of, 598 
Leaf, digitalis, 844 

Tobacco, 842 
Leaves, aconite, 697 
Bearberry, 814 
Belladonna, 835 
Buchu, 747 
Cherry-laurel, 777 
Hemlock, 785 
Hyoscyamus, 840 
Matico, 872 
Stramonium, 841 
Leech, the, 927 ; its action and uses, 927 
Leeches, action of chloroform on, 115; and of 
anaesthetics, 187 ; to genitals and thighs, as in- 
direct emmenagogues, 390 
Lemon, decoction of, 740 

Juice, characters, preparations, and uses of, 
740; it is refrigerant, antiscorbutic, and a 
powerful antiperiodic, 740 
Peel, characters, composition, and prepara- 
tions of, 739 
Lemons, oil of, characters, preparation, and ac- 
tion of, 739 
Leguminosie, 757, 766 

Leprosy, produced by the bacillus lepra?, 103 
Leptandra, characters, and action of, 851; on the 

bile and as a cathartic, 851 
Leptandrin, as a hepatic stimulant, 351 
Lettuce, experiments with the protoplasm of, 
and water on oxygen, 79; as a hypnotic, 182; 
composition of, 810 
Leucin, action of, on bacteria, 99 
Leucocytes, nature of, action of drugs on, and 
methodof experimenting on, lOelseg.; diagram 
to illustrate the action of quinine on, 73; the 
protoplasm of, contracts in any direction, 116; 
anesthetics act as poisons to, 187 
Lewin, reference to, 824 
Lichens, 907 
Liliacese, 889 
Lime, as a caustic, 304; as an astringent, 308; 

composition of, 549 
Lime, character, tests, and preparations of, 549, 

550 
Lime, as an astringent and as an antacid, 551 
Chlorinated, HIT, 168,654 
I [ypophosphate of, 554 
Liniment of, 550 
Phosphate of, 558 
Precipitated carbonate of, 558 



GENERAL INDEX. 



955 



Lime — 

Saceharated solution of, 550 
Slaked, 550 
Sulphurated, 554 
Syrup of, 550 
Lime salts, sources and test of, 548 ; general pre- 
paration of, 549 ; impurities and tests of, 549 
Lime water, action of, on bacteria, 98 ; as a direct 
antacid, 322; as a vermicide, 355 ; composition 
of, 549 
Limonis succus, 447 
Linaceae, 729 

Liniments, or embrocations, 439 

Linimentum aconiti, 440, 698, 863 

Ammonite, 440, 734, 819 

Belladonna, 440, 836, 862 

Fluidum, 836 
Calcis, 440, 734, 819 
Camphorie, 440, 734, 819, 862, 863 

Compositum, 440, 852, 863 
Cantbaridis, 440, 883, 925 
Cbloroformi, 440, 675, 819, 863 
Crotonis, 440, 780, 868 
Hydrargyri, 440, 583, 863 
Iodi, 440, 470, 518, 663 
Opii, 440, 709, 863 
Plumbi subacetatis, 440, 598, 734 
Potassii iodidi cum sapone, 440, 470, 518, 740, 

819, 820 
Saponis, 440, 819, 852, 862 
Sinapis compositum, 440, 727, 863, 868, 869 
Terebinthime,440, 819, 863, 883 

Aceticum, 440, 482, 863, 883 
Linseed, arid linseed tea, as demulcents, 307; com- 
position, action, and use of, 729 ; cbief use is 
as a demulcent, 729 
Meal, 729 
Oil, 730 
Lippia Mexieana, composition, action and uses 

of, 818 
Liqueurs, as cardiac stimulants, 291 
Liquor acidi arseniosi, 440, 611 
Ammonias, 291, 541 
Ammonii acetatis, 440 

Citratis, 440, 541 
Fortior, ^40 
Antimonii chloridi, 440, 480, 617 
Arsenicalis, 440, 611 
Arsenici hydrochloricus, 440, 611 

et Hydrargyri iodidi, 440, 584 
Atropiae, 440 

Sulphatis, 440, 837 
Bismutbi et ammonias citratis, 440 
Calcis, 440, 550 

Chloratae, 440, 468 
Saccharatus, 440, 550, 906 
Cblori, 440 

Epispasticus, 440, 482, 661, 925 
Ferri acetatis, 440 
Chloridi, 440 
Citratis, 440 

et Quinmas citratis, 440, 636, 796 
Mtratis, 440 
Perchloridi, 440, 634 

Fortior, 440 
P^rnitratis, 440, 480 
Persulphatis, 440 
Subsulphatis, 440 
Tersulphatis, 440 
Gutta-percha, 440, 816 
Hydrargyri nitratis acidus, 440, 480, 584 

Perchloridi, 440, 584, 589 
Iodi, 440, 470, 518 

Compositus, 440, 470, 518 
Lithias, 322 

Effervescens, 440, 535 
Magnesias carbonatis, 440, 562 

Citratis, 440, 562 
Magnesii citratis, 440 
Morphias acetatis, 440, 482, 712 

Hydrochloratis, 440, 480, 712 
Nitro-glycerini, 668 
Pepsini, 440, 916 
Plumbi subacetatis, 440, 596, 598 

Dilutus, 440, 598 
Potassas, 322, 440, 509 

Effervescens, 440, 510 



Liquor potassas permanganatis, 440 
Potassii, 440 

Arsenitis, 440, 611 
Citratis, 440 
Sodas, 322, 440 

Arseniatis, 440, 612 
Chloratas, 440 
Effervescens, 440, 527 
Sodii arseniatis, 440 

Silicatis, 440 
Strychnias, 440, 822 
Zinci chloridi, 440, 568, 570 
Liquorice, as a stimulating expectorant, 227 
Liquorice root, characters and composition of, 

757 ; preparation, action, and uses of, 757 
Lister, Sir Joseph, originates the antiseptic mode 
of treatment, 106; on the untoward conse- 
quences of operations, 689 
Lithia, benzoate of, 535 
Bromide of, 536 
Carbonate of, 535 
Citrate of, 535 
Salicylate of, 536 
Lithium, symbol and atomic weight of, 36 ; more 
poisonous than sodium or potassium, 49; its 
relation to other members of a group, 42 ; phy- 
siological action of, 51 ; causes contraction of 
the vessels, 246 ; sources, reaction, impurities, 
and tests of, 534 ; general action of, 535 
Lithium, bicarbonate, as a direct antacid, 322 
Carbonate, as a direct antacid, 322 
Citrate, as a remote antacid, 322 
Lithontriptics, nature and uses of, 376 
Litmus, 908 

Paper, blue, 908 
Ked, 908 
Tincture, 908 
Solution of, 908 
Litteljohn, Dr., reference to, 336 
Liver, effect of the, on the action of drugs, 56, 59; 
caustics employed to open abscesses of the, 306; 
action of drugs on the, 347 ; important function 
of the, in the general system, 348; action of 
hepatic stimulants and cholagogues on, 348; 
power of the, in destroying the poisonous 
properties of some vegetable alkaloids, 349; five 
principal functions of the, 350; experiments 
on the action of hepatic stimulants, 350; list 
of these stimulants, 351 ; diagram of the stom- 
ach, intestines, and, 351 ; experiments on the 
action of cholagogues, 351, 352 ; importance 
of combining hepatic and intestinal stimulants 
to ensure complete cholagogue effect, 353; ad- 
juncts to cholagogues, 353; uses of hepatic stimu- 
lants and cholagogues on the, 354; action of 
hepatic depressants on the, 354 ; action of acids 
on the, 476 ; of chloride of ammonium, 540 ; of 
mercury, 581; of phosphorus, 604; of alcohol, 
649, 654 ; of dandelion, 810 
Liversedge, references to, 88 
Lobelia, as a depressant expectorant, 227 ; as a 
poison, with its antidote, 420 ; characters and 
composition of, 814 ; action of, on the respira- 
tory centre, the blood-pressure, the vaso-motor 
centre and the vagi, 814; uses of, 814 
Lobeliaceas, 814 

Lobeline, as a myotic, 198 ; as a depressant expec- 
torant, 227 ; action of, on the vagus ends of the 
heart, 280 
Lockyer, J. N., propounds the hypothesis that 
all the elements are compounds, 37; reference 
to, 50 
Loganiaceas, 821 
Logwood, characters, composition, and uses of, 

765 
Long, Dr. C. W., first uses ether as an anaesthetic, 

192 
Loos, reference to, 143 
Lotio hydrargyri flava, 550, 590 

Nigra, 550, 583, 588 
Loven, reference to, 256 
Lozenges, 451 
Luchsinger, Dr., references to, 59-61,133, 134, 379, 

839 
Luciani, reference to, 272ra. 

Ludwig, -references to, 163, 166n., 234, 244ra., 245, 
247, 256, 259, 285, 347 



956 



GENERAL INDEX. 



Ludwig and Coats's apparatus for experimenting 
on the frog's heart, 265, 266, 267, 273, 365, 368 

Lumbar genital centre, connection of the, with 
the generative organs, 386 

Lungs, application of drugs to the, 412; by inha- 
lation of vapors, 412 ; by the bronchitis kettle, 
413; and by smoke, 413; action of gold on the, 
641; of ipecacuanha, 803 

Lupuline, as a general anodyne, 183, 184; char- 
acters, composition, action, and uses of, 881 ; as 
a tonic, stomachic, and soporific, 881 

Lupulinum, 881 

Lupulus, as a general anodyne, 183 

Lussana, reference to, 352 

Lymph, an abnormal condition of, one of the 
chief causes of dropsy, 297, 298 



M. 



Mace, as a carminative, 330 ; characters and uses 
of, 861 

McKendrick, reference to, 245 

Mackenzie, J. N., reference to, 221n. 

Maclagan, Dr. Craig, reference to, 607 

Magendie's experiments on the spinal cord, 160 ; 
references to, 325, 825 

Magenta, 695 

Magnesia, as a direct antacid, 322 ; as a laxative 
and purgative, 339; carbonate of, as a purga- 
tive, 339; characters and action of, 560, 561; 
sulphate of, 560; enema of sulphate of, 560; 
carbonate of, 561; light ditto, 561; solution of 
carbonate of, 562; solution of citrate of, 562 

Magnesium, symbol and atomic weight of, 36 ; its 
relation to other members of a group, 42 ; phy- 
siological action of, 51 ; causes contraction of 
the vessels, 246; sources, reactions, and prepa- 
rations of, 559; impurities, tests, and action of, 
560; sulphate of, 560; carbonate of, 561 

Magnesium, carbonate and bicarbonate, as a 
direct antacid, 322 

Magnetic oxide of iron, 632 

Magnoliacerc, 705 

Malaria, and all diseases of malarious origin, 
quinine and cinchona bark are almost specifics 
in, 109 ; condition of vaso-motor centre in, 725 

Malpighian corpuscles, the, 365, 366, 367, 369 

Malt, extract of, 905; as a digestive ferment, 905 

Malvaceae, 734 

Mammalia, 913 

Mammals, action of nitro-glycerine on, 668; of 
chloral hydrate, 671; of opium, 716; of ery- 
throxylon, 733 

Manganese, symbol and atomic weight of, 36 ; as 
an indirect emmenagogue, 391; properties, 
action, and uses of black oxide of, 640; of sul- 
phate Of, 640 

Manna, as a laxative, 339; characters, compo- 
sition, and use of, 820; as a laxative, 821 

Manometers, fallacies of mercurial, 235 

Monsel's solution of iron, 631 

Marble, white, 549 

Marey, references to, 125 

Marey's levers, 217; pneumograph, 217; and 
Incinodromometer, 259; reference to, 262 

Marigold, 812 

Marjoram, wild. See Origanum 

Marruhiuni, characters and use of, 855; as an 
expectorant, 855; and in large doses a laxative, 
855 

Marsh gas as a poison, with its antidote, 417 

Marshinallow. See Althsca 

Marshmallows, as demulcents, 307 

Marx, reference to, 57 

Maryland pink. 8ee Kpigelia 

Massa copaibae, 441, 768 
Fen i earbonat is, 441 
Ilydrargyri, 441, 583 

Massage, action Of, on muscles, 107 

Masses, 1 1 1 

Mastication, arteries of the brain dilated in ani- 
mals by the movements of, 176 

Mas! Icatoi les, nature and use of, 418 

Mastich, characters, composition, and uses of, 
754 



Materia medica, definition of, 33 
Inorganic, 455 et seq. 
Organic, 643 et seq. 
Proper, 33 
Vegetable, 697 et seq. 

Matico, as a styptic, 309 ; and stimulant diuretic, 
374; characters, action, and uses of, 872; as a 
styptic, 872 ; leaves, 872 

Maynard, reference to, 196 

Mays, reference to, 268 

Meconic acid, 711 

Medicated baths, 403 

Medicine, materia medica gives an account of the 
various remedies used in, 33 ; preventive medi- 
cine, or prophylaxis, growing importance of, 
34 ; cause of the rapid advance of, 34 

Medulla oblongata, nature and functions of, 207 
et seq.; diagram representative of various 
groups of ganglion cells or "centres," in the, 
210; experiments on the, 218; blood vessels 
relax after section of the, 229; stimulating 
effect of asphyxial blood on the, 262; the nerve- 
centre which regulates the secretion of the 
saliva situated in the, 313; the nerve-centre 
which regulates the movements of vomiting is 
situated in the, 323; the nervous centre for the 
renal arteries in the, 370 ; action of spirit of 
ether on the, 662; of carbolic acid, 688; of 
aconitine, 700 ; of delphinine, 702 ; of hydro- 
chlorate of apomorphine, 714; of caffeine, 743; 
of physostigmine, 762; of oil of eucalyptus, 
781; of thymol, 854 

Medusae, action of drugs on, 109-113; effect of 
stimuli on the rhythmical movements of, 109- 
112; and of various poisons on, 111,112; general 
results of various experiments on, 113, 114 

Mel boracis, 441, 923 
Depuratum, 441, 923 
Despumatum, 441, 923 
Eoste, 441, 773, 923 

Meliacese, 746 

Mendelejeff, perfects the classification of the 
elements in series, 43-47 ; table of his arrange- 
ment, 45; his predictions regarding gallium, 
46; reference to his classification, 495 

Menispermaceaj, 705 * 

Menispermum (Canadian moonseed), characters, 
composition, and uses of, 705 

Menstruation, action of emmenagogues on, 390 

Menthol, action of, on the brain and spinal cord, 
194; as a rubefacient, 304 

Mercurial cachexia, 580; tremors, 580; and 
paralysis, 580 

Mercurial preparations, as cholagogues, 340 

Mercurialism, nature and cause of, 612; one of 
the best preparations for producing, 586 

Mercuric chloride, effects of, on the blood 82; on 
annulosa, 116; as a caustic, 304; as a hepatic 
stimulant, 351 

Mercuric nitrate, as a caustic, 304 

Mercuric oxide, as a caustic, 304 

Mercury, symbol and atomic weight of, 36; 
physiological connection between calcium and, 
47; causes salivation, 50; action of, on muscle, 
124; on the vaso-motor nerves, 281; and its 
compounds as a sialagogue, 314; as an altera- 
tive, 358; its power in fibrin and syphilitic 
deposits, 361 ; used to break up deposits of 
lymph, and to prevent adhesions in iritis and 
pericarditis, 361; and in the treatment of the 
secondary stage of syphilis, 361 ; action of, on 
the kidneys, 376; sources and reactions of, 578; 
general impurities and tests, 579; general 
action of, 579-583 ; on the skin, 579; effects of, 
on the body, termed "mercurialism," 579; action 
of, on the mouth, 579; salivation, 580; causes 
fever, 580; the fumes of, produce a state called 
mercurial cachexia, 580; which results in mer- 
curial tremors in the muscles, 580; and paraly- 
sis, 580; mental powers also affected, 580; 
special action of, on the brain, 581; action of, 
modified by sex, age, and idiosyncrasy, 581; 
action of, on the stomach, 581; the liver, 581, 
582; and blood, 582; has the power of causing 
the absorption of fibrinous exudations, 582; 
action of, on the pulse, 582; on respiration, 
582; and the temperature, 583; cause of the 



GENERAL INDEX. 



957 



salivation produced by, 583 ; action of, on the 
urine, 583 

Mercury, nature, preparations, action, and uses 
of, 583-587 
Acid solution of nitrate of, 591 
Aninioniated, 590 
Black lotion of, 588 
Corrosive chloride of, 589 
Cyanide of, 593 
Green iodide of, 592 
Mild chloride of, 587 
Ointment of nitrate of, 591 
Perchloride of, 589 
Red iodide of, 592 
Red oxide of, 590 
Red sulphide of, 593 
Subehloride of, 587 
Sulphate of, 587 
Yellow oxide of, 590 
* Yellow subsulphate of, 587 

Mercury salts, as a cholagogue, 353 

Metallic salts, as poisons, with their antidotes, 
420; general tests for the acid radicals in, 496; 
list of tests for the different acids, 496^98 

Metals, general classification of the, 495; I., 
monad metals, 495; 1, metals of the alkalis, 
498; 2, ammonia, 498; general characters and 
reactions, 498, 499; physiological action, 499; 
general action of the alkaline group, 499-501 ; 
and of the group of chlorides, 502, 503 ; general 
action of the sub-group of sulphates, 504; com- 
parative action of the alkaline metals, 504; 
1, metals of the alkalis — potassium, 505-522; 
sodium, 522-534; lithium, 534-536; monad 
metals, group 2, ammonium salts, 536-546; II., 
dyad metals, 546 ; reactions of the metals in 
class IL, 547; group 1, metals of the alkaline 
earths, 546; general action, 547; calcium, 548- 
554; appendix to group 2, aluminium, 555-558; 
and cerium, 558 ; group 2, magnesium, 559-562; 
general action of heavy metals on the circula- 
tion, intestinal canal, blood, tissue, muscles, 
nerves, nerve-centres, and glands, 562-565; 
group 3, 565; general action of, on the system, 
565; zinc, 566-572; copper, 572-574; cadmium, 
574; argentum, 574-578; mercurv, 578-593; lead 
and tin, 593-600 

MethaBinoglobin, origin, nature, and changes of, 
80, 81 

Methyl, effect of the introduction of, into the 
molecule of the strychnine, brucine, and the- 
baine, 50 

Methyl-atropine, -codine, -morphine, -nicotine, 
-quinine, and -veratrine, paralyzing action of, 
51 

Methyl-atropine, action of, on the motor nerves, 
&c, 839 

Methyl-conine, action of, on the spinal cord, 787 

Methylene, bichloride of, preparation, character, 
and action of, 673 

Methyloxyehinicine, constitution of, 696 

Methyl-strychnine, action of, on muscle, 139; on 
the vagus ends in the heart, 280; methyl- 
strychnine, characters of, 825 

Meyer, reference to, 241 

Meyer, Hermann, reference to, 85 

Meyer, Lothar, his labor in completing the classi- 
fication of the elements in series, 43 

Meyer, R., reference to, 222 

Meyer, Sigmund, reference to, lMn. 

Mezereon, as a vesicant, 304; as a sialagogue, 314 

Mezereum, as an alterative, 358 

Microbacteria, 90 

Microbes, recent increase in knowledge of, 34; 
destruction or prevention of, diminishes 
disease, 34 ; references to, 103, 106 

Micrococci, referenc s to, 90, 92, 94, 103 ; list of 
diseases caused by, 103 

Microzymes, references to, 97, 98, 108 

Milk, action of drugs upon, 392; what the char- 
acter of the, depends upon, 392; substances 
excreted by the, 392 ; various drugs adminis- 
tered to the mother react upon the child 
through the, 393; action of pilocarpine on the 
secretion of, 750; its composition, therapeutics, 
and use, 914 

Milk, sugar of, its characters, and uses, 915 



Milk of sulphur, 462 
Mills, Mr., reference to, 678 
Mimosese, 770 

Mistura ammoniaci, 441, 789 
Amygdalae, 441, 775 
Asafcetidfe, 441, 787 
Chloroformi, 441, 675 
Creasoti, 441, 482, 691 
Creta?, 441, 770 
Ferri aromatica, 441, 778, 794 

Composita, 441, 7.56, 860, 906 
et ammonii, 441 
Acetatis, 441, 634 
Gentians:, 441, 738, 792, 830 
Glycyrrhizse composita, 441, 664 
Guaiaci,441, 746, 770, 906 
Magnesife et asafcetidse, 441, 787 
Potassii citratis, 441, 739, 740 
Rhei et soda?, 441, 857 
Scammonii, 441, 832, 914 
Sennte composita, 441, 757, 766 
Spiritus vini gallici, 441, 658, 920 
Mixtures, 441 

Molecules, origin and nature of, 37 ; simple and 

complex, 38; condition of, in a solid and 

gaseous state, 38; the vibrations of, determined 

by their weight, 49 

Mollusca, action of drugs on, 114; effects of 

various poisons on, 114 
Molybdenum, symbol and atomic weight of, 36; 

its relation to other members of a group, 42 
Mommsen, reference to, 144 
Monobromo-camphor, as a hypnotic, 181 ; action 

of, on the cardiac muscle, 281 
Morat, reference to, 243, 262 
Morete, 878 
Mori succus, 447 

Morphia, acetate of, characters and preparations 
of, 712 
Hydrochlorate of, ditto, ditto, 712 
Morphia; acetas, 709 
Acetatis liquor, 709 
Hydrochloras, 429, 709 
Hydrochloratis liquor, 709 
Morphina, 429 

Morphine, effect of habit on the quantity that 
can be taken; 59; action of, on oxidation, 79; 
on the blood, 82; as a sedative, 146; action of, 
on the spinal cord, 150, 159; as a spinal stimu- 
lant, 167; as a powerful hypnotic, 181, 182; 
induces sleep and lessens pain, 181; as a local 
and general anodyne, 183; as a myotic, 198, 
199; action of, in diminishing the excitability 
of the respiratory centre, 223; and when com- 
bined with atropine, 223; as an antisialic, 318; 
as a local and general sedative, 328 ; action of, 
on the intestines, 334 ; action of, on urea, 360 ; 
value of, in laryngeal phthisis, 412 ; as a poison, 
with its antidote. 420 ; antagonistic action of, 
to certain alkaloids, 424, 425 
Morphine, characters, reactions of, &c, 711; 
opium versus, 722 
Acetate of, character and preparations of, 

712 
Hydrochlorate of, characters of, &c, 712 

Apo-, characters, action, 
and uses of, 713, 714 
Sulphate of, preparations of, 713 
Morshead, reference to, 199 
Morton, Mr., his use of ether in dentistry, 192 
Moseley, reference to, 115, 115n. 
Moss, Iceland, its characteis, composition, and 

therapeutics, 907 
Moss, Irish, characters and use of, 912 
Mosso, references to 104, 125, 143, 247, 349 
Motion and oxidation, relations of, in the animal 

economy, 75 
Motor ganglia, action of oatmeal on the, 906 
Motor nerves. See Nerves 
Mould fungi, origin, nature, and effects of, 89-91; 

diseases caused by, 91 
Mouth, application of drugs to the, 414 ; as washes, 
413 ; as caustics, by rubbing, 413 ; as mastica- 
tories, 413; as gargles, 413; action of acids in 
the, 476; action of alkalis in the, 500; of the 
metals, zinc, copper, cadmium, and silver, 565; 
of silver, 576 ; of alcohol, 649, 650 ; of spirit of 



958 



GENERAL IKDEX. 



ether, 662 ; of chloral hydrate, 670 ; of purified 
chloroform, 675: of creasote, 691; of tannic 
acid, S76 ; of aloes, 893 

Mucilages, 442 

Mucilaginous remedies, useful in cases of irri- 
tating cough, 222 

Mucilago acacias, 442, 770 
Ainyli, 442, 904 
Cydonii, 442, 771 
Sassafras medulla 3 , 442, 865 
Tragacantha?, 442, 758, 820 
Ulmi, 442, 878 

Mucous membranes, action of morphine and 
atropine on the secretions of the, 223; character 
and action of the secretion of the, 223 ; of heat 
and cold on the circulation and secretion of 
the, 224 : of drugs on the secretion of the, 225- 
227; drugs which increase the ciliary motion in 
the tracheal, 227 ; action of chloride of ammo- 
nium on the gastric, 540 ; of tannic acid, 876 

Mulberrv juice, characters and use of, 878 

Murrell,"references to, 608, 612 

Muscarine, action of, on mollusca, 114; as a 
myotic, 198, 199 ; action of, on the respiratory 
centre, 214, 219 ; on the frog's heart, 271 ; on the 
inhibitory power of the vagi, 274; on the gan- 
glia, 276; action of, neutralized by atropine, 
277; action of, on inhibitory ganglia, 280; on 
the cardiac muscle, 281 ; as a sialagogue, 314, 
315; as a general emetic, 326; as an antihy- 
drotic, 381; antagonism of, to atropine, 422- 
425 

Muscle, action of drugs on, 116-138; on voluntary, 
116; elasticity, extensibility, and retractility 
of, 117; irritability of, 117; contraction of, 117; 
latent period of, 118; muscle-dynamite, nature 
and action of, 118n.; summation of stimuli, 
120; contraction, 120; fatigue, 121; contracture 
of, 122; tetanus, 123; poisons, 124-128; massage 
of, 128; propagation of the contraction wave in 
128; rhythmical contraction of, 128; connection 
between chemical constitution and physiologi- i 
cal action on, 130; action of drugs on, relative, I 
not absolute, 131; action of drugs on involun- 
tary muscular fibre, 132; contraction, 132, 
effect of stimuli on the, 133; of cold and heat, ! 
133; relation of the contractile tissue to the ; 
nerves, 134 ; propagation of contraction waves, j 
134: effects of stimulation of the vagus and a ! 
weak interrupted current, 135 * artificial 
rhythm, 135; hypothetical considerations re- I 
garding the action of drugs on muscle, 136 

Muscles, spasms and cramps of the, nature, cause, 
and general treatment of, 193-195; of the eye, j 
196 et seq.; of respiration, 210; difference be- I 
tween the vessels of the intestines and those of ! 
the, 242; the vaso-motor centre has no power 
over the vessels of the, 242; action of chlorides ! 
on the, 504; of ammonium salts, 504; of potash 
.-alts. 5o7; of ammonium chloride, 539 ; poison- ! 
ous action of the heavy metals on the, 464 ; of 
platinum, 641; of spirit of other, 662; of nitrite 
of amyl, 666 : of nitro-glycerine, 668 ; of chloral 
hydrate, 671 ; hydrochlorate of apomorphine 
on the fibres of the, 714; of caffeine on ditto, 
743: of pilocarpine on muscles and muscular 
fibre, 749, 750; of physostigmine on ditto, 762; | 
of quinine, 801 ; of strychnine, 824; of curare, 
826; of belladonna or atropine, 838; of digita- 
lin, 845; of reratrine, 896; of oatmeal, 906 

Muscular contraction, apparatus for registering, 
118; muscular poisons, Dumber and action of, 
124-128; muscular fibre, importance of the ac- 
tion of chloroform and other on, 188, 189; 
nerves die sooner than the, 217 

Mushrooms as poisons, with their antidotes, 420 
Musk, antispasmodic action of, 194, 195,913; as 
an antispasmodic and stimulant, 914; its action 
on the respiratory centre, 914 
Mustard leaves and liniment of, as rubefacients, 
804, 305; as a sialagogue, 314 ; as a local emetic, 
326; as a carminative, 830; as a stimulant diu- 
retic, 874; baths, poultices, and stupes, as Indi- 
rect emmenagogues, 390; hath, 403; powdered, 
726; white, 72''.; black, 726; characters and 
Compositions Of the powdered, 726; prepara- 
tion* of, 727 



Mustard, oil of, action of, on enzvmes, 86; on 
bacteria, 96, 99, 100; as a vesicant, 304, 727; 
characters and preparations of, 727 ; action of, 
on the skin, and internally as a prompt emetic, 
727, 72S; it is also used externally as a counter- 
irritant, in the form of a poultice, &c, 728 

Mycoderma, vini, nature and action of, 89 

Mydriatics, and their action in dilating the pupil 
of the eye, 198-200 

Myositis, infective, micrococci present in, 103 

Myotics, and their action in contracting the 
pupil of the eye, 198-201 

Myristicacese, 860 

Myrrh, as a direct emmenagogue, 390 ; characters 
and composition of, 756 ; action and uses of, as 
an astringent and expectorant, 756 

Myrtacese, 778 

Myrtle, oil of, action and uses of, 780 ; is an anti- 
septic, rubefacient, internal irritant, and expec- 
torant, 780 



N. 



Njegeli, references to, 89, 102 

Naphthalin, source and characters of, 694 ; mode 
of administration, 694; action of, in destroying 
low organisms and preventing the germina- 
tion of their spores, 694; as an antiseptic, and 
when used internally, 694; uses of, 694 

Naphthol, characters, action, and uses of, 694 

Narcotics, nature and action of, 182 

Nasal douche, diagram of a, 410 

Natalo'in, nature and action of, 891 

Nativelle's digitaline, 845 

Nauseant, antimony as a, 616 

Nerein, action of, on the cardiac muscle, 281 

Neroli, oil of, 737 

Nerve centre, the, which regulates the move- 
ments of vomiting, 323 

Nerve centres, in respiration, nature and func- 
tions of the, 209-219; for the secretion of sweat 
situated in the spinal cord, 378; hbw they may 
be stimulated, 378; situation of the, for the 
movements of the bladder, 383; action of pot- 
ash salts on the, 507 ; poisonous action of the 
heavy metals on the, 564 ; action of gold on 
the, 641 ; of alcohol, 648, 652 ; of erythroxylon, 
733; of caffeine, 743; of hydrochlorate of pilo- 
carpine, 750; of physostigmine, 762 ; of quillaia 
(saponin), 775; of oil of eucalyptus, 781; of 
thymol on the, of the cord and medulla, 854; 
of camphor, 863; of oil of turpentine, 883 

Nerve stimulants divided into two kinds, 176; 
tonics, when necessary, 357 

Nerves, relation of the contractile tissue to the, 
134; action of drugs on, 138-147; on motor, 138- 
144; paralysis of the motor ending? of the, 139, 
140; paralysis may be due to disturbance of 
rhythm between muscle and, 138; experiments 
illustrative of paralysis, 140-142; list of drugs 
which have the same paralyzing action on the, 
as curare, 142; irritation of the motor endings 
of the, by drugs, 143; action of drugs on the 
trunks of the motor, 144; on sensory, 144; the 
general action, 144; the local action, 146; action 
and uses of local sedatives and anaesthetics on, 
146; and of drugs on the peripheral ends of the 
sensory, 117; pain ascribed to vibrations of, 
or of the sheaths, 185: action of anaesthetics on 
the, 185 et seq. ; the chief afferent, expiratory, 
and inspiratory, 215-218; of drugs on the respi- 
ratory, 218; the, die sooner than the muscular 
fibres, 217; action of drugs on the vaso-motor 
and vaso-d dating, 248; action of the, on the 
vessels of circulation, 251; influence of, on 
blood-pressure, 253-256; inhibitory nerves, 253; 
quickening nerves, 254; vaso-motor nerves, 
254; depressor nerves, 255; action of dm 
the accelerating, 262; action of the, on the 
secretion of saliva, 311 317; diagrams illus- 
trating this action, :;i2, 313, 316; action of the 
afferent, on vomiting, 323, 324; dlagramshow- 
tng the afferent, by which the vomiting centre 
may be excited, 324; of the kidney, 370, 371; 
action of ammonium Baits on motor, 504; of 



GENERAL INDEX. 



959 



potash salts on ditto, 507 ; of strong solution of 
ammonia, 542 ; poisonous action of the heavy 
metals on the, 564; action of silver on the, 576; 
of salts of iron, 628; of manganese salts, 640; of 
alcohol, 652-654 ; of spirit of ether, 662 ; of ni- 
trite of amyl, 666; of chloral hydrate, 671; of 
purified chloroform, 676 ; of carbolic acid, 688 ; 
of codeine, 714; of opium on the sensory, 718; 
of pilocarpine on the efferent and other, 749, 
750; of physostigmine on the motor and sen- 
sory, 762; of sulphate of strychnine on the 
sensory, 822; of belladonna or atropine on the 
motor, 838; of tobacco on the motor and secret- 
ing, 843; of Indian hemp on the sensory, 880; 
of veratrine, 896 ; of colchicum, 899 ; of extract 
of ergot, 910 

Nervine tonics, zinc salts as, 568; sulphate of 
copper as, 573 

Nervous debility and irritability, relieved by 
mustard applications, 305 

Nervous ganglion in some lower organisms, na- 
ture and functions of the, 207 et seq. 

Nervous system, general irritability of the, gen- 
erally precedes an attack of gout, 194; regulating 
action of the, 286-290 ; action of silver on the, 
576 ; of purified chloroform on the, 676, 677 ; of 
iodoform, 682 ; of aconitine, 701 ; of opium on 
the central, 715, 718, 724 ; of pilocarpine, 749, 
750; of elaterin, 785 ; of quinine, 800; of strych- 
nine, 824; of solanine, 835; of tobacco, 843; of 
digitalin, 845; of extract of ergot, 910 

Neuralgia, blisters and cautery of great use in, 
305 

Neuralgic pains, relieved by rubefacients, 305 

Newlands, Mr., makes the first natural classifica- 
tion of the elements, 42, 43; points out a curi- 
ous relationship between the lithium and cal- 
cium group of elements, 43; and notes that the 
eighth element is a kind of repetition of the 
first, 43 

Newman, reference to, 245 

Newt, diagram of the circulation in the kidney 
of the, 367 

Nickel, symbol and atomic weight of, 36 ; ph ysio- 
logical action of, 51; causes slight contraction 
of the vessels, 246 

Nicotia, action of, on oxidation, 79, 82 

Nicotine, action of, on medusae, 112; onmollusca, 
114; on ascidians, 115; on the spinal cord, 150; 
as a spinal stimulant, 167 ; as a myotic, 198 ; on 
the respiratory centre, 215; on the vessels of 
circulation, 247; on the vagus roots, 261; on 
the heart of the frog, 273 ; on the inhibitory 
power of the vagi, 274; on the vagus centre, 
279 ; on the vagus-ends in the heart, 280 ; action 
of, on the intestines, 334; on the sweat centres, 
379 ; antagonism of, to morphine, 422-425. See 
also Tobacco. 

Niobium, symbol and atomic weight of, 36 

Nitrates, test for, 497 

Nitrate of ammonia, 545 
Iron, 634 
Lead, 599 
Potash, 512 
Potassium paper, 513 
Silver, 575 

Diluted, 575 
Moulded, 575 

Nitrate of silver, action of, on the mucous mem- 
brane, 226; difference of the action of, on the 
mucous membrane and on the trachea, 226; 
value of, in laryngeal phthisis, 412 

Nitric acid, as a caustic, 304; as a poison, with its 
antidote, 417 ; properties and uses of, 480 

Nitrite of amyl, ethyl, &c. See Amyl, Ethyl, &c, 
nitrite of 

Nitrites, effects of mixing, with freshly-drawn 
blood, 80; of poisoning by, on the color of the 
blood, 214; on the capillaries, 282 ; all nitrites 
act as vascular stimulants, 293 

Nitro-benzol, as a poison, with its antidote, 420 
Nitrogen, 601 ; symbol and atomic weight of, 36 ; 
its relation to other members of a group, 42 ; 
experiments as to the excretion of, in the body, 
359 
Nitrogen monoxide, nature, action, uses, and 
mode of administration of, 601, 602 



Nitro-glycerin, as a poison, with its antidote, 420 

Nitro-glycerine, glonoine, preparation and prop- 
erties of, 668; action of, similar to that of 
nitrite of amyl and other nitrites, 668 ; in frogs 
and mammals, 668; on the blood and blood- 
pressure, 668; why it acts more powerfully 
than other nitrites, 668 ; uses of, 668 

Nitrohydrochloric acid, properties and uses of, 
&c, 481 ; dilute ditto, 481 

Nitro-muriatic acid, action of, on the urine, 377 

Nitrous ether, as a vascular stimulant, 292; as a 
refrigerant diuretic, 374 

Nitrous oxide, as an ansesthetic, 186 et seq.; 
nature and action of, 601, 602 

Nose, application of drugs to the, 410 ; as snuff, 
410 ; by insufflation, 410 ; by the nasal douche, 
410; diagram of nasal douche, 410; action of 
pilocarpine on the, 750 

Nothnagel, reference to, 317, 334, 703 

Nowak, reference to, 132 

Nussbaum, reference to, 366 

Nut, areca, 903; as an anthelmintic, 903 

Nutgalls, action and uses of, 875 

Nutmeg, characters and composition of, 860 ; vol- 
atile oil of, 860 ; expressed oil of, as a stimulant 
and carminative, 860 

Nutmeg and oil, as carminatives, 330 

Nutrition, remedies which improve, 358 ; what 
healthy nutrition depends on, 358 

Nux vomica, as a stimulating expectorant, 227 ; 
as a cardiac tonic, 294 ; as an antihydrotic, 381 ; 
characters, composition, and preparations of, 
821 



0. 



Oak-bark as an astringent, 308 ; action and uses 

of, 874 
Oatmeal, 906 ; action and uses of, 906 
CEsophagus, the, of various animals, muscular 

structure of, 134 
Officinal preparations. See the different drugs 
Oil, castor. See Castor oil 

Oil, cod-liver, 921 ; its characters and composition, 
921; its physiological action, 921; powers of 
absorption and assimilation, 921 ; therapeutics, 
922 
Oil, ethereal, 663 
Oil of allspice, 779 

Almonds, 776 

Bitter, 776 

Amber, 884 

Anise, 789 

Bergamot, characters and use of, 739 

Cajuput, 780 

Caraway, 791 

Castor, 868 

Chamomile, 809 

Cinnamon, 861 

Cloves, 100, 778 

Copaiva, 769 

Coriander, 792 

Croton, 867 

Cubebs, 871 

Dill, 790 

Eucalyptus, 781 

Fir wool, 884 

Gaultheria, 816 

Juniper, 887 

Lavender, 852 

Flowers, 852 

Lemons, 739 

Mace, 125 

Mustard. See Mustard oil 

Myrtle, 780 

•Neroli, 737 

Nutmeg, expressed, 860 
Volatile, 860 

Orange flowers, 737 

Peel, 738 

Peppermint, 853 

Pimenta, 779 

Pimento, 779 

Kue, 747 

Eosemary, 279, 851 



960 



GENERAL INDEX. 



Oil of— 

Santal, 866 
Scotch fir, 884 
Spearmint, 853 
Sesamurn, 856 
Tar, 886 
Theobroraa, 741 
Turpentine, 100, 226, 291, 304 
Valerian, 806 
Oil of turpentine, action of, on bacteria, 100 ; of 
the vapor of, on the mucous membrane, 226 ; 
great therapeutical value of the vapor of, in 
bronchitis, 226; as a cardiac stimulant, 291 ; as 
a rubefacient, 304; as an antidote to phos- 
phorus, 421 
Oils, ethereal, action of, on bacteria, 105 ; on the 
vaso-motor centre, 279; aromatic volatile, as 
cardiac stimulants, 291 ; volatile as rubefacients, 
304 ; as an antidote to phosphorus, 421 
Oils, fixed and volatile, 442, 443 
Ointment, sulphur, 461; alkaline sulphur, 462; 
various kinds of iodine, 470; iodide of sulphur, 
470. See Unguentum 
Ointments, their nature', number, and uses, 452 
Oleaceoe, 818 
Oleate of mercury, 494 
of veratrinum, 494 
Oleates, 443 
Oleatum hydrargyri, 443, 494, 583, 590 

Veratrinse, 443, 494, 895 
Oleic acid, action of, on bacteria, 99 ; properties 

and uses of, 494 
Oleoresina Aspidii, 443, 907 
Capsici, 443, 835 
Cubebie, 443, 871 
Lupulini, 443, 881 
Piperis, 443, 870 
Zingiberis, 443, 900 
Oleoresins, 443 
Oleum adipis, 442 
JEthereurn, 442 
Ainygdake, 442, 776 

Amar^e, 442 
Expressum, 442 
Anethi, 443, 790 
Anisi, 442. 443, 705 
Anthemidis, 443, 809 
Aurantii, corticis, 442 
Florum, 442 
Bergamii, 442 
Cajuputi, 442, 443 
Cari, 442, 791 
Carui, 443, 791 
Caryophylli, 442, 443, 778 
Chenopodii, 442 
Cinnaniomi, 442, 443, 861 
Copaiba', 442, 443, 768 
Coriandri, 442, 443, 792 
Crotonis, 442 
Cubebae, 442, 443, 871 
Erigerontis, -1 12 
Eucalypti, 442, 781 
Fceniculi, 442 
Gaultheri*, 1 12 
Gossypii seminis, 442 
Hedeomse, 112, 855 
Junipcii. 112, It:; 
Lavandula', 112,443 

Florum, 442 
Limonis, 1 12, 113,739 
Lini, 442, 729 
Mentha piperitse, 1 12, 443 

Yiridis, 112, 113 
Morrhuse, 142 
Myrciae, 143 
Myristinic, 113, 860 

Expressum, 112,860 
Olivse, 142 

Phosphoratum, 1 12, 603 
Picia Uquidse, us 
Pimento, 143, 779 
I5i.ii, i, 112 

Rosse, 148 
Rosmarinl, 1 18 
Bute, 148 
Sablnee, 148, 888 
Bantall, W3 



Oleum- 
Sassafras, 443, 864 

Sesami, 442 

Sinapis, 443, 727 

Volatile, 443, 727 

Succini, 443 

Terebinthinse, 443 

Theobromse, 442 

Thymi, 443 

Tiglii, 442 

Valeriana?, 443, 805 
Oleum animale, action of, on bacteria, 99 
Oleum pini pumilionis, as a stimulating expec- 
torant, 227 
Oleum pini sylvestris, as a stimulating expec- 
torant, 227 
Olive oil, as a demulcent, 307 ; characters, com- 
position, and preparations of, 818 ; action and 
uses of, 818, 819 
Oleum menthte piperitse action of, on bacteria, 99 
Onion, as a stimulating expectorant, 227 
Ononis spinosum, as a stimulant diuretic, 374 
Operations, surgical, Sir Joseph Lister on the 

best mode of performing, 689 
Ophthalmia, gonorrhceal, contagious, and nean- 

otorum, caused by micrococci, 103 
Opium, effect of habit on the quantity that can 
be taken, 59 ; abnormal effects of, in some cases 
of fever, 62 ; some persons very slightly affected 
by, 65 ; as a sedative, 146 ; as a spinal stimulant, 
146; different actions of, in different doses, on 
the brain, 178; one of the most powerful 
hypnotics, 181 ; induces sleep and lessens pain, 
181; as a local and general anodyne, 183; as a 
myotic, 198; action of, on the respiratory cen- 
tre, 215; on the brain, 218; in diminishing the 
excitability of the respiratory centre, 223; 
action of, on the vessels of circulation, 249; as 
a vascular sedative, 300; as an, antisialic, 318; 
as a local and general sedative, 328 ; action of, 
on the intestines, 333-335, 337; as a purgative, 
336 ; as a vesical sedative, 384 ; as a poison, with 
its antidotes, 420; antagonistic action of, and 
belladonna, 424, 425; antagonism of, to other 
drugs, 422-425; characters and preparations of, 
709, 710; alkaloids of, 711 ; physiological action 
of, 715; general action of, exclusively on the 
central nervous system, 715; and in mammals 
especially on the brain, 715; in the frog it acts 
on the motor ganglia of the heart, 715 ; action 
of, on fiogs, 715; on birds, 716; on mammals, 
716; on man, it acts chiefly on the brain, 716 ; 
in producing sleep and, in large doses, death, 
716; diagnosis between poisoning by, and in- 
toxication and apoplexy, 717 ; treatment in 
poisoning by, 717; precautions, 717; treatment 
of the symptoms after an ordinary dose, 717; 
action of, on special organs, 717 ; on the sensory 
nerves, the spinal cord, and the brain, 718; on 
the pupil, the circulation, and the vaso-motor 
centre in the medulla, 718; has a peculiar ac- 
tion on the peripheral vaso-motor apparatus, 
718; on secretion, 719; on sweat and the urine, 
719; on the intestines, 719; elimination, 719; 
circumstances modifying the action of, 720; sex 
and idiosyncrasy, 720 ; habit, 720 ; opium eating, 
721 ; action of, in disease, 721; and in combina- 
tion with other drugs, 721 ; action of the al- 
kaloids of, 721 ; the morphine group and the 
codeine group, 722 ; how codeines are produced, 
722; action of apomorphine and morphine, 
722; therapeutics — general uses and local uses, 
722; on the digestive system, 723; the respi- 
ratory tract, 723; the circulatory system, 724; 
the genito-urinary tract, 72 1; the skin, 721; 
two most important uses of opium and morphia 
to relieve pain and produce sleep, 724; action 
of, on the nervous system, 724; contni-indica- 
tions, 725 
Opium denarcotisatum, 710 

Opium, powdered, preparations and composition 
Of 710 

Orcnidacese, 899 

Organism, the animal, general relations between, 
and substances affecting it, 35-52; circum- 
stances which affect the action of drugs on the, 
52-67; effects Of oxidation on, 75 etseq.; rela- 



GENERAL INDEX. 



961 



tions of motion and oxidation in, 75 ; excess 
of temperature injurious to, 104 
Orange, bitter, 737 
Flower water, 737 

Flowers, character, composition, and uses of, 
737 
Oil of, 737 
Peel, bitter, 737 
Oil of, 738 
Sweet of, 738 
Origanum, characters, action, and uses of, 856 ; as 

a diaphoretic and emmenagogue, 856 
Orthospermae, 787 

Osmic acid, action of, on bacteria, 99 ; as a caus- 
tic, 304 
Osmium, symbol and atomic weight of, 35 ; physi- 
ological action of, 51 
Ovarian irritation, diagram showing how, proba- 
bly causes constipation, 336 
Oxalates, test for, 497 
Oxalate of cerium, 558; of iron, 637 
Oxalic acid, as a poison, with its antidote, 417 ; 

nature and use of, 485 
Oxidation, relations of motion and, 75; of proto- 
plasm, 77 ; action of drugs on, 79 ; methods of 
ascertaining the effects of drugs on, 81 
Oxide of lead, 596 

Manganese, black, 640 

Red, 590 
Mercury, yellow, 590 
Silver, 577 
Zinc, 569 
Ox bile, purified, 917 
Oxgall, 916; inspissated, 917 
Oxygen, symbol and atomic weight of, 36 ; broken 
up by electricity, and forms a new element, 
ozone, 40; its relation to other members of a 
group, 42 ; necessary for protoplasmic life, 71 ; 
power of protoplasm over, 78 ; action of haemo- 
globin on, 79; effects of other gases on, 80; of 
carbonic oxide on, 80; of charcoal, 82; effects 
of, on mould fungi, 89 ; on bacteria, 91 ; ex- 
cess or absence of, causes tetanus, 162 ; effects 
of the presence or absence of, on the blood, 211- 
214; its preparation, 456; properties, physio- 
logical action, and uses, 456, 457 
Oxyhsemoglobin, 78-81 
Oxymel, 441, 482, 923 

Scillae, 441, 482, 890, 923 
Ozone, origin and nature of, 40; action of, on 
albumen, 69 ; power of protoplasm in forming, 
78; action of phosphorus in forming, 78; na- 
ture and uses of, 457, 458 ; diagram illustrating 
the formation of, by electricity, 457 ; diagram 
representing the formation of, by the oxidation 
of phosphorus, 457 



Pachydermata, 918 

Paget, Sir James, reference to his lecture on 
''Elementary Pathology," 64 

Pain, origin and nature of, 184 ; where seated, 184 ; 
how caused, and how relieved, 184; action and 
uses of anodynes in, 184, 185; relieved by an 
effort of the attention, 185 ; action of anaesthe- 
tics in relieving, 185 et seq.; and of electricity 
and cold, 185 ; Mortimer Granville's treatment 
of, 185 ; action of anaesthetics in alleviating or 
destroying, 185 et seq. 

Pale catechu, 804 

Pale cinchona bark, 794 

Pale rose, composition and uses of, 772 

Palladium, symbol and atomic weight of, 35 ; 
physiological action of, 51 

Palmitic acid, action of, on bacteria, 99 

Palpitation, of the heart, effect of blood-pressure 
on, 262, 263 ; the principal drugs which dimin- 
ish it, 300 

Pancreas, action of drugs on the, 354 

Pancreatic juice, importance of the, in the pro- 
cess of digestion, 355; effects of the secretion 
of the, 355 ; and of different drugs on the, 355 

Pancreatin, utility of, in aiding digestion, 321 

Papain, 777 

Papaveraceae, 708 

61 



777 

Papayotin, preparation, action, and uses of, 777 ; 
digestive power of, on muscular fibre and con- 
nective tissue, 777 

Paper, litmus, blue, 908 
Red, 908 

Paper, turmeric, 901 ; as a test for alkalis, 901 

Papers, 446 

Papilionacese, 757 

Papillon, M., reference to, 50 

Paracotobark, 862 

Paraffin, as an emollient, 307 

Paraldehyde, a hypnotic, 181; a general anaes- 
thetic, 186 

Paralysis, of the respiration and heart, danger 
from anaesthetics, 189; treatment necessary 
when this occurs, 189 ; of the sphincter muscle 
of the iris of the eye, 199 ; and of the dilator 
muscle of the same, 200 

Parasiticide, balsam of Peru as a, 759 

Pardington, Dr., reference to, 154 

Pare, Ambrose, reference to, 106 

Pareira, as a stimulant diuretic, 374; brava, action 
of, on the bladder, 383 

Pareira root, characters and composition of, 707 ; 
action and uses of, 707 

Parsley, as a stimulant diuretic, 374 

Passiflorae, 777 

Pasteur, divides bacteria into two classes, 91 

Paton, reference to, 758 

Pavy, reference to, 115n. 

Pearl barley, 904 

Pedaliaceae, 856 

Pellitory root, characters, action, and uses of, 
806 

Pennyroyal, 855 

Pentad elements, 600-642 

Pepper, as a carminative, 330 

Pepper, black, as a stimulant diuretic, 374; char- 
acters, composition, and preparations of, 870; 
action and uses of, 871 ; as a stomachic, &c, 871 

Peppermint camphor, characters, action, and 
uses of, 853; as an antiseptic and antineural- 
gic, 854 

Peppermint and oil, as a carminative, 330 

Peppermint oil, action of, on bacteria, 100; char- 
acters, action, and use of, 853; as a carminative 
and stimulant, 853 

Pepsin, action of, on fibrine, 84, 85; action of, as 
an artificially digestive substance, 321 ; nature 
of, 916 

Pepsinum saccharatum, 916; its therapeutics, 916 

Peptogens, their action in increasing the gastric 
juice, 320 

Peptones, action of, on the intestines, 334; action 
of the liver on, 348 

Perchloride of mercury, 589 

Perinaeum, a wet sponge applied to the; causes 
the evacuation of urine, 384 

Peristalsis, and mode of increasing, 193 ; some 
hepatic stimulants which increase, 352 

Permanganate of potash, action of, on bacteria, 
100 ; as a powerful antiseptic, may be used to 
wash out abscesses, and as a lotion for ulcers 
or wounds, 107; action of, on muscle, 120, 122; 
characters, action, and uses of, 515 

Peroxide of hydrogen, preparation, properties, 
action, and uses of, 458 

Perspiration, antipyrin causes profuse, 696 

Peru, balsam of, as a parasiticide, 759 

Pessaries, nature and uses of, 416 

Petals, cabbage-rose, 772 
Red poppy, 725 
Red rose, 773 

Petrolatum, properties and uses of, 647 

Petroleum benzin, or ether, properties and uses 
of, 647 ; petroleum ointment, 647 

Petroleum ether, action of, on bacteria, 98 

Pettehkofer, reference to, 352, 359 

Pharmaceutical preparations, 427-454; general 
principles which govern, 427, 428 ; the following 
are the principal abstracts, 429 ; vinegars, 429 ; 
alkaloids, 429 ; waters, 430 ; cataplasms or poul- 
tices, 431 ; cerates, 431 ; papers, 431 ; collo- 
dions, 432 ; confections, electuaries, or conserves, 
432 ; decoctions, 432 ; elixirs, 433 ; plasters, 433 ; 
injections, enemas, or clysters, 433; essences, 



962 



GEXERAL INDEX. 



434; extracts, 434-437 ; fluid or liquid extracts, 
435; fresh or green extracts, 437; glycerines, 
437: inlusions, 437; hypodermic injection, 439; 
liniments or embrocations, 439; solutions, 440; 
masses, 441 ; honeys, 441 ; mixtures, 441 ; muci- 
lages, 442; oils, fixed and volatile, 442 ; oleates, 
443: oleoresins, 443; pills, 444; powders, 444; 
resins, 445; spirits, 445; suppositories, 446; 
juices, 447; syrups, 447; tinctures, 448-451; tri- 
turations, 451; ointments, 452; vapors, inhala- 
tions, 453; wines, 453 

Pharmacology, definition of, 33; one of the most 
important subdivisions of materia medica, 33; 
rapid advances of, of late years, 34; difficulty 
students find in dealing with, 34; the great 
object of, 47; the connection between chemical 
constitution and physiological action the most 
important one in, 50; importance of compara- | 
tive, 63, 64; inhibition, and the action of drugs 
on inhibitory centres play a very important 
part in, 154-158 

Pharmacy, definition of, 33, 427 

Pharyngeal irritation the probable origin of the 
so-called stomach cough, 222 

Pharynx, structure and functions of, 222 ; cough 
caused by irritation of the, 222 ; application of 
drugs to the, 413 ; as washes, 413 ; as caustics, 413 

Phenol. See Carbolic acid 

Phenvl-alcohol. See Carbolic acid 

Phosphates, test for, 497 

Phosphate of soda, as a cholagogue purgative, 
353 ; nature of, 538; of sodium, as a saline pur- 
gative, 339 ; of lime, 553, of iron, 638 

Phosphides, test for, 497 

Phosphide of zinc, 572 

Phosphoric acid, physiological action of, 51 ; as a 
poison, with its antidotes, 417 ; properties, &c, 
483; dilute ditto, 483 

Phosphorus, symbol and atomic weight of, 36; 
occurs in two forms, red and yellow, 40 ; in 
combination sometimes pentad and sometimes 
triad, 40 ; its relation to other members of a 
group, 42; secondary effects of, as an irritant 
poison, on the system, 347 ; destroys the glyco- 
genic function of the liver, 350; has a special 
action on tissue change, 360; in poisoning by, 
action of, on the urine, 360 ; used in nervous 
debility, 361 ; as a poison, with its antidotes, 
421 : preparation and characters of, 602 ; action 
of, 603: on the liver and bones, 764; on the 
lower jaw, 603 ; in poisonous doses, 604 ; pro- 
duces fatty defeneration of the liver, stomach, 
and kidneys, 604; treatment in cases of poison- 
ing by, 604; cause of the fatty degeneration, 
604 : action of compounds containing, 604 ; uses 
of, 605 

Phthisis, caused by the bacillus tuberculosis, 103 ; 
when accompanied by a copious secretion of 
mucus, a combination of morphine and atro- 
pine useful in, 223 ; the atropine beneficial also 
in lessening sweating in, 223; alkalies useful 
in diminishing the moist nVes heard in the 
lungs in, 225 ; tartar emetic ointment and 
croton-oil liniment sometimes useful in, 305; 
on the ni,L r ht sweats of, 382; diagram illustrating 
the action of antihydrotics in diminishing 
sweating in, 381; probable mode of action of 
arsenic in, 609 ; how the disease originates and 
increases, 609 

Phylolaccin, as a hepatic stimulant, 351 

Physiological action, relation between atomic 
weight and, 49; between spectroscopic char- 
acters and, 49; between isomorphism and, 51; 
Blake's division of the elements into nine 
groups, according to their, 51 

Physiological reactions, 4S ; divided into groups, 
1- 

PhyBOStigma, lethal dose of, o'^; action of, on 
muscle, 128 el seq.; effects of a solution of, 
applied locally to t lie nerve trunk, 144; action 
of, on the motor centres of the brain, 172 ; as a 
myotic, 198; <*i the respiratory centre, 215, 219; 
on the blood-pressure, 250 ; chiefly affects t he 
heart, 260 : action of, on the vagus, 261 ; on the 
frog's heart, 271 ; on the ganglia, 276, 277 ; on 
the vagus ends in the heart, 280 ; on the 
cardiac muscle, 281 : action of, on the secretory 



and sympathetic nerves, 315; as a sialagogue, 
314,315; as an antisialic, 318; the paralyzing 
action of atropine counteracted by, 318 ; as a 
hepatic stimulant, 351; as a poisbn with its 
antidotes, 421 ; antagonism of, to atropine, 
420-425; antagonistic action of, 422-425; 
nature, physiological action, and therapeutics 
of, 761-765. See also Physostigmine 
Physostigmina? salicylas, 430 
Physostigmine, salicylate of, characters of, 761; 
action of, on the muscular fibres and nerve 
centres, 762 ; general action on the muscles, 
spinal cord, medulla, and motor and sensory 
nerves, 762; on the brain, eye, respiration, and. 
circulation, 763; on muscle, stomach, and 
intestines, 763; on the spleen, bladder, and 
uterus, 764; on the secretions and secreting 
cells, 764; uses of, 764; treatment of poisoning 
by, 765 
Phytolacca berry, 859 

Eoot, characters, and action of, 859 ; as an 
emetic, narcotic, and alterative, 859 
Picric acid, action of, on bacteria, 96, 100 
Picrotoxin, effect of temperature on the action 
of, 61; action of, on oxidation, 79; powerful 
convulsant action of, 174; action of, on the 
accelerating centre, 279; as an antihydrotic, 
381 ; as a poison, with its antidotes, 421 ; antago- 
nism of, to chloral, 420-425 ; characters of, 707 ; 
action of, on the medulla, motor centres, spinal 
cord, and temperature, 707 ; uses of, 708 
Picrotoxinum, 430 
Pills, 444 

Pilocarpine hydrochloras, 430 
Pilocarpine, effects of cold on the action of, 60 ; as 
a myotic, 198 ; action of, on the mucous mem- 
brane, 226; as a depressant expectorant, 227: 
effect of, on the frog's heart, 271 ; on the cardiac 
muscle, 281 ; as a sialagogue, 314 ; action of, on 
the peripheral ends of the sweat nerves, 379; 
as an antihydrotic, 3S1 ; as a poison, with its 
antidote, 421 ; antagonism of, to atropine, 421- 
425 
Pilocarpus (jaborandi), characters of, 749 
Pilula aloes, 444, 819, 892 

Barbadensis,444, 791, 819, 893 
et asafcetidav, 444, 788, 819, 891, 892 
et ferri, 444, 630, 892 
et mastiches, 444, 754, 773, 892 
et myrrha?, 444, 756, 891, 892, 902 
Socotrime, 444, 819, 860, 891 
Antimonii composite, 444, 583, 588, 617, 619, 

746 
Asafoetidie, 444, 787, S19 

Composita, 144, 756, 787, 788, 906 
Cambogia? composita, 444, 744, 819, 892 
Catharticae composite, 444, 5S3, 588, 744, 783, 

S33, 892 
Colocvnthidis composita, 444, 512, 779, 783, 
832, 892 
et hvoscyami, 444, 512, 779, 
783, 832, 892 
Conii composita, 444, 786, 803, 906 
Ferri carbonatis, 444, 630, 906 

Iodidi, 444, 470, 637, 757, 906 
Composita', 444, 756 
Galbani compositae, 444, 756, 787, 788 
Hydrargyri, 444, 583, 7.17 

Subchloridi composita, III, 756j 
587, 617, 619, 746, 869 
Ipecacuanha- cum scilla, 444, 512, 710, 890, 906 
Kitro-glyc-erini, 668 
Opii, 444, 710, 819 
Phosphori, 444, 603 
Plumbi cum opio, 444, 598, 709 
Quinia', 111, 796 

Composita, 891.892, 906 
IMiei, 111, si*), 857 
Saponis composita, 1 1 1, 709, 719 
Scamnionii composita, II I, 832, '.'1 I 
Scilhc composita, 111, 719, 890, 900,906 
Pimeuta, 779 

Oil of, 779 
Pimento, characters and composition of, 779 

Oil of, 779 
Pine bath, 101 
Pinkroot. See Spigelia 



GENERAL INDEX. 



963 



Piperaceae, 870 

Piperine, 430 ; character, action, and uses of, 870, 
871 

Pisces 920 »• 

Pitch, Burgundy, 885 
Canada, 885 
Hemlock, 885 

Pitres, reference to, 171ra., 172/!. 

Piturine, as a mydriatic, 198 

Plasters, 433 

Plasters, utility of, in chest complaints and in 
bronchitis, 228 

Platinum, symbol and atomic weight of, 36 ; 
physiological action of, 51; action of, on 
muscle, 124 ; causes powerful contraction of the 
vessels, 246; properties, action and uses of foil, 
641; of solution of perchloride of, 641; of 
platinum black, 642 

Pleurisy, tartar emetic ointment and croton-oil 
liniment sometimes useful in, 305 

Pleurisy root. See Asclepias 

Plumbi acetas, 642 
Iodidum, 470, 599 

Pneumonia, contagious, micrococci present in, 
103 

Podophylli resina, 704 

Podophyllin, as a drastic purgative, 339 ; and as a 
cholagogue, 340. See also Podophyllum root, 
and Resin of podophyllum 

Podophyllum root, characters, properties, and 
composition of, 703, 704; resin of, nature, 
properties, and uses of, 704 

Poisoning, what is necessary to be done in all 
cases of, before administering the antidote, 
416; by acids, 477; chronic, by copper, 566; by 
phosphorus, and its treatment, 603, 604; by 
arsenic, and its treatment, 606; chronic, by 
arse uic, 606 ; by antimony, 613; chronic alco- 
holic, 653; treatment of, by chloral, 672; by 
opium, 716; by physostigmine, 764 ; by strych- 
nine, and its treatment, 823 ; by belladonna or 
atropine, 840; by digitalis, and its treatment, 
850; by croton oil, and its treatment, 867 ; by 
colchium, 899; treatment of, by cantharides, 
927 

Poisonous gases, with their antidotes, 416 

Poisons, effect of heat on the power of, 59-62; 
different effects of, ou different animals, 58-62; 
effects of various, on medusge, 111, 112 ; list of 
muscular, 124-128; effects of certain, on the 
color of the blood, 214; on the muscular fibre 
of the ventricle of the heart, 271 ; on the heart 
itself, 273; of two classes of, on the vagus, 274- 
277; list of cardiac, 281; most suitable emetics 
for removing, from the stomach, 32S ; action of 
various irritant, on the general system. 344- 
346 ; peculiarities in the action of different 
irritant, 346; secondary effects of irritant 
poisoning, 347 ; list of the more common, with 
their antidotes, 416-421 ; carbonic acid as a, 
488 ; has three stages— dyspnoea, convulsions, 
paralysis, 488 ; copper as a, 566 

Poke berry. See Phytolacca berry 
Root. See Phytolacca root 

Polygalacepe, 730 

Polygonacere, 857 

Poniea?, 771 

Pomegranate, as a vermicide, 355 ; characters, 
composition, and use as an anthelmintic, 
782 
Root bark, 782 

Poppy capsules, character of, 708 ; composition, 
action, and uses of, 708 

Poppy petals, red, characters, composition, and 
use of, 725 

Potash, physiological action of, 51 ; action of, 
on protoplasm, 71 ; permanganate of, effect of, 
on infusoria, 75; on bacteria, 96; on muscle, 
120; salts of, effects of, on muscular contrac- 
tion, 126; action of, on the ends of the vaso- 
motor nerves, 249; action of, combined with 
other ingredients, on the frog's heart, 270; as 
a caustic, 304 ; difference between the action 
of, and soda, on the intestines, 334; used in 
gout, 361 

Potash salts, preparation, nature, and uses of the 
following — 



Potassium acetate, 506, 510 
Acid tartrate, 506, 511 
Bicarbonate, 506, 510 
Bichromate of, 516 
Bitartrate of, 511 
Bromide, 507, 520, 523 
Carbonate, 506, 508 
Caustic potash, 506, 508 
Chlorate, 506, 513 
Citrate, 506, 513 
Cyanide, 511 
Ferrocyanide, 511, 517 
Hypophosphite, 506 
Iodide, 511, 518 
Liquor potassse, 506, 508 

Potassii, 506 
Nitrate, 507, 512 
Nitrate of potash, 512 
Permanganate, 507, 515 
Potassa with lime, 509 
Solution of potash, 508 
Sulphate, 507, 512 
Sulphite, 506 
Sulphurata, 507, 516 
Tartrate, 509, 512 
Tartrate of potash, 512 
Potash salts, general sources and reactions of, 
505, 506 ; action of, on the general system, 
506-509 
Potassse cum calce, 550 
Permanganas, 509 
Tartras, 511 
Potassa?, liquor, singular effect of a single drop 

of, 422 
Potassic picrate, effects of, in destroying bacte- 
ria, 93 
Potassii iodidum, 470 

Potassium, symbol and atomic weight of, 36 ; its 
relation to other members of a group, 42; and 
especially to lithium, 43; action of, on muscles, 
125, 126, 130. 137, 138 ; on the vaso-motor cen- 
tre, 279 
Potassium acetate, action of, on bacteria, 99; as 
a remote antacid, 322; as a refrigerant diure- 
tic, 374 
Potassium bicarbonate, as a direct antacid, 322 
Potassium bichromate, action of, on baeteria, 98 
Potassium bitartrate, as a remote antacid, 322 : 
as a saline purgative, 339 ; a hydragogue, 340 ; 
and a refrigerant diuretic, 374 
Potassium bromide, action of, on bacteria, 98; 

on the nervous system, 186 
Potassium carbonate, as a direct antacid, 322 

Chlorate, action of, on bacteria, 99 ; as a re- 
frigerant diuretic, 374 
Potassium chloride, causes great contraction of 
the vessels, 246 ; neutralizes the action of vera- 
trine in certain cases, 271 
Potassium chromate, action of, on bacteria, 98 
Potassium citrate, as a remote antacid, 322 ; and 

refrigerant diuretic, 374 
Potassium iodide, action of, on bacteria, 98; as a 

depressant expectorant, 227 
Potassium nitrate, as a refrigerant. diuretic, 374 
Potassium permanganate, action of, on bacte- 
ria, 98 
Potassium salts, action of, on the cardiac mus- 
cle, 281 ; on the vaso-motor nerves, 281 ; on the 
capillaries, 282 ; as refrigerant diuretics, 374 ; 
antagonism of, to barium, 420-425 
Potassium sulphate, as a hepatic stimulant, 351 
Potassium tartrate, as a remote antacid, 322 ; as 
a saline purgative, 339 ; and sodium, as ditto, 339 
Potato and potato water, experiments with, on 

oxygen, 79 
Poultice, action of a warm, on the mucous mem- 
brane, 224 ; and on the chest, 228 ; use of a 
warm, in inflammation, 302, 303 ; as an emol- 
lient, 307 ; uses of, and how to apply different 
kinds of, 402 ; a linseed, 729 
Poultices, or cataplasms, 431 * 
Powders, 444 

Power, Mr., reference to, 372, 847 
Prayer beads, 760 

Precipitated sulphur, its preparation, &c, 462 
Pregnancy, best mode of treating the vomiting 
of, 328 



964 



GENERAL INDEX. 



Preventive medicine, growing importance of, 34; 
ehiefly owing to recent increase in knowledge 
of microbes and their action in causing dis- 
ease, 34 
Prevost on poisoning by mercury, 47 
Prever, reference to, 143, 422 
Prickly ash, 748 
Prinos (black alder), characters and action of, as 

an astringent, 754 
Prolapsus of the uterus, emetics to be used with 

caution in persons suffering from, 328 
Prophylactic, quinine as a, 802 
Prophylaxis. See Preventive medicine 
Protoplasm, action of drugs on, 70-74; method of 
experimenting on amcebte and leucocytes, 70-72 ; 
relations of motion and oxidation to, 75 ; oxi- 
dation of, 77 ; oxygen-carrying power of, 78 ; 
potash salts poisons or destroys, 507 
Protoplasmic poison, anaesthetics act as a, 187 ; 

and potash salts, 5u7 
Prune, composition and use of, 776 ; Virginian 

prune, or wild cherry, 776 
Prunes, as a laxative, 339 
Prussic acid, 489 

Ptomaines, alkaloids formed by putrefaction, 
103 ; action of, on muscle, 125 ; how formed, 349 
Ptyalin, 84 

Puerperal fever, micrococci present in, 103; sin- 
gular cause of an epidemic, 106 
Pulmonary sedatives, nature, number, and uses 

of, 220-224 ; divided into three classes, 220 
Pulsatilla, characters and composition of, 702; 
action of the oil of, as a vesicant, 702 ; pure 
anemonin has a depressant action on the cir- 
culation, respiration, and spinal cord, 702; 
causing feeble pulse, slow respiration, paralysis, 
dyspnoea, and death, 702 ; uses of, as a diapho- 
retic and emmenagogue, 702 
Pulse rate, relation of, and arterioles to blood-pres- 
sure, 237; diagrams of a pulse curve, 238 ; effect 
of the arterioles on pulse curves, 240 ; effect of 
drugs on the, 259; of irritant poisons on, 346; 
of arsenic, 607; of nitrite of amyl, 665-667 ; 
of chloral hydrate, 671 ; of purified chloroform, 
677; of carbolic acid, 689; of creasote, 691; of 
staphisagria, 701; of anemonin, 702; of hydro- 
chlorate of apomorphine, 712 ; of erythroxylon, 
732 ; of caffeine, 743 ; of Jamaica dogwood, 769 ; 
of oil of valerian, 805; of gelsemium, 827; of 
tobacco, 845 ; of camphor, 864; of Indian hemp 
or American cannabis, 880; of squill, 890; of 
hellebore, 594 ; of veratrine, 897 
Pulvis amvgfiake compositus, 445, 770, 775, 906 
Antimonialis, 445, 553, 617, 620 
Aromaticus, 445, 860, 900, 901 
Catechu compositus, 445, 731, 759, 805, 860, 861 
Cinnamotui compositus, 445, 759, 901, 902 
Cretie aromaticus, 445, 552, 860, 861, 901, 902, 
906 
Aromaticus cum opio, 445, 552, 710 
Compositus, 445, 552, 906 
EfFervescens compositus, 445 
Elaterii compositus, 445, 784 
Glycyrrhiza; compositus, 445, 462, 757, 766, 906 
Ipecacuanha compositus, 445, 512, 710, 803 

et Opii, 445, 710, 803 
.Talap;c compositus, 445, 511, 833, 900 
Kino compositus, 445, 710, 759, 861 
Morphina- compositus, 445, 713 
Opii compositus, 445, 710, 758, 791, 870, 900 
Rhei, 858 

Rhei compositus, 445, 858, 900 
Seammonii compositus, 115, 834, 900 
Tragacantha: compositus, 1 45, 758, 904. 906 
Pumpkin seed, composition and uses of, as an 

anthelmintic, 785 
Pupil of the eve, structure of, and action of 

drugs on the, 196-204 
Purgatives, aid the action of antiperiodics, and 
sometimes cure ague without them, 109; nature 
Of, 388: divided into laxatives (list of the chief), 
:;:;-: simple. 838; drastic, 388; saline, 388; hy- 
dragogues. 338, and oholagogues, 888; action of, 
340; Dr. lias's researches into the action of, 
341-844; the various uses of, 848, 844; to re- 
move I'm eal matters from the intestinal tube, 
348; to remove liquid from the body, 848; to 



lower the temperature in fever, 344 ; to lower 
the blood-pressure, 344; they act as hepatic 
depressants, 384; as antipyretics, 360; as an- 
aphrodisiacs, 388; as indirect emmenagogues, 
391; resin of podophyllum as a, 704; gamboge 
as a, 744; buckthorn as a, 753; senna as a, 
766; tamarind as a, 767; olive oil as, 820; 
manna as, 820; castor oil as, 869 ; oil of turpen- 
tine as, 883 ; aloes as, 893 ; treacle as, 906 ; oat- 
meal as, 906 

Putrefaction, alkaloids formed by, 103; antisep- 
tics arrest the, 106, 107 

Pyaemia, micrococci present in, 103 

Pye, Mr., references to, 260, 372 

Pye-Smith, Dr., reference to, 332«., 839 

Pyrethrum, 806 

Pyrethrum, as a sialagogue, 314 

Pyrocatechin, characters, action and uses of, 692 

Pyrophosphate of iron, 639 

Pyrophosphate of soda, 533; action of, on the 
nerve centres of the spinal cord, &c, 605 

Pyroxylin, 735 

Pyroxylinum, 735 



Q. 

Quassia, as a vermicide, 355 
Quassia and quassia wood, properties and compo- 
sition of, 752 ; action and uses of, 752 ; is simply 
a pure bitter stomachic, 752 
Quebracho, as a depressant expectorant, 227 
Quebracho bark, white, characters, action, and 

uses of, 828 
Queen's root. See Stillingia 
Quercus alba, the bark of, 875; characters, action, 

and use of, as a local astringent, 875 
Quillaia (saponin), characters, composition, ac- 
tion, and uses of, 774; action of, as a local 
irritant, 774; produces local paralysis and 
anaesthesia, 774; action of, on the voluntary 
- muscles, the intestine and the heart, 774; on 

digitalis, and on the nerve centres, 774 
Quince seed, characters and use of, 771 
Quinia, sulphate of, 796 
Quinise sulphas, 430, 796 
Quinicine, constitution of, 696 
Quinidinse sulphas, 430, 799 
Quinidine, sulphate of, 798 
Quinina, 430, 799 
Quininse sulphas, 799 
Bisulphas, 799 
Hydrobromas, 799 
Valerian as, 799, 805 
Quinine, example of the empirical use of, 33; 
utility of, in ague. 33; action of, on protoplas- 
mic movements, 72, 73; on the mesentery of a 
frog, 72; on infusoria, 75; effects of, on oxida- 
tion, 79, 82; on bacteria, 93, 99, 100; as a dis- 
infectant, 108; as an antiperiodic almost a 
specific in intermittent fevers, periodic head- 
aches, neuralgias, <kc, 109 ; action of, on asci- 
dians, 114; on annulosa, 115; on muscle, 124 et 
seq.; on the spinal cord of a frog, 153; on the 
ear, 205; on taste, 206; on the respiratory 
centre, 215; on the frog's heart, 269; on the 
motor ganglia, 280; on the capillaries, 2S2; on 
the secreting cells of a gland, 313; arrests secre- 
tion of saliva, 316; lessens tissue change, 360; 
as an antihydrotic, 381 ; value of, in the high 
temperature of the night sweats of phthisis, 
383; as a direct emmenagogue, 390; one of the 
chief ccbolics, 391; as a poison, with its anti- 
dotes, 419; antagonism of, to atropine, 420-425 
Quinine, characters and action of, 796 
Bisulphate of, 797 
Eydrobromate of, 797 
Hydrochlorate of, 797 
Sulphate of, 796 
Valerianate of, 797 

Physiological action of— general action, 799, 
800; special action— on the alimentary 
canal, 779; on the stomach, 800; on the 
blood, 800; on the circulation, 800; on the 
heart and respiration, 800 ; on tissue change, 
and on the nervous system, 800; on the 



GENERAL INDEX. 



965 



spinal cord, 801 ; on the muscles and uterus, 
801 ; uses — as an antiseptic, a tonic, and an 
antiperiodic, 801 ; as an antipyretic and a 
prophylactic, 802 



R. 



Rabbits, experiments with drags on, 66, 67; two 
kinds of muscles in, red and white, 118 ; num- 
ber of stimuli necessary to cause tetanus in the 
latter, 123; Stenson's experiment on the ab- 
dominal aorta of, 152; the cerebral hemispheres 
of, more developed than those of the frog, 168 ; 
effect of the removal of the cerebrum on, 168 ; 
easiest way of anaesthetizing, 191; effect of in- 
jecting drugs into the jugular veins of, 213; 
effect of the inhalation of tobacco smoke on, 
218; experiment on the ear of, 243; method of 
maintaining artificial circulation in the ear of, 
245; action of the heart in, 252, 253; difference 
between dogs and, in this respect, 253; the 
vagus centre in. stimulated through the nasal 
nerves, 261; Ziilzer's experiments with, 303; 
experiments with, as to the antagonism of 
drugs, 423h.. 

Rabuteau, M., references to, 49, 50, 52 

Radicals, compound, nature of, 47; most of them 
possess a paralyzing power over the motor 
nerves, 51 

Raisins, composition and uses of, 745 

Rales, moist, nature and treatment of, 225 

Ranke, references to, 161 

Ranunculaceae, 697 et seq. 

Ranvier, L., references to, 64, 162, 298 

Raspberry, characters and use of, 772 

Rat paste, as a poison, with its antidote, 421 

Rational therapeutics, explanation and example 
of, 33 

Rattle-snake poison, action of, on the red cor- 
puscles of the blood, 73 

Rectum, action of aloes on the, 893 

Red cinchona, 795 
Bark, 795 

Red poppy petals, characters, composition, and 
use of, 725 

Red rose, and red rose petals, 773 

Red sandal wood, 759 

Red saunders, natuie and use of, 759 

Refined silver, 574 

Refrigerants, nature and uses of, 317; tamarind 
as a, 767 

Regnard, reference to, 99 

Regurgitation, mitral and tricuspid, nature and 
cause of, 294; value of digitalis and other car- 
diac tonics in, 293, 294; the question of the use 
of digitalis in aortic regurgitation considered, 
295 ; diagram to illustrate the tendency to syn- 
cope in aortic, 296 

Reichert, reference to, 492 

Remedies acting on the surface op the 
body, 301-310 ; irritants and counter-irritants, 
301-307; subdivided into four classes, 301; 
rubefacients and their uses in chronic and 
acute inflammation, 301-305; diagrams illus- 
trative of the action of, 302, 303; list of the 
principal rubefacients, 304; friction one of 
the simplest, 305 ; vesicants and their uses, 305 ; 
pustulants, 305; and caustics, 306; general 
uses of caustics, 306 ; emollients and demul- 
cents, 306; list of the principal demulcents, 
307; and emollients, 307; action of demulcents 
and emollients, 307; their therapeutic uses, 
308; astringents, local and remote, and their 
uses, 308, 309; styptics and their action, 309 

Resin, composition and use of, 885 

Resin of podophyllum, preparation, characters, 
and composition of, 704 ; action of, as a drastic 
purgative, and a hepatic stimulant, 704 ; uses 
of, 704 

Resin of scammony, 832 
Jalap, 833 

Resina Copaibae,445 
Guiaci, 445 
Jalapae, 445, 833 
Podophylli, 445, 704 



Resina — 

Scammoniae, 445, 832 
Scammonii, 445, 832 

Resins, 445 

Resorcin, characters of, 691 ; action of, as an anti- 
septic, 691; on frogs, warm-blooded animals, 
and man, 691 ; uses of, 692; utility of, as an 
antipyretic, 692 

Respiration, action of drugs on, 207-228; respira- 
tory stimulants and depressants, 207 ; mechan- 
ism of, in some of the lower organisms, 207, 
208 ; diagrams illustrative of this, 208 ; in the 
higher organisms, 209; muscles of, 209, 210; 
centres of, 209-212 ; certain conditions of, called 
apnoea, dyspnoea, and convulsions, 212 ; action 
of certain conditions of the blood on, 212, 213; 
result of the presence or absence of air on 
external and internal, 214 ; action of drugs on 
the centre of, 214-219 ; diagram showing posi- 
tion of the centre of, and the afferent nerves 
which influence it, 216 ; method of testing the 
movements of, 217 ; action of drugs on the 
nerves of, 217; of irritant poisons on, 346; 
action of hydrocyanic acid on, 491 ; of mer- 
cury, 491; of strong solution of ammonia, 541; 
of gold, 641; purified chloroform, 676-679; of 
creasote, 691 ; of salicylic acid, 693 ; of anti- 
pyrin, 695; of aconitia, 698; of staphisagria 
or stavesacre, 701; of anemonin, 702; of ery- 
throxylon, 732; of caffeine, 742; of physostig- 
mine, 762; of quinine, 800; of strychnine, 824; 
of solanine, 834; of belladonna or atropine, 
838; of digitalin, 846; of thymol, 854; of 
monobromated camphor, 864; of Indian hemp 
or American cannabis, 880 ; of oil of turpen- 
tine, 882; of veratine, 896; of extract of ergot, 
910 

Respiratory centre, nature and functions of, 209- 
212 ; action of drugs on the, 214, 215 ; diagram 
showing the position of the, and the afferent 
nerves which influence it, 216 ; action of drugs 
on the respiratory nerves, 217; of sternuta- 
tories, 219; of pulmonary sedatives, 220-224; 
drugs which increase the activity of the, 227 ; 
connection of the, with the sweat glands, 382 ; 
action of gold on the, 641 ; of alcohol, 653 ; of 
carbolic acid, 687; of quillaia (saponin), 774; 
of musk, 913 

Respiratory passages, in disease of the, warmth 
usually applied by means of inhalation, 308 ; 
action of gold on the, 641 

Respiratory tract, action of opium on the, 723 

Rhamnaceae, 753 

Rhamni succus, 447 

Rhamnus, as a purgative, 339 

Rhatany root, composition, action, and use of, 
chiefly as an astringent, 731 

Rheochord, Du Bois-Reymond's, 117 

Rheum, 857 

Rheumatic gout, remarkable instance of acci- 
dental cure in, 301 

Rhodium, symbol and atomic weight of, 36 

Rhubarb, as a sialagogue, 314; as a purgative, 
339; and as a cholagogue, 340; as a hepatic 
stimulant, 351 ; as a cholagogue purgative, 351 

Rhubarb, 858 

Root, characters and composition of, 859; 
action and uses of, 858; as a tonic, astrin- 
gent, and purgative, 858 

Rhus aromatica, in incontinence of urine, 756 

Rhus glabra (sumach), nature and uses of, as an 
astringent, 755 

Rhus toxicodendron (poison ivy), as a vesicant, 
304; characters, action, and uses of, 755 

Ribbert, reference to, 366 and n. 

Richardson, B. W., reference to, 601ft. 

Richet, references to, 123 

Rigollot's, mustard leaves, usefulness of, 727, 728 

Ringer, Dr. S , references to, 60, 199, 269, 271, 300, 
422, 475, 570, 585, 608, 612, 825, 846 

Roberts, reference to, 320ft. 

Rochelle salt, as a hepatic stimulant, 351 ; nature 
and uses of, 528 

Rodentia, 910 

Rohrig, reference to, 350 

Romanes, reference to his researches on the 
medusae, 109, 110, 113 



966 



GENERAL INDEX, 



Root, Aconite, 697 

Arnica, 811 

Bark, cotton, 734 

Bark, pomegranate, 782 

Belladonna, 836 

Black snake, 703 

Blood, 725 

Caluniba, 706 

Colchicum, 897 

Culver's, 851 

Dandelion, 810 

Gentian, 830 

Green hellebore, 893 

Hemidesmus, 829 

Horseradish, 728 

Liquorice, 757 

Pareira, 707 

Pellitorv, 806 

Phytolacca, 859 

Pink, 827 

Pleurisv, 828 

Podophyllum, 703 

Poke, 859 

queen's, 867 

Rhatanv, 731 

Rhubarb, 857 

Sassafras, 864 

Scammony, 831 

Senega, 730 

Serpentary, 865 

Sumbul, 791 

Valerian, 805 
Rosacea?, 771 
Rose, dog, fruit of the, 773 

Oil of, characters, &c, of, 772 

Pale, 772 

Red, 773 

Petals, 773 
Rosea?, 772 
Roseine. 695 
Rosemary, characters of, 851 

Oil of, characters, actions and use of, 851 ; asa 
stimulant and carminative, 852 
Rosenberger, on bacteria, 92 
Rosenthal, Professor J., references to, 125, 161, 

216, 845 
Rossbacb, references to, 69, 74, 221, 225, 226, 362, 

380, 423, 507, 735, 876 ; on bacteria, 92 
Rovighi, reference to, 174?j. 
Roy's tonometer, 235 

Rubefacients, and their action in chronic and 
acute inflammation, 301-304; list of the princi- 
pal, 304; friction one of the simplest, 304; acids 
as, 475 ; oil of rue as a, 747 ; oil of myrtle as a, 
780; oil of cajuput, 780; camphor as, 863 
Rubiaceae, 793 

Rubidium, symbol and atomic weight of, 36; 
phv.-iologieal action of, 51; action of, on the 
muscles, 130,137 
Rubus, characters and uses of, 771 
Rue, as a direct emmenagogue, 391 
Rue, oil of, nature and use of, 747; is a rubefa- 
cient, antispasmodic, and an emmenagogue, 
747 
Ruminantia, 913 

Russell and Lapraik, references to, 50 
Russian bath, account of the so-called, 404 
Rutaceae, 7 17 
Rutese, 747 

Ruthenium, symbol and atomic weight of, 36 
Rutherford, reference to, 350, 354,705 
Rye, ergot of, 908 



s. 

8a< < ii \i:a i id carbonate of iron, 630 
Fervoua carbonate of iron, 630 
Iodide of, 638 
Baccharatum, pepsinum, 916 
Saccharine Bubstancea are stimulating expecto- 
rant, ■i-il 
Saccharine solution of linn', as a dlred antacid, 

822 
Sachs, reference to, 1 18 



Saffron, 902; as a coloring agent and carminative, 
902 

Sage. See Salvia 

St. Bartholomew's Hospital Reports, reference to, 
601». 

Salad oil (French), action of, on bacteria, 98 

Salicacea?, 872 

Salicin, character, action, and uses of, 873; as an 
antipyretic, 873 

Salicin urn, 430 

Salicylates, test for, 497 

Salicylate of lithium, 536 

Salicylate of soda, action of, in producing visions, 
204; on the ear, 206; nature of, 532 

Salicylates, antiperiodics, 108 

Salicylic acid, action of, on enzymes, 86 ; bacteria, 
96,99,100; an antiperiodic, 108; on the vaso- 
motor centre, 279 ; on the cardiac muscle, 281 ; 
on the pancreatic juice, 355; characters and 
tests of, 692; action of, in preventing the devel- 
opment of bacteria, 693; on the temperature, 
pulse rate, blood-pressure, and respiration, and 
the ears, 693; on the circulation, 693; how- 
excreted, 693 ; uses of, 693 

Saline solutions, effects of, on infusoria, 75 

Saliva, cause of, and mode of secretion, 311-314; 
diagram representing the general relation of 
nerves to the secreting cells and vessels of a 
gland, 312; diagram to show the nerves by 
which the secretion may be excited, 313; vari- 
ous causes which stimulate the secretion of, 
314; action of sialagogues on the secretion of, 
314, 315 ; excretion by the, 315 ; diagram of the 
gastro-salivary circulation, 316; uses of, 316; 
action of erythroxylon on the secretion of, 733; 
of caffeine on ditto, 743; of Jamaica dogwood, 
770; of pellitorv root, 807 

Salivarv centres, action of carbolic acid on the, 
689 

Salivary glands, action of cantharides on the, 
925 

Salivation, produced by mercury, 579; what it is 
in part due to, 583; action of gold in producing, 
641 ; of curare, 826 

Salis, characters, composition, and use of, 872 

Salt, effects of common, on protoplasmic move- 
ment, 71; on bacteria, 98; as a local emetic, 
326; as a refrigerant diuretic, 374; effects of, in 
large quantities, on the general system, 502 

Salts, inorganic, isomorphic, ferrous, manganous, 
ferric, physiological action of, 51; of barium, 
action of,"on muscles, 126; of zinc and copper, 
action of, on the respiratory centre, 215; results 
of experiments with several metallic, 246; of 
calcium and distilled water, prolong the beat- 
ing of the frog's heart, 270 

Salts of the cinchona alkaloids, 799 

Salts of the heavier metals as astringents, 308 

Salvia, characters, action, and uses of, 856; as a 
tonic, carminative, and an astringent, 856 

Sal volatile, as a cardiac stimulant, 291 

Sal volatile, 543 

Samarium, symbol and atomic weight of, 36 

Sandal wood, red, 759 

Sanguinaria (blood root), action of, on the vaso- 
motor centre, 279; as an alterative, 358; char- 
acters and composition of, 725; action of, on 
the Intestinal canal, and the medullary centres, 
725; on the brain and spinal cord, 725; chiefly 
used as a stimulant expectorant, 725 

Sanifas, nature and use of, 884 

Santal, oil of, characters, action, and use of, 866 

Santalacea, 866 

Santini, reference to, 174«. 

Santonica, as a vermicide, 355; as a stimulant 
diuretic, 374; characters and composition of, 

SOS 

Santonin, as a vermicide, 355; characters and 
preparation of, sgs ; action of, on the cerebrum 
and medulla of the frog, 808 ; effects of large 
doses on man, 808; action of, on the vision and 
on the urine, 808; used only as a vermicide, 
SO! I 

Santoninate of sod a, 532 
Bantoninum, 130, 808 
Sapindaceee, 732 

Saponin, nature, action, and uses of, 77 I 



GENERAL INDEX. 



967 



Saponin, action of, on the respiratory centre, 
215 ; on the nose, 219 ; as a stimulating expec- 
torant, 227 ; action of, on the vagus ends of the 
heart, 280; on the inhibitory ganglia, 280; ou 
the cardiac muscle, 281; on the heart, 300; 
antagonistic action of, 423, 425 
Sapotacese, 816 

Sarsaparilla, as an alterative, 358 ; as a stimulant 
diuretic, 374 ; nature and action of, 888 ; as a 
diuretic, tonic, and alterative, 889 
Sassafras, characters of, 864 

Oil of, 864 ; action and use of, as a diaphoretic, 

865 
Pith, characters and uses of, 865 ; as a demul- 
cent, 865 
Root, characters and composition of, 864 
Sassy bark, action of, on the nose, 219 ; compo- 
sition, action, and use of, 771 
Savine, as a stimulant diuretic, 374 ; as a direct 
emmenagogue, 390; a chief ecbolic, 391; as a 
poison, with its antidotes, 421 
Savine, 887 

Tops, 887 
Saunders, red, nature and use of, 759 
Scammony, as a drastic purgative, 339 ; as a ver- 
mifuge, 355 
Scammony, characters, &c, of, 831 

Resin of, 832 ; action and use of, as a drastic 

purgative and a vermifuge, 833 
Root, 831 
Scandium, symbol and atomic weight of, 36 
Scharrenbroich, reference to, 81 
Schiff, Professor, references to, 211, 261,320,348, 

607 
Schizomycetes, 90. See Bacteria 
Schlesinger, references to, 105 
Schmidt-Mulheim, reference to, 347 
Schmiedeberg, Professor, references to, 67, 104, 

137, 258ra., 275, 422, 846, 847 
Schonlein, reference to, 130». 
Schroeder, Von, reference to, 122n. 
Schroff, Von, references to, 143, 147, 204ra. 
Schroff (junr.), reference to, 726 
Schulte, reference to, 81 
Schultzen, Otto, reference to, 715«. 
Schweigger-Seidel, reference to, 368n. 
Scillain, action of, on the cardiac muscle, 281 ; as 

a cardiac tonic, 294 
Scoparin, 758 

Scurvy, due to imperfect nutrition, 358; is sup- 
posed to be due to a deficiency of potash in the 
blood, 358; is removed by fresh vegetables or 
lime juice, 358 
Scutellaria, characters and uses of, 856 ; has been 

used as a nervine tonic, 856 
Scybala, diagram illustrating diarrhoea depending 

on the presence of, in the intestine, 338 
Sea-bathing, 403 

Secretion, from the bronchial tubes, 223; from 

the air passages, 223; nature of the, from the 

mucous membrane, 223 ; action of drugs on the, 

225 ; action of belladonna or atropine on, 839 

Secretions, action of opium on the, 719 ; physos- 

tigmine, 764 
Sedatives, nature and uses of, 146 ; pulmonary, 
220-223; cardiac, 299, 300; vascular, 300; gastric, 
328; vesical, 384; urinary, 385 
Seed, American worm, 859 
Oil, cotton, 734 
Oil of flax, 730 
Pumpkin, 785 
Quince, 771 
Seeds, Colchicum, 898 
Jequirity, 760 
Stramonium, 842 
Seegen, Professor, reference to, 348?*., 456 
Selenic acid, physiological action of, 51 
Selenium, symbol and atomic weight of, 36 
Senega. Sre Saponin 
Senega, as a general emetic, 326 
Senega root, composition, preparation, action, 
and use of, 730, 731 ; is a stimulating expec- 
torant, diuretic and diaphoretic, 731 
Senna, characters, composition, action, and uses 
of, 766 
Alexandrian, 766 
Tinnevelly, 766 



Sensation, anaesthetics destroy, 185 

Septic poisoning, and bacteria, 92 ; effects of, and 
modes in which it may be produced, 106, 107 

Series, arrangement of the animal kingdom and 
of the elements in, 43; Mendelegeffand Meyer 
the perfecters of this system of classification, 
43 ; Mendelejeff 's classification in, 45 ; difference 
in the even and uneven series, 46 ; irregularities 
in the system, 46,47 

Serpentaria, 865 

Serpentary root, characters, action, and uses of, 
865, 866 ; as a tonic, diaphoretic, and diuretic, 
866 

Serum, and blood, action of, on the frog's heart, 272 

Sesamum, oil of, characters and action of, 856 

Setschenow's centres, 153; experiment on a frog, 
153, 154 

Severini, reference to, 247 

Shenstone, Mr., reference to, 825 

Sherry, characters and uses of, 658 ; wine, 745 

Shorthouse, Dr., reference to, 196n. 

Sialagogues, nature and action of, 311-313; dia- 
grams illustrative of 1he nerves and glands 
acted on by, 312, 313; divided into two classes, 
topical and remote, 314, 315 

Sialics and ami, nature and action of, 318 

Silicon, symbol and atomic weight of, 36; its 
relation to other members of a group, 42 

Silver, symbol and atomic weight of, 37 ; physi- 
ological action of, 51 

Silver, characters, action, and uses of— 
Cyanide of, 577 
Iodide of, 577 
Nitrate of, 575 

Diluted, 575 
Moulded, 575 
Oxide of, 577 
Refined, 574 

Silver nitrate, as a caustic, 304; as an astrin- 
gent, 308; as a local sedative, 328 

Simarubacese, 752 

Simpson, Sir J. Y., his mode of administering 
chloroform, 191; and discovery of the use of, as 
an ansesthetic, 193 

Sipping, the action of, a powerful stimulant to 
the brain, 177 ; increases the secretion of the 
bile, 353; and abolishes the inhibitory action 
of the vagus on the heart, 354; the value of 
Carlsbad water in hepatic disease is probably 
owing to its being taken in sips, 354 

Sitz bath, cold, 399 ; hot, 402 

Skatol, action of, on bacteria, 99 

Skin, action of drugs on the, 377-383 ; as diapho- 
retics and sudoritics, 377 ; effects of warmth on 
the, 378 ; excretion by the sweat glands, 379 ; 
relation between sweat glands and kidneys, 
379 ; action of the, in regulating temperature, 
380 ; antihydrotics or anhydrotics, 381 ; diagram 
to illustrate the action of anhydrotics, 381; 
the night sweats of phthisis, 882 ; cause of pro- 
fuse sweating, 382; application of drugs by the, 
393; three methods ot applying drugs to the — 
(1) by epidermic application, 393-395; power of 
absorption of the, 394,395; by baths, 395; the 
cold bath, 396 ; objects of the cold bath, 396-398 ; 
the cold pack, 398; cold sponging, 398; cold 
douches, 399 ; the sitz bath, 399 ; cold foot bath, 
400; cold compresses, 400; tepid baths, 401; 
warm baths, 401 ; hot baths, 401 ; hot foot bath, 
402; hot sitz bath, 402; poultices, 402; medi- 
cated baths, 403; acid bath, 403; alkaline baths, 
403 ; sulphurous baths, 403 ; the mustard baths, 
403; the pine bath, 404; vapor baths, 404; 
calomel fumigation, 404; air baths, 404; the 
Turkish bath, 404; by friction, 405; by inunc- 
tion, 406; (2) by endermic application, 407; (3) 
by hypodermic application, 407; diagram of 
syringe for hypodermic injection, 408; objec- 
tions to hypodermic injections, 408; action 
of hydrocyanic acid on the, 490; of alkalis, 
499, 500; soda as a stimulant to the, 525; of 
dried alum, 556; of nitrate of silver, 576; of 
arsenic, 606 ; of antimony, 613 ; of iron salts, 
627 ; of alcohol, 650, 653; of spirit of ether, 662; 
of purified chloroform, 675; of opium, 724; of 
mustard, 727 ; of pilocarpine, 751 ; of chrysa- 
I robin, 765 ; of oil of copaiva, 769 ; of Jamaica 



968 



GENERAL INDEX. 



dogwood, 770; of oil of eucalyptus, 781; of 
ipecacuanha, 803; of tannic acid, 876; of col- 
chicuin, 89S 
Skull-cap. See Scutellaria 

Sleep, remedies which induce, 179 ; the cerebro- 
spinal system functionally inactive in, 179; 
certain parts of the nervous system may still 
remain active, 179 ; the inactivity caused by 
anaemia, 179; state of the arteries of the brain 
during, 179; and in normal, 180; the brain 
anaemic during, 180; two things necessary to 
produce, 180 ; to lessen circulation in the brain, 
and to lessen its functional activity, 180; posi- 
tion may sometimes induce, 180 ; cold to the 
abdomen prevents, and warmth procures, 180; 
warmth to the stomach in the shape of warm 
food and drinks, causes, 181 ; efficacy of the wet 
pack in inducing, 181 ; cold feet prevents, 181 ; 
and cooling the surface of the body sometimes 
induces, 181; opium and morphia the chief 
hypnotics or inducers of, 181 ; list of the prin- 
cipal hypnotics, 181 ; nature of the reflexes in 
ordinary and mesmeric, 186 
Slippery elm, 878 
Smell, action of drugs on, 206 
Smelling salts, stimulating action of, on the brain, 

177 
Smells, remedies for destroying disagreeable, 

105-108 
Sniilacere, 888 
Smoke, utility of inhaling certain kinds of, in 

asthma, 413 
Smut, corn, characters and action of, 911 
Snail, structure of the heart of the, 285 
Snake-bite, as a poison, with its antidote, 421 ; 

action of strong solution of ammonia in, 542 
Snake poison, effects of, on the blood, 82; action 

of ammonia in, 292 : 
Sneezing, drugs which cause, their number, 

nature and uses, 219, 220 
Snuff, Ferrier's, composition and use of, 622 
Soap, as an emollient, 307 
Soap, curd, 914 
Soap, hard, chaiacters, &c, of, 819 

Soft, 819 
Soap, solt, action of on bacteria, 99, 100 
Socalo'in, nature and action of, 891 
Soda, as a caustic, 304; difference between the 

action of, and potash on the intestines, 334 
Soda, nature, action, and uses of — 
Acetate of, 528 
Benzoate of, 531 
Bi borate of, 528 
Bicarbonate of, 526 
Bisulphite of, 533 
Borate of, 528 
Borax, 528 
Bromide of, 531 
Carbonate of, 525 
Caustic, 526 
Chlorate of, 530 
Chloride of, 524 

Effervescent, citro-tartrate of, 527 
1 1 v]... phosphite of, 530 
Iodide of, 531 
Nitrate of, 524 
Phosphate "i; 530 
Pyrophosphate <>f, 532 
Salicylate of, 532 
Santoninate of, 532 

S> pint ion of, 526 

Sulphate of, 529 

Sulphite of, 533 

Sulphocarbolate of, 533 

Tartarated, 528 

Valerianate of, 538 
Soda .'-alts, sources of, 522; reactions of, 522; pre- 
paration- of, 528; impurities of, 524; tests for 
impurities in, 524 ; genera] action of, 521; their 
action, in Large doses, on muscle and nerve, 524 
Soda tartarata, 511 
Bods, arsenias, on 

,\ reeniatis, liquor, on 

Citro-tartras effervescens, 527 

Valerian as, 660 
Sodlc hyposulphite, 93 

SodiC sul]. hate, action of, on bacteria, 9.". 



Sodii iodidum, 470 

Santoninas, 808 
Sodium, symbol and atomic weight of, 37; its 
relation to other members of a group, 42, phy- 
siological action of, 51 
Sodium Acetate, as a remote antacid, 322 
Benzoate, as a hepatic stimulant, 351 
Bicarbonate, action of, on the ear, 205; as a 

direct antacid, 322 
Carbonate, as a direct antacid, 322 
Chloride, as a vermicide, 355 
Citrate, as a remote antacid, 322 
Phosphate, as a hepatic stimulant, 351 
Salicylate, as a hepatic stimulant, 351 
Salts, action of, on the intestines, 334; as a 

refrigerant diuretic, 374 
Sulphate, as a hepatic stimulant, 351; an- 
tagonism of, to barium, 422-425 
Sokoloff, reference to, 133?*. 
Solanacese, 834 
Solution of— 

Acetate of ammonia, 544 
Ammonia, 542 

Basic ferric sulphate of iron, 631 
Bichromate of potassium, 517 
Carbonate of magnesia. 561 
Chloride of calcium, 552 
Chloride of iron, 633 
Chloride of tin, 600 
Chloride of zinc, 569 
Chlorinated lime, 467 
Citrate of ammonia, 544 
Citrate of bismuth, 623 
Citrate of iron and quinine, 636 
Citrate of magnesia, 562 
Iodide of arsenic and mercury, 612 
Liquor potassse permanganatis, 515 
Litmus, 908 

Perchloride of (strong), 633 
Pernitrate of iron, 637 
Persulphate of iron, 637 
Potash, 509 

Red prussiate of potash, 517 
Soda, 525 

Sr.bacetate of lead, 598 
Subsulphate of iron, 631 
Tersulphate of, 631 
Turmeric, 901 

Yellow prussiate of potash, 517 
Solution, test, of albumen, 920 
Solutions, 440 

Sonnenschein, references to, 104 
Soporific, Indian hemp or American cannabis as 

a, 880 ; lupulin as, 881 
Soporifics, 179. See Hypnotics 
Spanish flies, 925 

Sparteine, action of, on inhibitory ganglia, 280 
Spasm, nature and cause of, 193 ; general mode 
of treatment, 193-195 ; list of antispasmodics 
and adjuvants, 195 
Spearmint and oil, as a carminative, 330 
Spearmint, oil of, characters, action, and use of, 

853; as a carminative and stimulant, 853 
Spectrum of simple and compound bodies, 38; of 
calcium chloride, 39 ; of lithium, 39; of calcium, 
40; hemoglobin and its derivatives, 81 
Spence, Dr. A. J., references to, 166 
Spermaceti, 919; as an emollient, 920 
Sphacelinic acid, 910 
Splnerobacteria, 90 

Sphincter muscle of the iris, nature and func- 
tions of, 197 
Spider's web as a styptic, 309 
Spigelia, characters "and use of, 821 ; as an anthel- 
mintic, 827 
Spinal centre for respiration, 211; vaso-motor, 
251, 262, 824; for secretion of sweat, 377 ; for the 
generative organs, 886 
Spinal cord, action of drugs on the, 117-167; the 
three functions of the, 1 17; action of drugs on 
the conducting power of the, 117; mode of 
testing this, 117; mode of ascertaining the 
power of the, to conduct sensory impressions, 
148; and reflex stimuli, 148: and of the time 
required for transverse and longitudinal con- 
duction, 1 1^; diagrams illustrative of this, 149, 
I 151; mode of experimenting on the action of 



GENERAL INDEX. 



969 



drugs on the reflex action of the, 151 ; direct, 
indirect, and inhibitory paralysis of the, by 
drugs, 151, 152 ; list of, and uses of, depressants 
for the, 152; inhibitory paralysis of the, 153; 
experiments illustrative of this, 153 ; diagram 
to illustrate inhibition in the, 156; explana- 
tion of the actions of certain drugs on the, on 
the author's hypothesis, 158-163; stimulating 
action of drugs on the reflex powers of the, 
163; Magendie's series of experiments on the 
action of poison on, 163-167 ; diagram illustra- 
ting Magendie's method of investigating the 
mode of action of strychnine on, 165; stimu- 
lants for the, and their uses, 167 ; antagonism 
between drugs acting on the respiratory centre 
and the, 425; action of ammonium salts on 
the, 504 ; of bromide of potassium, 521 ; of am- 
monium chloride, 540 ; of manganese salts, 640 ; 
of spirits of ether, 662; of nitro-glycerine, 668; 
of chloral hydrate, 671; of carbolic acid, 688; 
of aconitia, 689; of delphinine, 702; of codeine, 
714; of opium, 718; of sanguinaria, 725; of 
physostigmine, 762; of Jamaica dogwood, 769; 
of oil of eucalyptus, 781 ; of con'ine, 786 ; of 
quinine, 801; of oil of valerian, 806 ; of strych- 
nine, 825; of curare, 826; of gelsemium, 827; of 
tobacco, 843 ; of digitalin, 844 ; of thymol, 854 ; 
of colchicum, 898 
Spinal depressants, number, nature and uses of, 

152; stimulants, 167 
Spirit, proof, 658; rectified, 658; of French wine, 658 
Spirit of chloroform, as a cardiac stimulant, 291 
Spirit of ether, as a cardiac stimulant,* 291 
Spirits, 445 

Spirits, as a carminative, 330 
Spiritus retheris, 446, 662 

Compositus, 446, 661, 663 
Nitrosi, 446 
Ammonia?, 446 

Aromaticus, 446, 540, 541,543,661, 

860 
Fcetidus, 446 
Anisi, 446, 790 

Armoracise compositus, 446, 728, 738, 860 
Aurantii, 446, 738 
Cajuputi, 446, 780 
Camphorse, 446, 862 
Chloroformi, 446, 675 
Oinnamomi, 862 
Cinnamonii, 446 
Frumenti, 446 
Gaultheria?, 446, 816 
Juniperi, 446, 887 

Compositus, 446, 791, 887 
Lavandulae, 446, 852 
Limonis, 446, 739 
Menthse piperita?, 446, 853 
Viridis, 446, 853 
Myrcise, 446, 738, 779 
Myristicae, 446, 860 
Odoratus, 446, 737, 739, 740, 852 
Rectifieatus, 446 
Rosmarini, 446, 852 
Tenuior, 446 
Vini gallici, 446 
Spiritus vini gallici, mistura, 920 
Spirobacteria, 90 

Splanchnics, the, and the kidneys, 370 
Spleen, action of alcohol on the, 649 ; action of 

physostigmine, 764 ; of oil of eucalyptus, 781 
Squill, action and. use of, 890 ; in large doses, 890 ; 
on the pulse, and as a diuretic and expecto- 
rant, 890 
Squills, action of, on the blood vessels, 223; as a 
stimulating expectorant, 227; as a cardiac 
tonic, 294; as a general emetic, 326; as a re- 
frigerant diuretic, 374 
Squirting cucumber fruit, 784 
Stannius, reference to, 824 
Stannius's experiments as to the actions of the 

various cavities of the frog's heart, 282-285 
Staphisagria, or stavesacre, cbaracters and com- 
position of, 701 ; action of, in frogs, 702 ; del- 
phinine acts like aconitine on the pulse and 
respiration, 702 ; on the spinal cord and medulla, 
702; on the vagus and the heart, 702; uses of, 
702 



Star-anise, character and composition of, 705 

Starch, 904 ; characters and uses, 904 

Starch, is converted into dextrin and sugar by 
boiling with acids, 82 ; as a demulcent, 307 

Stavesacre, 701 

Stearic acid, action of, on bacteria, 99 

Stenhouse, Dr., reference to, 758 

Stenosis, mitral, cardiac tonics useful in, 295 ; 
aortic, digitalis of doubtful use in, 295 

Stenson's experiment on the abdominal aorta of 
a rabbit, 152 

Sterculiacese, 741 

Sternutatories, or errhines, number, nature, and 
uses of, 219, 220; contra-indications of, 220; 
must be used with caution in certain cases, 220 

Stevens, reference to, 846 

Stewed apples, as a laxative, 339 

Stillingia, as an alterative, 358; characters and 
uses of, 867 ; as an alterative, 867 

Stimulant, beef-tea versus alcohol as a, 656 

Stimulants, spinal, 167; nerve, 176; cerebral, 176; 
cardiac, 291; vascular, 292; hepatic, 361; diu- 
retic, 373, 374 

Stirling, references to, 123 

Stolnikow, reference to, 722ra. 

Stomach, impaired power of the, in the aged, 
310; normal and abnormal condition of, 319; 
irritability of the, 319; diagram to illustrate 
the supposed nervous connections of the, 319 ; 
three factors in the process of digestion in the, 
320 ; action of drugs on secretion in the, 320 ; 
drugs which stimulate the secretion of the 
gastric juice, 320; importance of thorough 
mastication, 320; supply of artificially diges- 
tive substances to the, 321 ; action of drugs on 
the movements of the, 321 ; absorption from 
the, 321 ; action of calomel on the, 322 ; use of 
gastric sedatives in relieving pain in the, 328 ; 
and vomiting from the, 328 ; list of sedatives 
which have the most powerful action on the, 
in certain circumstances, 328 ; action of, in 
expelling gases from the, 329, 330 ; drugs which 
tend to prevent fermentation in the, 329 ; they 
remove pain and distention of, and diminish 
local spasm, 330 ; action of irritant poisons on 
the, 344, 345; diagram to show the nervous 
mechanism by which the action of the heart 
may be depressed by irritation of the, 345; 
diagram of the liver, intestines, and, 351 ; ap- 
plication of drugs to the, 414 ; the stomach- 
pump, 414; the gastric syphon, and its use, 
414 ; action of acids in the, 476 ; of alkalis, 501 ; 
of the metals— zinc, copper, cadmium, and silver, 
565, 566 ; of nitrate of silver, 576 ; of mercury, 
581 ; of phosphorus, 604 ; of arsenic, 606 ; of 
antimony, 613; of iron salts, 628; of gold, 641 ; 
of alcohol, 650 ; of spirit of ether, 662 ; of chlo- 
ral hydrate, 671; of aconitia, 700; of pilocar- 
pine, 749 ; of physostigmine, 764 ; of quinine, 
799 ; of tannic acid, 876 ; of oil of turpentine, 883 

Stomach cough, probable origin of the so-called, 
222; rationale of the, 222 

Stomachic, black pepper as a, 871 ; lupulin as, 881 
Storax, characters, composition, and use of, 874 ; 

prepared, 874 
Stramonium, as a narcotic, 182; as a general ano- 
dyne, 183; action of, on the lung, on the respi- 
ratory centre, and on the ends of the vagi, 223; 
on the vagus centre, 279 ; on the vaso-motor 
centre, 279 ; as a poison, with its antidote, 421 
Stramonium leaves, characters of, 841 
Seed, 842 

Seeds, characters, action, and use of, 842; as 
an antispasmodic, 842 
Strieker's stage, uses of a, 70 
Stromuhr, Ludwig's, 259 

Strontium, symbol and atomic weight of, 37; 
physiological action of, 51; action of, on the 
muscles, 131, 137; causes contraction of the 
vessels, 246 
Strophanthine, as a cardiac tonic, 294 ; as a refrig- 
erant diuretic, 374 
Strophanthus hispidus, action of, on the cardiac 

muscle, 281 ; as a cardiac tonic, 294 
Strychnina, 429, 822 

Strychnine, cumulative action of, 58; effect of, on 
protoplasm, 72; has little power on infusoria, 



970 



GEXEEAL IXDEX. 



75: effects of, on oxidation, 79, 82; action of, on 
medusa?, 112; onmollusca,114; onascidians,115; 
and on annulosa, 116; on muscle, 120, 139; 
effect of, on the spinal cord, 150, 15s ; effect of, 
in causing tetanus, 160, 161-163; Magendie's 
series of experiments on the action of, 163-167 ; 
as a spinal stimulant, 167; action of, on the 
brain of dogs, 172; and of men, 178; on the ear, 
205; on taste and the sense of smell, 206; on 
the respiratory centre, 215; as a stimulating 
expectorant, 227 ; action of, on the vaso-motor 
centre, 251, 279 ; as a cardiac tonic, 294 ; as a 
vascular tonic, 297; fails to poison -when the 
vagi are divided, 322 ; as an antihydrotic, 381 ; 
action of, in lessening the night sweats in 
phthisis, 381-383 ; as an aphrodisiac, 388 ; as an 
indirect emmenagogue, 391; as a poison, with 
its antidote, 421; antagonism of, to other drugs, 
422-425 : antagonistic action of, to chloral, 424, 
425 
Strychnine, 822 

Sulphate of, preparation and characters of, 
s22 : action of, on low organisms, on 
oxidation, and fermentation, 822; on the 
reflex nerve centres, on the intestines and 
sensory nerves, 822; poisoning by, and 
treatment for, 823; action of, on the 
alimentary canal, on the blood and circu- 
lation, 823: on the heart, respiration, and 
muscles, 824; on the nervous system and 
brain, 624; on the spinal cord, 824; uses of, 
825 
Stuart, Anderson, references to, 124, 137 
Sturiones, 920 

Styptic, action of dried alum as a, 556; strong 
solution of perchloride of iron one of the most 
powerful styptics, 634; matico as a, 872 
Styria, arsenic-eaters of, account of the, 607 
Subchloride of mercury, 587 
Sublimed sulphur, its preparation, characters, 

&C., 461 
Subnitrate of bismuth, 622 
Subsulphate of mercury, as a local emetic, 326 
Succus belladonna?, 447*, 836 
Conii, 447, 786 
Hyoscyami, 447, S41 
Limonis, 485 
Scoparii, 447, 758 
Taraxaci, 447, 810 
Sudorifics, action of, on the secretion of sweat, 377 
Suet, 914; prepared, 914 

Suffocation, cause of, 214; produced by the action 
of certain poisons on the respiratory tract, 346 
Sugar, 905 : as a vehicle and corrigent, 906 ; pre- 
servative and antiseptic, 906; sugar, refined, 905 
Sugar of milk, 915 
Sulpha-moglobin, 81 

Sulphate of aluminium, action of, on bacteria, 98 
Sulphate of aluminium, 558 
Ammonium, 545 
Atropine. s :;7 
Boberia. ><;•" 
Hyoscyamine, 841 
Iron, 629 

and Ammonium, 637 
Dried, 630 
Granulated, 630 
Precipitated, 630 
Magnesia, 560 
Mercury, 587 
Morphine, 713 
Potash, 512 
Soda, 529 
Zinc. 570 
Sulphate of bebei inc. action of, on protoplasm, 72 
Sulphate "f potash, as a cbolagogue purgative, 

Sulphate of potassium, sodium, and magnesium, 
as saline purgatives, '■'>'■'•'.* 

Sulphate o/ Boaa, as a cholagogue purgative, 853 

Sulphates, genera] action of, 504 

Sulphide of mercury, red, 

Sulphite of Boda, •">:;:; 

Sulphites, teal for, 198 

Salpbocarbolateofsoda, 533 

Sulphocyanide of potassium, action of. on mol- 
luscs, 1 1 1 



Sulpho-vinate of sodium, as a saline purgative, 

339 
Sulphur, symbol and atomic weight of, 37; its 
relation to other members of a group, 42 ; as a 
stimulating expectorant, 227; as a laxative and 
purgative, 339 
Sulphur and its elements, 461-464; sublimed sul- 
phur, flowers of sulphur, 461 ; confection of 
sulphur, 461 ; sulphur ointment, 461 ; washed 
sulphur, 461 ; alkaline sulphur ointment, 462 ; 
precipitated sulphur, lac sulphuris, or milk of 
sulphur, 462 ; sulphuretted hydrogen, or hydro- 
gen sulphide, 462 ; general action of sulphuret- 
ted hydrogen, 463; special action, 463; action 
and uses of sulphur, 463, 464; iodide of, 470 
Sulphur lotum, 461 

Precipitatum, 461 
Sulphurated potash, 516 

Sulphuretted hydrogen, action of water of, on 
bacteria, 99; as a poison, with its antidote, 
416 ; its preparation and properties, 462, 463 
Sulphuric acid, physiological action of, 51; direct 
and local action of, 53; effects of, on alcohol, 
82 ; on bacteria, 96, 9S ; as a caustic, 304 ; as a 
poison, with its antidote, 417; properties and 
uses of, 477 
Sulphuris iodidum, 462, 470 
Sulphurous acid, action of, on enzymes, 86; on 

bacteria, 96 ; properties and uses of, 478 
Sulphurous bath, uses of a, 403 
Sumach, as an astringent, 755 
Sumbul, as an antispasmodic, 195; characters 
and uses of, chiefly in hysteria, 791 
Root, 791 
Suppositoria acidi carbolici cum sapone, 446, 688, 
914 
Acidi tannici, 446, 742, 876, 924 

cum Sapone, 446, 914 
Hvdrargyri, 446, 583, 742, 924 
Morphite, 446, 712, 742, 924 

cum Sapone, 446, 712, 914 
Plumbi composita, 446, 598, 742, 924 
Suppositories, nature and uses of, 415 
Suppositories, 446 

Surgical operations, use of antiseptics in, 106; Sir 
Joseph Lister on the best mode of performing, 
689 
Sustschinsky, reference to, 277 
Sweat, mode" of secretion of, 377; various causes 
which arrest or increase the secretion of, 378; 
excretion by the sweat glands, 379; relation 
between the sweat glands and the kidneys, 379; 
uses of diaphoretics and sudorifics in increas- 
ing the secretion of, 377 ; action of antihy- 
drotics on the secretion of the, 381; the night 
sweats of phthisis, 382; diagram to illustrate 
the action of antihydrotics, 381; connection of 
the respiratory centre with the sweat glands, 
383; various drugs which act on the secretion 
of, 382 ; action of carbolic acid on the sweat 
centres, 689 ; action of opium on the secretion 
of, 719; and of erythroxyl.m, T;!-'! 
Sylvester's plan of artificial respiration, 680 
Syncope, caused by sudden change of posture, 
186, 187 ; by the use of anesthetics, 189-191 ; by 
fainting and shock, 230-232; by the incautious 
use of cardiac tonics, 296; by the lownessofthe 
blood-pressure, 295; by the administration of 
digitalis, 296 
Syphon, gastric, nature and uses of, ill 
Syringe, diagram of a, for hypodermic injection, 
' in-- : of a vulcanite, for injecting solutions into 
the ear, 410; of a vulcanite, for injecting solu- 
tions into the urethra, 415 
Syrupus acaciae, i it, 77o 
Acidi citrici, I 17, 185 
Hydriodici, 1 17 
Allii, 117, 889 
Althsese, 447, 786 
Amygdala?, n:. 77'; 
Aurantii, 147, 148, 788 

Floris, 148,787 
Calcii lactophosphatis, 117, 558 
Calcis, H7, 550 
Cheken, 770 
Chloral, us, 670 
FerrJ Bromidi, 1 17 



GENERAL INDEX. 



971 



Syrupus Ferri— 

Iodidi, 447, 448, 470, 638 
Phosphatis, 448, 484, 528, 639 
Quinina? et strychnina? phosphatum, 
447, 639, 796, 822 
Heinidesmi, 448, 829 
Hypophosphiturn, 447, 531, 554 

cum Ferro, 447, 637 
Ipecacuanha?, 447, 803 
Kranieria?, 447, 731 
Lactucarii, 447, 811 
Limonis, 447, 448, 485, 739, 740 
Mori, 448, 879 
Papaveris, 448, 708 
Picis liquid a?, 447, 886 
Pruni Virginian a?, 447 

Fluidum, 777 
Rhanini, 448, 753, 779, 900 
Rhei, 447, 792, 857, 858 

Aroniaticus, 447, 778, 857, 858 
Rhceados, 448, 725 
Rosa?, 447, 773 

Galliea?, 448, 773 
Rubi, 447 

Ida?i, 447, 772 
Sarsaparilla? compositus, 448, 766, 772, 816, 8( 

888 
Scillae, 448, 890 

Compositus, 448, 617, 620, 731, 890 
Senega?, 448, 731 
Semite, 448, 766, 792 
Tolutanus, 448, 760 
Zingiberis, 448, 900 
Syrup of bromide of iron, 638 
Syrups, 447 
Szpilman, reference to, 134 



T. 



Tamarind, character, composition, and use of> 
766, 767 

Tannate of soda, action of, on the kidneys, 376 

Tannic acid, 875 

Tannic acid, as an astringent, 308 ; preparation 
and properties of, 875 ; action of, on the skin, 
mucous membranes, mouth, and stomach, 876; 
on the blood and kidneys, 876; uses of, exter- 
nally and internally, 876, 877 

Tannin, action of, on bacteria, 99; on the mucous 
membranes. 226; as a styptic, 309; as a vermi- 
cide, 355 ; action of, on the kidneys, 376; indi- 
gestibleness of tea partly due to the tannin it 
contains, 742 

Tansy, characters and uses of, 807; as a diuretic, 
stimulant, emmenagogue, and anthelmintic, 
808 

Tantalum, symbol and atomic weight of, 37 

Tar as a stimulating expectorant, 227 ; action 
and use of, 886 ; as a stimulant, 886 

Tar, oil of, 886 

Taraxacum, 810 

Taraxacum, as a stimulant diuretic, 374 

Tartar emetic, effects of, on the blood, 82; as a 
depressant expectorant, 227 ; action of, on the 
system, in causing vomiting, 325 ; as a general 
emetic, 326 ; nature aud use of, 614-616 ; oint- 
ment, 621 

Tartarated soda, as a remote antacid, 322 

Tartaric acid, as a poison, with its antidote, 417; 
properties of, &c, 484 

Tartrate, test for, 498 

Tartrate of iron and ammonium, 635 
Potassium, 635 
Potash, 512 
Soda, 528 

Taste, action of drugs on the sense of, 206 

Tea, characters, action, and uses of, 742; a 
powerful cerebral stimulant, 742 ; indigestible- 
ness of, partly due to the tannin it contains, 
742 

Teeth, danger of extracting the, with chloroform, 
in certain cases, 189; action of drugs on the, 
310; importance of the, for mastication, 310; 
what the decay of the, is chiefly due to, 310, 
554; the best substances for cleansing the, 310; 
and for protecting and preserving the gums, 



311,500; remedies for toothache, 311, 554,689, 
691, 723 

Tellurium, symbol and atomic weight of, 37 ; its 
relation to other members of a group, 42 

Teleostese, 921 

Temperature, effect of, on the action of drugs, 59, 
62; on the secreting nerves, 60 ; of the body 
half a degree higher in India, 62 ; effects of, on 
ferments, 84; on mould fungi, 91; on bacteria, 
93 ; excess of, injurious to the human organism, 
but destructive of bacteria, 104 ; effects of, on 
the rhythmical action of medusa?, 110; on 
mollusca, 114; on muscles, 126 et seq.; effects 
of, on the poisonous action of guanidine, 162 ; 
the, of warm-blooded animals, 361 ; action of 
antipyretics on, 362; action of the skin in 
regulating the, 380; action of salicylate of soda 
on the 532; of mercury on the, 583; of alcohol, 
651 ; of chloral hydrate, 671 ; of carbolic acid, 689 ; 
of salicylic acid, 693; of aconitine, 700; of 
erythroxylon, 733; of caffeine, 743; of pilocar- 
pine, 751 ; of oil of eucalyptus, 781 ; of solanine, 
835; of belladonna or atropine, 839; effects of, 
on the action of digitalin, 847 ; of thymol, 854; 
of camphor, 863, 864; of Indian hemp or 
American cannabis, 880; of oil of turpentine, 
883; of thuja, 887; of veratrine, 897 

Tents, nature and uses of, 416 

Tepid baths, 401 

Terbium, symbol and atomic weight of, 37 

Terebinthacea?, 754 

Tetrachloride of carbon, as an anaesthetic, 186 

Thalamiflora?, 697 et seq. 

Thallium, symbol and atomic weight of, 37; 
physiological action of, 51 

Thebaine, a» a spinal stimulant, 167; action of, 
on the respiratory centre, 215; on the vaso- 
motor centie, 279; antagonism of, to chloral, 
422-425 ; acts like strychnine, 825 

Theobroma, oil of (cacao butter), characters 
uses, &c, of, 741 

Theobromine, action of, on muscles, 128 

Therapeutics, definition of, (1) may be either 
empirical or rational, 33; explanation and 
example of empirical therapeutics, 33; and 
also of rational, 33, 34; first stage of rational, 34; 
what should follow this, 34 

Thermometer, importance of cleansing and dis- 
infecting, 106, 107 

Theveresine, action of, on the cardiac muscle, 
281 

Thevetin, action of, on the cardiac muscle, 281 

Thighs, utility of mustard stupes, poultices, and 
leeches to the, as indirect emmenagogues, 390 

Thirst, two kinds of, local and general, 317; 
nature of local, and how it is lessened or 
quenched, 317; general, and the means of 
alleviating, 317 

Thomas, reference to, 61 

Thorium, symbol and atomic weight of, 37 

Thoroughwort, 810 

Throat, action of pilocarpine on the, 751 

Thuja, characters and action of, S86; in pro- 
ducing abortion, convulsions, and paralysis,. 
886, 887; on the vessels and temperature, 887; 
uses of, as a diuretic, astringent, aromatic, and 
vermifuge, 887 

Thulium, symbol and atomic weight of, 37 

Thymol, action of, on enzymes, 86 ; on bacteria, 
96, 99, 100; preparation and characters of, 854; 
action of, as a disinfectant, and on the nerve 
centres of the medulla and cord. 854 ; on the 
respiration, blood-pressure, and temperature, 
854; how eliminated, 855; utes of, as an anti- 
septic, 855 

Ticunas. See Curare 

Tinctura aconiti, 448, 450, 698 
Aloes, 448, 450, 757, 891, 892 

et Myrrh a?, 448, 756, 892 
Arnica?, 450, 811 

Florum, 448, 812 
Radicis, 448, 811 
Asafcetida?, 448, 450 
Aurantii, 450, 738 

Recentis, 450, 738 
Amari, 449, 737 
Dulcis, 449, 738 



972 



GENERAL INDEX. 



Tinctura — 

Belladonna;, 449, 450, 836 
Benzoini, 449, 817 

Composita, 449, 450, 7G0, 817, 874, 
891, 892 
Brvoniae, 449, 785 
Buchu, 450, 74S 
Calendula;, 449, S12 
Calumbae, 449, 550, 706 
Camphorse composita, 450, 710, 790, 817, 863 
Cannabis indicae, 449, 450, S79 
Cantharidis, 449, 450, 925 
Capsici, 449, 450, 835 
Cardamomi, 449, 901 

Composita, 449, 450, 745, 791, 861, 
901, 924, 
Cascarillae, 450, 867 
Castorei, 450, 913 
Catechu, 450, 861 

Composita, 449, 770 
Chiratae, 449, 450, 831 
Chloroformi composita, 450, 675, 901 
Ciniicifugae, 449, 703 
Cinchona?, 449, 795 

Composita, 449, 450, 738, 794, 795, 

866, 902, 924 
Flavae, 450, 795 
Ciunamomi, 449, 450, 861 
Cocci, 450, 924 
Colchici, 449 

Seminum, 450, 898 
Seminis, 898 
Conii, 449, 450, 786 
Croci, 449, 450, 902 
Cubebae, 449, 450, 871 
Digitalis, 449, 450, 844 
Ergotae, 450, 908 
Ervthrophlcei, 771 
Ferri acetatis, 449, 450, 510, 631 
Chloridi. 449, 633 
Perchloridi, 450, 634 
Gallae, 449, 450, 875 
Gelsemii. 449, 827 

Gentianae composita, 449, 450, 738, 830, 901 
Guaiaci, 449, 746 

Ammoniata, 449, 450, 543, 746 
Herbarum receutium, 449 
Humuli, 449, 881 
Hydrastis, 449, 705 
Hyoscyanii, 449, 450, 841 
Ignatiae, 449, 821 
Iodi, 449, 450, 470, 518 
Ipecacuanha; et opii, 449, 710, 803 
Jalapae, 450, 834 
Kino, 449, 450, 759 
Krameria', 449, 450, 731 
Laricis. 450, 885 
Lavandula: composita, 449, 450, 759, 778, 852, 

860, 861 
Limonis, 450, 739 
Lobelia', 440. 450, 814 

.Etherea, 450, 662, 814 
Lupuli, 450, 881 
Maticae, 440, 872 
Moschi, 449,911 
Myrrhae, 449, 450, 756 
Nucis vomicae, 449, 450, 821 
Opii, 449, 450, 710 

Ammoniata, 450, 541, 710, 790, 817, 902 
Camphorata, M9, 710, 790, 817, 862 
Deodorata, 1 19, 710 
Phy80Stigmatis, 149, 761 
Pyrethri, 1 19, 450, 807 
Quassiae, 1 19, 150, 752 
Quebracho, 828 
Quiniae, 150, 797 

Ammoniata, 450, 797 
Rhei, 449, 150, 792, 857, 858,901, 902 
Aromatica, 149, 77s, 857, 858 
Dulcis, 1 19, 857, 858 
Sabinae, 150 

linai i:i . 1 I'.), 726 
Saponifl \ Lridifl, 1 19, 819 

Sdllae, ir.t, 151, 

Sen< ra . L0L 781 

Sennae, 151, 745, 766, 791, 792 

Serpentarise, 149, 151, 366 



Tinctura — 

Stramonii, 449, 451, 842 
Sumbul, 449, 451, 791 
Tolutana, 449, 451, 760 
Valerianae, 449, 451, 805 

Ammoniata, 449, 451, 543, 805 
Vanilla;, 450, 899 
Veratri viridis, 450, 451, 894 
Zingiberis, 450, 451, 900 

Fortior, 451, 910 

Tin, symbol and atomic weight of, 37 ; causes 
powerful contraction of the vessels, 246 ; gen- 
eral action of, 593 ; nature and uses of granu- 
lated, 600; of solution of chloride of, 600 

Tincture, litmus, 908 

Tincture, turmeric, 901 

Tincture of acetate of iron, 633 

Tinctures, 448-451 

Tissue change, action of drugs on, 356-364; 
of tonics, 356; of haeinatinics, or blood tonics, 
357 ; of alteratives, and their action on the tis- 
sues, 35S-361 ; of antipyretics, or febrifuges, 361 ; 
list of the chief, their action, 362 ; and their 
uses, 363; experiments as to the action of drugs 
on, 359; action of the heavy metals on, 564; of 
silver, 576 ; of salts of iron, 628; of alcohol, 650; 
of quinine, 800 

Titanium, symbol and atomic weight of, 37 

Tobacco, effect of the inhalation of the smoke of, 
on a rabbit, 218 ; snuff, action of, on the nose, 
219 ; the vapor of tobacco has a local sedative 
action on the lung, 223 ; tobacco as a sialagogue, 
314, 315 ; as a poison, with its antidote, 421 

Tobacco, 842 ; tobacco leaf, character of, 842; gen- 
eral action of, 843 ; on the motor and secreting 
nerves, the intestine, the heart, and vaso-motor 
system, 843 ; in frogs and warm-blooded ani- 
mals, 843; special action of, on the spinal cord, 
circulation, and vagus, 843 ; on the blood-pres- 
sure, heart, and alimentary canal, 843 ; uses of, 
843; on the effects of tobacco-smoking, 843 

Toldt, reference to, 132 

Tolu, balsam of, characters and uses of, as an ex- 
pectorant, 760 

Tonics, as adjuvants to antispasmodics, 194; list 
of cardiac, 293-297; of vascular, 297; of gastric, 
318 ; nature and action of, 356 ; subdivisions of, 
356 : states in which gastric, digestive, vascular, 
and nerve tonics are indicated, 357 ; haema- 
tinics, or blood tonics, 357 ; their mode of ac- 
tion on the blood, 357 ; alteratives and their 
action, 358-361; nature, action, and uses of 
antipyretics or febrifuges, 361-364; quassia as 
a tonic, 752 ; cheken as, 779; quinine as a, 801 ; 
wormwood as, 807 ; oil of chamomile as, 809; 
eupatorium as, 810; rhubarb as, 858 ; sulphate 
of beberia as, 865 ; serpentary root as, 866 ; cas- 
carilla bark as, 867; elm as, 878; lupulin as, 
881 ; sarsaparilla as, 889 ; Iceland moss as, 908 

Tonometer, Boy's, 235 

Toothache, may frequently be removed by means 
of a brisk purgative, 184; various remedies for 
alleviating, 311, 689, 691, 723 

Tortoise, experiments on the muscular structure 
of the, 123, 135; difference betwixt the mam- 
malian heart and that of the, 262 

Tragacanth, characters, composition, and uses of, 
758 

Traube, references to, 54, 260?i. 

Traubes curves, nature of, 234 

Treacle, as a laxative, 906 

Trephining, utility of, in investigating the func- 
tions of the brain, 171, 180 

Trichlorhydrin, as an anaesthetic, 186 

Trimethylamine, action of, on bacteria, 99 

Triticum, 904 

Trituratio elaterini, 451, 785 

Triturations, 151 

Trochisci, 770 

Acidi tannici, 151, 876 
Ammonii chloridi, LSI, 540 
Bismuthi, 451, 622, 623 
Catechu, 151, 770, 805 
Crete, 151, 
Cubebae, 451, 871 
Ferri, 151,631 

Redact!, 151,633 



GENERAL INDEX. 



973 



Trochisci — 

Glycyrrhiza? et opii, 451, 709, 790 
Ipecacuanha?, 451, 803 
Krameria?, 451, 731 
Magnesise, 451 
Mentha? piperita?, 452, 853 
Morphia?, 451, 712 

et Ipecacuanhas, 451, 712, 803, 816 
Morphina? et Ipecacuanha?, 452, 713 
Nitro-glycerini, 668 
Opii, 451, 710, 757 
Potassa? chloratis, 451, 514 
Potassii chloratis, 452 
Sodii bicarbonatis, 452, 527 

Santoninatis, 452, 532, 808 
Zingiberis, 452 
Trypsin, action of, on fibrine, 84, 85 
Tungsten, symbol and atomic weight of, 37; its 

relation to other members of a group, 42 
Tiirck's method of experimenting on reflex ac- 
tion, 151 
Turmeric, 901 ; as a condiment, 901 
Paper, 901 
Solution of, 901 
Tincture, 901 
Turpentine, as a stimulating expectorant, 227 ; 
action of, on the vaso-motor centre, 279 ; as a 
vermicide, 355 ; as a stimulant diuretic, 374 
Turpentine, oil of, action of, on the mucous mem- 
branes, 226 ; importance of, in bronchitis, 226; 
as a poison, with its antidote, 421 
Turpentine, characters of, 882 
Canada, 882 

Oil of, characters and action of, 882 ; when 
inhaled and internally, 883; on the stom- 
ach, respiration, and temperature, 883; on 
the nerve centres and the kidneys, 883 ; use 
of, externally and internally, and as a ver- 
mifuge, 883, 884 
Turpentine water, action of, on enzymes, 86 
Tweedy, Mr. J., reference to, 196, 202 



u. 



Ulcers, chronic, use of vesicants in, 305 ; of as- 
tringents, 309 
UlmaceaB, 878 
Umbellifera?, 785 
Unguentum, 919, 924 

Acidi carbohci, 452, 688, 919, 924 
Gallici, 452, 877, 919 
Tannici, 452, 876, 919 
Aconitia?, 452, 698, 919 
Antimonii tartarati, 452, 617, 620 
Aqute rosa?, 452, 772, 776, 920, 924 
Atropia?,452, 919 
Belladonna?, 452, 836, 919 
Cadmii iodidi, 452, 470, 574 
Cantharidis, 452, 819, 924, 925 
Chrysarobini, 452, 765, 919 
Cetacei, 452, 776, 920, 924 
Creasoti, 452, 691 
Diachvlon, 452, 557, 819 
Elemi; 452, 756 
Galla?, 452, 875, 919 

cum Opio, 452, 710, 875 
Hydrargyri, 452, 583, 914, 919 

Ammoniati, 452, 584, 591, 919 
Compositum, 452, 583, 819, 863, 

924 
Iodidi rubri, 452, 584, 592 
Nitratis, 452, 480, 584, 819, 919 
Oxidi flavi, 452, 583, 590, 919 

Eubri, 452, 583, 590, 776, 
919, 924 
Subchloridi, 452, 588, 919 
Iodi, 452, 518, 919 
Iodoformi, 452, 682, 919 
Mezerei, 452, 919, 924 
Picis liquidge, 452, 886, 924 
Plumbi acetatis, 442, 598 

Carbonatis, 452, 597, 919 
Iodidi, 452, 600, 919 
Subacetatis compositum, 452, 776, 863, 
924 



Unguentum — 

Potassa? sulphuratse, 452, 516, 919 
Potassii iodi, 470 

Iodidi, 452, 919 
Resinse, 452, 885, 924 
Sabina?, 452, 888, 919, 924 
Simplex, 452, 776, 919, 924 
Stramonii, 452, 842, 919 
Sulphuris, 452, 461, 919 

Alkalinum, 452, 462, 919 
Iodidi, 452, 470, 919 
Terebinthina?, 452, 883, 885, 919, 924 
Veratria?, 452, 819, 895, 919 
Veratrina?, 452, 895, 919 
Zinci, 452, 568, 569 

Oxidi, 452, 568, 569, 919 
Uranium, symbol and atomic weight of, 37 
Urari. See Curare 
Urea, drugs which act on the excretion of, 359 ; 

excreted by the tubules, 366, 367 
Urechitine, as a general emetic, 326 
Ureter, rhythmical contraction of the, 133 
Urethra, drugs employed in inflammation of the, 
385 ; application of drugs to the, 415 ; diagram 
of a vulcanite syringe for injecting solutions 
into the, 415 
Uric acid, effects of, on the blood, 82; action of 

lithontriptics on, 377 
Urinary sedatives and astringents, 385; urinary 

organs, action of cantharides on the, 926 
Urine, circumstances modifying the secretion of, 
369-377 ; the rapidity of the secretion of, de- 
pends on two factors, 369 ; arterial pressure in 
the glomeruli and the composition of the bloody 
369-371 ; curves showing the effect of erythro- 
phloeum on blood-pressure and secretion of the, 
371 ; action of lithontriptics on the, 377 ; how 
evacuation of the, is promoted, 384; action of 
the bladder on the, 383-385 ; action of mercury 
on the, 583 ; of nitrite of amyl, 666 ; of bella- 
donna or atropine, 839 ; of Indian hemp or 
American cannabis, 880; of colchicum, 899 ; of 
extract of ergot, 911 
Urticacea?, ulmea? (ulmaceae), 878 
Ustilago, 91 

Uterus, action of ecbolics on, 391 ; the involun- 
tary muscular fibres of the, controlled by two 
nerve centres, 391 ; nature of the nerves which 
stimulate the, 391 ; mode of aiding the expul- 
sive power of the, 392 ; application of drugs to 
the, 415; as pessaries, 416; as caustics, 416; 
utility of tents inserted in, 416 ; action of bo- 
rax on the, 529 ; of pilocarpine, 750, 751 ; of 
physostigmine, 764; of quinine, 801; of aloes, 
893 ; of extract of ergot, 911 
Uva ursi (bearberry), action of, on the bladder, 
384 ; as an astringent, 308 ; as a stimulant diure- 
tic, 374; characters and uses of, 814, 815; as an 
astringent and diuretic, 815 



y. 



Vagina, application of drugs to the, 415 ; as pes- 
saries, 416 ; as caustics, 416 

Yagus, effects of stimulation of the, 135 ; contains 
both expiratory and inspiratory fibres, 215; 
diagram illustrating this, 216 ; reference to the, 
218; experiments on the, 218; cough chiefly 
excited by branches of the, 220; heart's beats 
chiefly regulated by the inhibitory fibres of 
the, 259 ; action of drugs on the cardio-inhibi- 
tory functions of the, 260 ; reflex stimulation 
of the, 261 ; quickened pulse may be caused by 
paralysis of the, 261 ; action of drugs on roots 
of the, 261; irritation of the, causes still-stand 
of the heart, 274 ; action of two classes of poi- 
sons on the, 274; position of the accelerating 
nerves of the, in frogs and warm-blooded ani- 
mals, 274 and %. ; vagus centre in the heart, 
279 ; and ends, 280 ; nature of the action of the, 
upon the heart, 287 ; antagonistic action of cer- 
tain drugs on the, 423; of delphinine, 702; of 
pilocarpine, 750 ; of tobacco, 843 ; of digitalin 
on the roots and ends of the, 847 

Valerianic acid, action of, on bacteria, 99 



974 



GENERAL INDEX. 



Valerian, antispasmodic action of, 194, 195 

Valerian, characters, &c, 805 

Oil of, 806; action o', on the hrain and spinal 
cord, 806; on the blood-pressure and the 
pulse, 806 ; as an antispasmodic, 806 
Eoot, 805 

Valerian and oil, as a carminative, 330 

Valerianaceas, 805 

Valerianate of soda, 533; of zinc, 571; of iron, 
639 

Vanadium, symbol and atomic weight of, 37 

Vanilla, characters and action of, 899; as an aro- 
matic stimulant, 899 

Vapor acidi hydrocyanici, 453, 490 
Chlori, 453, 468 
Conue, 453, 786 
Creasoti, 453, 691 
Iodi, 453, 470 

Vapor baths, 404 

Vapor of hydrocyanic acid, 490 

Vapors, inhalations, 453 

Vascular stimulants, nature and uses of, 292; 
tonics, 297; and sedatives, 300; when vascular 
tonics are serviceable, 357 ; antipyretics, more 
useful in symptomatic fevers than in specific 
ones, 363 

Vaseline, properties and uses of, 647 

Vaso-motor and vaso-dilating nerves, action of 
drugs on, 248 ; the vaso-motor centre paralyzed 
by various drugs, 251 ; action of, on the smaller 
arteries and capillaries, 254; how the activity 
of the vaso-motor centre may be increased, 255 ; 
vaso-motor centre of the heart, 279; and nerves, 
281; action of the salts of iron on the, 628; of 
platinum on the, of mammals, 642; of alcohol, 
653; of carbolic acid, 688; of aconitine, 700; of 
opium on the peripheral, 718; of quillaia (sa- 
ponin), 775; of tobacco, 843; of extract of 
ergot, 910 

Vegetable alkaloids, poisonous properties of some, 
destroyed by the liver, 349 

Vegetable bitters, strong infusions of, as local 
emetics, 326 

Veins, nature and functions of, 229; blood in the, 
useless for nutrition, 229 ; action of the nervous 
system on the, 229 ; of the heart, 230 ; effect of 
an upright and of a horizontal position on the 
circulation of the blood in the, 230; arrest of 
circulation in the, the cause of fainting and 
shock, 230, 231; schema of the circulation from 
the heart to the arterial system and the, 232, 
233; action of blood-pressure on the, 234; 
method of ascertaining the blood-pressure on 
the, 234-236; causes of alterations in blood- 
pressure in the, 236; how blood-pressure may 
be raised and lowered in the, 237 

Venesection, as an antipyretic, 363 

Veratria, 429, 895 

Verarxina, 430 

Verat tine, effects produced by different doses of, 
on froga, 48; effects of heat or cold on the ac- 
tion of, 59; action of, on oxidation, 79; on me- 
dusa-, 112; on mollusca, 114; on ascidians,U5 ; 
on annulosa, 116; power of, for restoring mus- 
cle after fatigue, 120; as a muscular poison, 126- 
147: as a sedative, 146: action of, on the spinal 
cord, 150; as an anodyne, 184; on the respira- 
tory centre, 215, 219; action ofon the vagus roots, 
260; on the heart of the frog, 271 : on the 
vaso-motor centre, 279; on the cardiac muscle, 
281 : as a poison, with its antidote, 121 ; antago- 
nism of, to opium, 422-425 ; physiological ac- 
tion of, in large doses and externally, 896; 
internally, action of, on the brain, spinal cord, 
and muscles, S!)6; on the motor and sensory 
nerves, the circulation, and the pulse, 896; on 
blood-pressure, respiration, and temperature, 
" . u>es of, locally and internally, 896, 897 

Veratroidine,' 895 ; action of, on the vagus centre 
and ends, 895; on the spinal cord and respira- 
tory centre, 895; on the vaso-motor centre, 
blood-pressure, and the pulse, 895 

Veratruin album, action of, on the DOSe, 219 

Veratrum viride, action of, on the vagus centre, 
279; on the cardiac muscle, 281 ; on the palpi- 
tation of the heart, 800; nature and action of, 



Verbenancese, 818 

Vermicides. See Anthelmintics 

Vermifuges. See Anthelmintics 

Vesical sedatives and tonics, action of, on the 

bladder, 384 
Vesicants, 305; strong solution of ammonia as a, 

541 
Vesication, produced by acids, 475 
Vessels, blood, 229; reflex contraction of the, 231; 
experiments with bromide of potassium on the, 
250, 251 ; action of drugs on this reflex contrac- 
tion, 251 ; comparative effect of heart and, on 
blood-pressure on different animals, 252 ; influ- 
ence of nerves on blood-pressure in the, 253- 
256 ; action of pilocarpine on, 750; of thuja on, 
887. See Arteries and Arterioles 
Viburnum (black haw), characters and uses of, 

806 
Vienna paste, as a caustic to extirpate malig- 
nant growths, 306 
Visnal, reference to, 350 
Vinegar, properties and uses of, &o, 483 
Vinegar, aromatic, stimulating action of, on the 
brain, 177 ; action of the, on the heart in man, 
252 ; in dogs and rabbits, 252, 253 
Vinegar *, 429 

Vini gallici, mistura spiritus, 920 
Vinum aloes, 453, 891, 892, 900, 901 
Album, 453 

Fortius, 453, 745 
Antimoniale, 453, 617, 620 
Antimonii, 453, 617, 620 
Aromaticum, 453, 851, 856 
Aurantii, 738 
Colchici, 453, 897 

Radicis, 453, 897 
Seminis, 453, 898 
Ergot a?, 453, 908 
Ferri, 454, 629 

Amarum, 453, 636 
Citratis, 453, 635 
Ipecacuanha?, 453, 803 
Opii, 453, 710, 711,778, 861 
Quinise, 454, 485, 797 
Rhei, 454, 744, 857, 858 
Rubrum, 453 
Xericum, 454 
Viola tricolor (pansy), characters, composition, 

and uses of, 729 
Violacese, 729 

Virchow, references to, 161 
Visions, action of drugs in producing, 204 
Vitaceoe, 745 
Voit, reference to, 360 
Volatile oils, 442, 443 

Vomiting, relieved by blisters, 305; description 
of the act of, 323; and of the nerve centre 
which regulates the, act of, 323; action of the 
brain and afferent nerves on, 323: diagram 
showing the afferent nerves by which the vom- 
iting centre may be excited, 324 ; the action of 
drugs in causing. 324-326; the various uses of 
emetics in causing, 326-328; action of the most 
powerful sedative in persistent, is ice, 328; 
gastric sedatives in relieving, 329; list of seda- 
tives useful in vomiting arising from different 
causes, 329; the action of irritant poisons on 
the stomach gives rise to, :;4."> ; action of pilo- 
carpine on, 75D 

w. 

Warburg's tincture, 802 

Warm, foot, and hip baths, utility of, as indirect 
emmenagogucs, 890 ; warm baths, 401 

Warm-blooded animals, action of tobacco on, 
843; of thuja on, 887 

Warm clothing, importance of, to delicate people, 
228 

Warmth. See Heat 

Warmth and moisture, importance of ; in rooms 
occupied by patients bavins bronchial or chesl 
complaints', 228 ; as an emollient, 307 : poultices 
made of substances which retain, 307 ; action 
of, on the circulation of the blood and the 
secretion of sweat, 878 



GENERAL INDEX. 



975 



Warren, Dr., reference to his use of ether, 193 

Washed sulphur, its preparation, &c., 461 

Wassilieff, reference to, 107 

Water, lukewarm, as a local emetic, 326 ; in large 
quantities, as refrigerant diuretics, 373 

Water of ammonia, 542 

Waters, nature of, uses, and doses, 430 

Watts's modification of Mendelejeff's tables, ref- 
erence to, 495 

Wax, white, 924 

Wax, yellow, 923; its characters, composition, 
tests, and uses, 923 

Weber, E. H., reference to, 199 

Wedenskii, reference to, 129 

Wells, Mr. H., his use of nitrous oxide as an 
anaesthetic, 192 

Wernitz, reference to, 85 

Wheaten flour, 903 

White, reference to, 137 
Indian hemp, 829 
Precipitate, 590 
Quebracho bark, 828 
Wax, 924 

Wild marjoram. See Origanum 

Williams's apparatus used in researches in digita- 
ls, 267, 268 

Willow. See Salix 

Wilwhite, Dr., reference to his use of ether, 192 

Wine, spirit of French, 658; red wine, 659, 745; 
white wine, 658, 745 ; stronger ditto, 659 ; sherry, 
658, 745 

Wines, 453 

Wines, strong, as cardiac stimulants, 291 

Witchhazel. See Hamamelis 

Witkowski, reference to, 117 

Wood, Dog, 769, 793 
Guaiacum, 745 
Log, 765 
Quassia, 752 
Red sandal, 759 
Worm, 807 

Wood, H. C, references to, 103 

Wood charcoal, its preparation and characters, 
459; its action, uses, and administration, 459, 
460 

Wood tar, as a stimulatingexpectorant, 227 

Woorari. See. Curare 

Worms, the three chief kinds which infest the 
intestines, 355; list of the principal vermicides, 
355; and vermifuges, 355; and their adjuncts, 
355 

Wormseed, American. See Chenopodium 

Wormwood, nature, action, and use of, 807; as a 
stomachic tonic and anthelmintic, 807 

Wounds, value of astringents in, 309; of styptics, 
309 

Wourali. See Curare 

Wundt, references to, 149, 161, 162 

Wurrus. See Kamala 



X. 



Xanthine, action of, on muscles, 128 
Xanthoxyleae, 748 



Xanthoxylum (prickly ash), as an alterative, 

358; characters and use of, 748 
Xylol, action of, on bacteria, 99 



Y. 



Yeast, beer, character and uses of, 912 
Yeasts, origin and nature of, 89 
Yellow cinchona bark, 794 

Calisaya bark, 794 

Prussiate of potash, 517 
Yellow wax, 923 
Yolk of egg, 920 

Young, Dr., his table for dosage, 426 
Ytterbium, symbol and atomic weight of, 37 
Yttrium, symbol and atomic weight of, 37 ; physi- 
ological action of, 51 



Zabludowski, reference to, 128». 

Ziegler's Pathological Anatomy, reference to, as 

translated and edited by MacAlister, 92n. 
Zinc, symbol and atomic weight of, 37 ; physio- 
logical action of, 51 ; double salts of, action of, 
on the cardiac muscle, 281 ; on the capillaries, 
282 
Zinc, nature, characters, and uses of— 
Acetate of, 570 
Bromide of, 571 
Carbonate of, 569 

Precipitated, 569 
Chloride of, 569 
Iodide of, 571 
Oxide of, 569 
Of commerce, 568 
Phosphide of, 572 
Sulphate of, 570 
Valerianate of, 571 
Zinc chloride, as a caustic, 304 
Zinc salts, as anantihydrotic, 381 ; sources of, 566 ; 
general reactions and preparation of, 567 ; 
impurities, tests, and general action of, 568 
Zinc sulphate, as a caustic, 304; as an astringent, 

308 ; as a local emetic, 326 
Zinci acetas, 568 
Bromidum, 568 
Carbonas, 568 

Preeipitatus, 568 
Chloridum, 568 
Iodidum, 470, 568 
Oxidum, 568 
Phosphidum, 568 
Sulphas, 568 
Valerian as, 568 
Zincum granulatum, 568 
Zingiberacese, 900 

Zirconium, symbol and atomic weight of, 37 
Zuelzer, references to, 104, 303 
Zuntz, reference to, 81 
Zygophyllacese, 745 
Zymogens, ferment-forming substances, 87 



INDEX OF DISEASES AND REMEDIES. 



Abscess. 

Belladonna, 839. Internally and locally as 

plaster or liniment. 
Calcic Phosphate, 553. Where abscess is 

large. 
Calcic Sulphide, 555. Small doses frequently 

repeated, to hasten maturation or healing. 
Carbolic Acid, 689, 690. As dressing, and as 

injection after evacuation. 
Caustic Potash, 509. For opening abscess in 

liver. 
Cod-liver Oil, 358, 922. In scrofulous cases. 
Counter-irritation, 301. To surrounding 

parts, to check formation or hasten irrita- 
tion. 
Creasote, 577. Same as carbolic acid. 
Iodine, 471, 472. As injection into the sac. 
Permanganate of Potash, 107. As antiseptic. 
Poultices, 402, 729 
Salicylic Acid. 
Sulphides, 515, 555. To hasten suppuration. 



Acidity. 

Acids, 476. Before meals. 

Alkalis, 501. After meals. 

Bismuth, 621. 

Carbolic Acid, 691. To stop fermentation. 

Creasote, 690. 

Ipecacuanha, 804. In pregnancy. 

Kino, 759. Useful along with opium. 

Manganese Oxide, 640. Sometimes relieves, 

probably acting like charcoal. 
Mercury, 585. When liver deranged and stools 

pale. 
Nux Vomica, 821. In small doses before 

meals, especially in pregnancy. 
Pulsatilla, 702. 5 m. every four hours in 

water. 
Silver Nitrate, 328, 575. Same as silver oxide. 
Silver Oxide, 577. Especially useful when 

acidity is accompanied by neuralgic pains 

in stomach. 
Tannic Acid, 875. 

Acne. 

Alkaline Lotions, 509. When skin is greasy. 
Arsenic, 609. In chronic acne; generally, 

though not always, prevents the acne from 

bromides or iodide of potassium. 
Belladonna, 183, 184. As local application. 
Bismuth, 622. As ointment or powder. 
Borax, 529. Solution very useful. 
Glycerine, 820. Both locally and internally. 
Iodide of Sulphur, 470. In chronic cases. 
Mercury, 586. Weak lotions. 
Phosphorus, 605. In chronic cases in place of 

arsenic. 
Potassic Bromide, 186. Sometimes useful in 

moderate doses. 
Sulphur, 463. Internally and externally. 
Water. Hot sponging several times a day. 

Addison's Disease. 

Iron, 194 el seq. Antemetics and tonics. 



After-pains. 

Belladonna, 838. As ointment. 

Camphor, 864. Useful when combined withi 

morphia, 10 grs. with Y s gr. of morphia. 
Chloroform, 680. Liniment to abdomen along 

with soap liniment. 
Chloral, 673. In large doses arrests the pains. 
Cimicifuga, 703. Diminishes excitement. 
Ergot, 911. To keep the uterus constantly 

contracted and prevent accumulation of 

clots in its cavity, and consequently the 

pains which they would occasion. 
Gelsemium, 827. In 20 m. doses stops pains. 
Morphia and Atropia. Hypodermically very 

useful, y^/i gr. morphia with x a_ gr o 

of atropia. 
Opium, 722. The same as morphia. 
Poultices, 402. Warm, to the hypogastrium, 

relieve. 
Quinia, 802. 5-10 grs. night and morning, 

with neuralgic after-pains which do not 

yield to opiates. 



Albuminuria. 

Aconite, 701. In high temperature. 

Alkalies, 501. Diuretics. 

Arbutin, 815. 

Cannabis Indica, 880. In hematuria. 

Cantharis, 926. In hsematuria, after acute 

symptoms have gone, 1 m. every three 

hours. 
Chalybeate Waters, 564, 634. Not very useful 

in chronic cases. 
Chimaphila, 374, 815. Decoction of extract 

when urine scanty, or in hematuria. 
Gallic Acid, 878. In acute cases 5-10 grs. 
Iron, 634. Useful often— best as chalybeate 

waters. 
Lead, 596. Lessens albumen. 
Milk Cure, 914. 

Turkish Baths, 404. Useful in chronic cases. 
Turpentine, 374, 883. Sometimes very useful, 

diminishes albumen, and acts as diuretic. 



Alcoholism. 

Ammonia, 322. Aromatic spirits of, as sub- 
stitute for alcohol, to be taken when the 
craving comes on. 

Arsenic, 609. To lessen vomiting in drunk- 
ards. 

Bromides, 521. Useful during delirium 
tremens, or to lessen irritability. 

Capsicum, 816. As substitute for alcohol. 

Chloral, 672. To quiet nervous system and 
induce sleep. 

Lupuline, 881. Along with capsicum as sub- 
stitute for alcohol, also to quiet nervous 
system in delirium tremens. 

Nux Vomica, 821. As tonic and stimulant, 
both to nervous system and generally, to 
aid digestion. 

Opium, 722. May be necessary to produce 
sleep. 

Orange, 177. Slowly sucked, a substitute for 
alcohol. 



62 



(977) 



978 



INDEX OF DISEASES AND REMEDIES. 



Alcoholism. 

Phosphorus, 360, 605. In chronic cases as 

Dervine tonic. 
Picrotoxine, 279, 707. For tremors. 
Quinia, 801. As tonic and in gastric catarrh. 
Water, Cold, 177. A glass taken in small sips 

at a time as substitute for alcohol. 
Zinc Oxide, 568, 569. In chronic alcoholic 

dyspepsia, and nervous debility. 

Alopecia. 

Ammonia, 540. Very useful — IJfc ol. amygd. 

dul. Liq. ammonite aa f. Sj spt. Rosmarini, 

aqua?, mellis aa f. 5iij mm. fl. lotio (E. 

"Wilson). 
Arsenic, 609. Internally. 
Cantharides Tine, 926. One part to eight of 

castor oil rubbed in roots of hair morning 

and night. 
Glycerine, 820. Very useful ; either alone or 

in combination, appears greatly to assist. 
Nitric Acid, 480. With olive oil in sufficient 

quantity just to make it pungent. 
Shaving. Sometimes useful after illness. 
Sulphur Iodide, 471. Useful both internally 

and externally. 

Amaurosis and Amblyopia. 

Arnica, 811. Sometimes useful. 

Rue, 747. In minute doses in functional dim- 
ness of vision. 

Santonin, 809. Sometimes useful in later 
stages of iritis and choroiditis. 

Seton,301. In temple for along time some- 
times useful. 

Strychnine, 252, 825. Sometimes very useful. 

Yeratrine, 895. To eyelids and temples. Care 
must be taken to keep out of the eye. 

Amenorrhea. 

Aconite, 700. When menses suddenly checked, 
as by cold, &c. 

Aloes, S95. Alone or with iron. 

Ammonium Cbloride, 540. In headache, ma- 
larial. 

Arsenic, 607, 609. Along with iron in 
anieinia. 

Cimicifuga, 703. Sometimes gives good re- 
sults. 

Colocynth, 783. In anaemia with constipa- 
tion. 

Electricity. Locally applied, sometimes use- 
ful. 

Ergot, 911. 

Gold, Salts, 641. 

Ignatia, 821. In hysteria. 

Iron, 628, 634. In amemia. 

Manganese, 391, 640. Sometimes very useful. 

Nux Vomica, 381, 821. 

Pulsatilla, 702. Like Aconite. 

Rue, 391. In atonic condition of ovaiies of 
uterus. 

Sanguinaria, 358, 726. Like Rue. 

Savin, 390. Like Rue. 

Senega, 730. A saturated decoction in large 
dobes of a pint daily about two weeks 
before period. 

Serpentaria, 866. In anaemia. 

Silver Nitrate, 308, 575. Locally, to os uteri 
at period. 

Sit/. Bath*, 899. Hot, alone, or with mustard, 
for Borae days before the period. 

Spinal Ice Bag. To lumbar vertebra?. 



ANyL.MI a. 



Adds, 175, I7i;. 

A reenlc, 607. 609. Very useful along with or 

in place of iron, 
fold -ponging, :;<;:;, 899. 
Galvanization. 



Anemia. 

Hypophosphites of Lime, 553, or Soda, 530. 
In cases of nervous debility care must be 
taken that they do not derange the diges- 
tion. 

Iron, 628, 634. Yery useful where stomach is 
at all irritable. The carbonate is often best. 
Where mucous membrane very flabby large 
doses of theperchloride. Chalybeate waters 
more often succeed than pharmaceutical 
preparations. They may be mutated by 
one drop of the solution in a tumbler of 
water. 

Lactophosphate of Lime, 553. During nurs- 
ing, or where drain has taken place from 
body in shape of pus. 

Manganese, 640. May be given along with 
iron— not much use alone. 

Nux Vomica, 294, 821. Useful sometimes 
along with iron. 

Pancreatin, 321. In feeble digestion. 

Pepsin, 321. In feeble digestion. 

Phosphate of Lime, 553. During growth, or 
where system enfeebled by drain of any 
kind. 

Quinia, 109, 801. 

Wines, 291. Along with food to aid diges- 
tion. 



Aneurism. 

Aliment. Low diet ; absolute rest. 
Chloroform, 680, 681. Inhaled to relieve 

dyspnoea. 
Electrolysis. Sometimes useful in causing 

coagulation within the sac. 
Ergot, 909, 910. As adjunct to rest. 
Lefcd Acetate, 597. Useful, combined with 

rest. 
Potassic Iodide, 227, 519. Yery useful in doses 

of 30 grs. 
Yeratrum Viride,281, 300. Along with opium 

in quieting circulation. 



Angina Pectoris. 

Aconite, 300, 699, 700. 

Arsenic, 607, 609. To prevent paroxysms. 

Chamomile, 809. In hysterical symptoms. 

Ether, 662 To diminish pain. 

Laurocerasus, 777 

Morphia, 181, 183, 714. Hypodermically. 

Nitrite of Amyl, 666, 667. Gives g eat relief 

during paroxysms. 
Nitrite of Soda, 524. Less rapid than nitrite 

of amyl, but has more power to prevent 

return of symptoms. 
Nitro-glycerine, 668. Like nitrite of soda. 
Phosphorus, 361, 605. During intervals to 

lessen tendency. 
Quinia, sol. When any malarious taint is 

present. 
Strycbnia, 274, 279, 825. Sometimes useful in 

mild cases, in very small doses. 
Turpentine, 226, 884. Locally to the chest 

during paroxysms. 



Anus, Fissure of. 

Belladonna, 1S3, 1S4, 839. Locally, relieves 

spasms. 
Castor Oil, 3:'»9, 869. To keep motions soft. 
Collodion, 736. Locally, to protect. 
Hydrastis, 705. Local application. 
Iodoform, 682, 683. Locally, to heal and 

relieve pain. 
[odo-tanniD (solution of iodine in tannin). 

Useful locally. 
Opium and Gall Ointment, 709. Relieves 

pain. 
Potassic Bromide, 521. With five parts of 

glycerine locally. 
Ethatany, 782. injected after the bowels 



have been opened by enema. 



INDEX OF DISEASES AND KEMEDIES. 



979 



Anus, Fissure of. 



Sulphur, 339. To keep motions soft. 
Tannin, 876. Useful as local application. 

Aphonia. 

Alum, 555-557. As spray in chronic conges- 
tion of throat and larynx, with hoarseness. 

Ammonium Chloride, 539. As vapor in laryn- 
geal catarrh. 

Atropia, 839. In hysterical aphonia. 

Benzoin, Tincture of, 228, 817. Inhaled in 
laryngeal catarrh. 

Borax, 529. A piece the size of a pea slowly 
sucked. 

Glycerine of Tannin, 820, 876. Locally, to 
pharynx. 

Ignatia, 821. Like Atropia. 

Ipecacuanha, 803, 804. Wine as spray in 
laryngeal catarrh. 

Nitrate of Potash, 513. Like Borax. 

Nitric Acid, 4S1. In hoarseness from fatigue 
or indigestion. 

Rue, Oil of, 747. As inhalation in chronic 
catarrh. 

Sulphurous Acid, 477. As spray or inhala- 
tion in clergyman's sore throat. 

Turkish Bath, 405. In acute laryngeal catarrh. 

Uranium, Nitrate of, 37. As spray in very 
chronic catarrh. 



Aphtha. 

Bismuth, 622. As local application. 

Borax, 529. As honey or as glycerine, either 
alone or with chlorate ot potash. 

Copper Sulphate, 573. Weak solution painted 
over the aphthae. 

Coptis. Infusion is employed in New Eng- 
land. 

Glycerine, 820. 

Mercury, 583. In the form of hydr. cum 
creta in children, to remove the indiges- 
tion on which aphthae frequently depends. 

Mineral' Acids, 474. Dilute solution as paint. 

Potassic Chlorate, 374. Exceedingly useful 
as wash, 10 grs. to the oz., alone or with 
borax, also given internally. 

Potassic Iodide, 518. As local application, 
solution of 1-5 grs. to the oz. 

Quinia, 801. 1 gr. every two or three hours 
m aphthse in infants, consequent on diar- 
rhoea. 

Rhubarb, 858. To remove indigestion, as 
compound rhubarb powder. 

Salicylic Acid, 693. As local application. 

Sulphurous Acid, 477. As solution or spray. 

Apoplexy. 

Aconite, 700. To lower blood-pressure and 
prevent further haemorrhage, where pulse 
strong and arterial tension high. 

Cold Water, 363. To the head when face 
congested. 

Colocynth, 339, 784. As purgative. 

Croton Oil, 339, 868. As purgative, one drop 
on back of tongue, or part of a drop every 
hour. 

Diet and Hygiene, Prophylactic. 
Butcher's meat and stimulants to be taken 
very sparingly, exposure to heat, over- 
exertion, and especially anger, to be 
avoided. 

Elaterium, 340, 785. In suppository, or as 
enema, during attack. 

Electricity. To promote absorption, after 
partial recovery has taken place. 

Appetite, Impaired. 

Food. Savory, well cooked. 
Ignatia, 821. Corrects diseased appetite and 
hysteria. 



Atheroma. 

Ammonium Bromide, 544. To promote ab- 
sorption. 

Arsenic, 607. Often useful, especially when 
symptoms of imperfect action of kidneys. 

Cod-liver Oil, 921 

Digitalis, 850. Requires caution. 

Phosphorus, 361, 605. In minute doses, along 
with cod-liver oil. 

Quinia, 801. 

Ascites. 

Arsenic, 607, 609. In old persons with feeble 
heart. 

Copaiba, 374, 768. Especially useful in hepa- 
tic dropsy. 

Digitalis, 850. Best in cardiac dropsy; its 
action is increased by combination with 
squill and blue pill. 

Elaterium, 340, 785. As hydragogue cathar- 
tic. 

Jalap, 834. In compound powder as hydra- 
gogue cathartic. 

Milk Diet, 915. Sometimes very useful when 
kidneys are inadequate. 

Stillingia, 358, 867. In hepatic dropsy. 

Asthenopia. 

Atropia, 840. To prevent spasms. 

Asthma. 

Aconite, 701. In spasmodic cases, also in 
asthma consequent on nasal catarrh in 
children. 

Amyl Nitrite, 666. Sometimes cheeks parox- 
ysm. 

Antimony, 621. In asthmatic conditions in 
children, ^ gr. of tartar emetic every quar- 
ter of an hour. 

Arsenic, 609. In small doses in cases asso- 
ciated with bronchitis or hay fever. Inhaled 
as cigarettes. 

Asafcetida, 787. 

Belladonna, 840. Internally, in large doses 
or as cigarettes. 

Bromides. 

Cannabis Indica, 880 

Chloral, 672. During paroxysm. 

Chloroform, 676. Relieves when inhaled from 
tumbler or with warm water. 

Coffee, 804. Very strong during paroxysm. 

Colchicum, 899. "in gouty cases. 

Datura. See Stramonium. 

Ether, 662. In full doses at commencement 
of attack. 

Eucalyptus, 781. Sometimes along with stra- 
monium, belladonna, and tobacco. 

Galvanism of Pneumogastric Region. Posi- 
tive pole beneath mastoid process, negative 
pole to epigastrium. 

Grindelia, 813. To prevent or cut short 
attack. 

Ipecacuanha, 804. As spray in bronchial 
asthma, especially in children. 

Lobelia, 814. To prevent and cut short 
paroxysm. 

Nux Vomica, 227. 

Opium, 223. Hypodermically, during par- 
oxysm. 

Oxygen, 456, 457. As inhalation during par- 
oxysm. 

Pepsin, 321, 916. Exceedingly useful in pre- 
venting attacks. 

Potassic Iodide, 519. In large doses, when 
asthma due to acute bronchial catarrh. 

Potassic Nitrate, 513. Inhalation of fumes 
of touch paper relieves paroxysm. Some- 
times advisable to mix a little chlorate 
with it. 

Quinia, 215, 801. During intervals when 
attacks are periodical. 

Silver Nitrate, 575. Has been injected into 
• trachea. 



980 



INDEX OF DISEASES AND REMEDIES. 



Asthma. 

Stramonium, 842. Sometimes very useful. 
May be made into cigarettes, or 20 grs. of 
dried leaves may be mixed with nitrate of 
potash, and the fumes inhaled. A little 
powdered ipecacuanha may often be added. 

Sulphurous Acid, 477. 

Tobacco, 843. Smoking is sometimes benefi- 
cial. 

Astigmatism. 

Suitable Glasses. 



Atrophy. 



In muscular atrophy. 



Arsenic, 60! 

Electricity. 

Massage, 128, 406. 

Olive Oil, 820. Inunction to atrophied parts. 

Balanitis. 

Astringent Lotions. Alum, 557. Sulphate of 

zinc, 570. 
Lime Water, 550. As lotion. 
Mercury, 588. % gr. chlor. con. to an oz. 

lime water, as lotion. 
Oil, 819. 

Bed Sores. 

Alcohol, 304, 650. As wash, to prevent. 

Alum, 556. With white of egg as local appli- 
cation. 

Charcoal, 459. As poultices, to stop bed 
sores. 

Galvanic Couplet. Of zinc and silver; one 
element on sore, the other on adjacent 
part. 

Glycerine, 820. Prophylactic local applica- 
tion. 

Iodoform, 682. 

Silver Nitrate, 575. Dusted over open bed 
sores. 

Biliousness. 

Aconite, 701. As adjunct to podophyllum. 

Alkalies, 499,500. 

Aloes, 339. In constipation. 

Ammonium Iodide, 545. In catarrh of duo- 
denum and biliary ducts. 

Angostura, 747. In bilious fevers. 

Calumba, 706. As stomachic tonic. 

Carlsbad Water, 529. A tumbler sipped warm 
during dressing very useful. 

Horse Exercise. 

Hydrastis, 705. When chronic gastric catarrh 
"is present. 

Manganese, 640. In gouty cases. 

Mercurial Cathartics, 585." In moderate doses 
night and morning, or in small doses more 
frequently repeated. Especially useful 
when stools are pale. 

Milk Cure, 914. In obstinate cases. 

Mineral Acids, 481. Nitro-hydrochloric acid 
especially useful. 

Podophyllum, 340, 704. In place of mercury 
wh D stools dark. 

Rhubarb, 839,351, 353,858. 

Sal-ammoniac, 540. In hepatic abscess. 

Stillingia, 358, 867. in place of mercury. 

Bladder, Irritable. 

Aquapuncture. 

Belladonna, 384, 839. 

Benzoic Acid, 377. In large, prostate, and 

alkaline Conditions of urine. 
Benzoate of Ammonia, 817. Like Benzoic 

Acid. 
Cantharides, 925, in women without acute 

inflammation. 
Cubebs, 874, s 7i. Like Cantharides. 



Bladder, Paralysis of. 

Arnica, 811. 

Cannabis Indiea, 880. In retention, from spi- 
nal disease. 

Cantharides, 384, 925. In atonic bladder. 

Ergot, 911. In paralysis, either in bladder or 
sphincter, when bladder so that urine is 
retained, and incontinence in sphincter. 

Galvanism. 

Strychnia, 825. 

Blepharitis. 

Alum, 555-557. After acute symptoms sub- 
side. 

Bismuth, 328, 621. Equal parts of the sub- 
nitrate and glycerine as local application. 

Hydrastis, 705. As lotion. 

Mercury (Unguentum Hydrargyri Nitratis), 
591. Most useful application. If too strong, 
dilute with vaseline or simple ointment. 

Pulsatilla, 702. Internally and locally. 

Tannin, 376. 

Boils. 

Arsenic, 361, 608. To lessen tendency to re- 
currence. 

Belladonna, 837. Internally, or as local appli- 
cation. 

Camphorated Alcohol, 655. As local applica- 
tion in earlv stage. 

Carbolic Acid", 688-690. Injection. 

Collodion, 735. Painted over whole surface 
to abort in papular stage and over base, 
leaving centre free, in pustular stage. 

Counter-irritation, 433. By plasters sur- 
rounding the boil. 

Opium, 723. Locally to remove pain. 

Poultices, 402. To relieve pain and hasten 
maturation. 

Silver Nitrate, 575. Strong solution painted 
over the skin round boil. 

Strapping, 595. Properly applied gives great 
relief. 

Sulphides, 516, 554. In small doses to abort 
or hasten maturation. 

Bone, Diseases of. 

Cod-liver Oil, 226, 922. In scrofulous condi- 
tions. 
Iodine, 471, 922. Alone, or with cod-liver oil. 



Breath, Fcetid. 



Camphor, 863. 

Carbolic Acid, 688-690. Dilute solution as 

wash to mouth. 
Chlorine, 467, 557. Liq. chlor /and chlor. of 

lime as lotion. 
Permanganate of Potash, 107, 515. As wash 

to mouth. 

Brigiit's Disease. 

Baths, 395 el seq. Warm water and hot air 
and Turkish, to increase action of skin. 

Broom, 37 1, 758. As diuretic. 

Caffeine, 743. To increase secretion of solids. 

Cannabis Indiea, 880. As diuretic when he- 
maturia. 

Chimaphila, 815. 

Cod-liver Oil, 226, 922. 

Counter-irritation, 301, 302. Dry cupping 
most useful when tendency to uncinia. 

Elaterium, 785. As hydragogue cathartic for 
dropsy. 

Eucalyptus, 781. 

Gallic Acid, 877. Lessens albumen. 

Gold, Chloride of, 641. In contracted kidney. 

Hydrastis, 705. Lessens albumen. 

Iron, 634. To diminish aiucmia. 

Jaborandi, 751. In uraemia and dropsy. 

Juniper, Oil of, 887. Diuretic. 



INDEX OF DISEASES AND REMEDIES. 



981 



Bright's Disease. 

Lead, 594. Lessens albumen. 

Milk Care, 915. Pure skim milk diet some- 
times very useful when tendency to 
ursemia. 

Nitrous Ether, 374. As diuretic. 

Potassic Bitartrate, 339, 374. As hydragogue 
cathartic and diuretic. 

Potassic Bromide, 186. In ursemic convul- 
sions. 

Potassic Iodide, 519. 

Tartrates, 511, 528, 635. As diuretics. 

Turpentine, 374. As diuretic. 

Water. In large draughts as diuretic when 
excretion of solids is deficient, and in 
dropsy. 



Bronchiectasis. 



Chlorine, 467. As inhalation to lessen fcetor. 

Creasote, 691. As inhalation. 

Iodine, 471. As inhalation. 

Phosphates and Hypophosphites, 530, 553, 

638, 639. 
Quinia, 215, 801. 



Bronchitis, Acute. 



Aconite, 209, 701. }4-l m. every hour at com- 
mencement. 

Ammoniacum, 788. Very uselul in old people. 

Ammonium Carbonate, 542. Where much 
expectoration and much depression. 

Aeafootida, 787. Like Ammoniacum. 

Cimicifuga, 703. In acute catarrh and acute 
bronchitis when active symptoms have sub- 
sided. 

Colchicum, 361. In gouty cases. 

•Counter-irritants, 305, 390, 728. Dry cup- 
ping most efficient in acute cases; mustard 
leaves; mustard poultices. 

Cubebs, 872. When secretion copious. 

Ipecacuanha, 227, 228. When expectoration 
scanty, dryness in chest, ipecacuanha in 
large doses; also when expectoration has 
become 'more abundant, but difficult to 
expel. 

Lobelia, 227. When cough paroxysmal and 
expectoration slight. 

Nitric Acid, 480, 481. When expectoration 
free and too copious. 

Opium, 223, 292, 293. As Dover's powder to 
cut short attack, and along with expecto- 
rants to lessen cough. 

Quinia, 797. To reduce temperature. 

Sanguinaria, 725. After acute symptoms have 
subsided. 

Tartar Emetic, 227, 325, 326. In dry stage to 
promote secretion. 

Turpentine, 226. When expectoration very ■ 
profuse ; also as inhalation. 

Bronchitis, Capillary. 

Ammonium Carbonate, 542. Much expecto- 
ration andlividity commencing, and emetic. 

Ammonium Chloride, 227. 

Ammonium Iodide, 545. In small rapid doses 
relieves much. 

Camphor, 864. As expectorant. 

Cupping, 363. Four to six dry cups over the 
back often give very great relief, and if the 
pulmonary congestion appears very great 
wet cups should be placed instead, and 8-10 
ozs. of blood withdrawn from adult. 

Ipecacuanha, 227, 228. As expectorant and 
emetic. 

Mustard, 228. As poultices. 

Poultices, 228. Over whole chest. 

Serpentaria, 865. In children. 

Bronchitis, Chronic. 

Ammonia, 227. When there is difficulty in 
bringing up expectoration. 



Bronchitis, Chronic. 

Ammoniacum, 788. Very useful, especially in 
elderly people. 

Ammonium Chloride, 227. 

Antimony, 227. When secretion scanty. 

Arsenic, 607, 608. In emphysema and asth- 
matic attack as cigarettes. 

Asafoetida, 787. 

Balsam of Peru, 227. When expectoration 
copious. 

Balsam of Tolu, 227. The same. 

Benzoin, 227. As inhalation or as spray. 

Camphor, 864. 

Carbolic Acid, 689. As inhalation or as spray. 

Codeia, 715. In place of opium when the lat- 
t©r cliscifirrGCs 

Cod-liver Oil. 226, 921, 922. One of the most 
useful of all remedies. 

Colchicum, 897. In acute cases. 

Copaiba, 769. Like Balsam of Peru. 

Digitalis, 223. Where heart feeble. 

Emetic, 227. 

Eucalyptus, 781. 

Galbanum, 788. 

Gallic Acid, 877. 

Hydrastis, 705. In chronic coryza. 

Iodine, 471. As inhalation. 

Iron, 627. When expectoration is profuse. 

Koumiss Cure, 915. Sometimes very useful. 

Lobelia, 814. When there is spasmodic 
dyspnoea. 

Opium, 223. To lessen secretion and cough. 

Phosphates, 530, 554, 639 

Senega, 227, 326, 731. When eupulsive efforts 
are feeble. 

Serpentaria. 866. Like Senega. 

Squill, 227, 326, 890. Where expectoration is 
thick. 

Sulphur, 227, 463. Where expectoration co- 
pious. 

Sulphurous Acid Gas, 478. As inhalation or 
spray. 

Sumbul, 195, 791. 

Tar, 227, 886. To lessen secretion and allay 
cough. 

Turpentine, 226. 

Bronchorrhcea. 

Ammoniacum, 788. 

Ammonium Iodide, 545. Small doses fre- 
quently repeated. 

Asafoetida, 787. 

Eucalyptus, 781. Sometimes very useful. 

Grindeha, 812, 813. 

Iodine, 471. As counter-irritant to chest, and 
as inhalation. 

Lead Acetate, 597. To lessen secretion. 

Spinal Ice Bag. To lessen secretion. 

Sulphurous Acid Gas, 478. As inhalation or 
spray. 



Bruises. 

Aconite, 697. Liniment locally, to relieve 

pain. 
Arnica, 811. As local application, no more 

use than alcohol, and sometimes gives rise 

to much inflammation. 
Capsicum, 835. To remove discoloration of 

bruise. 
Oil of Bay. Same as Capsicum. 
Opium, 183. Local application to relieve 

pain. 
Sulphurous Acid, 477. As local application 

constantly applied. 



Bubo. 



Ice, 224. To relieve pain and lessen inflam- 
mation. 

Iodine, 472. As counter-irritant applied round 
the bubo. 

Iodoform, 681. As local application. 



982 



INDEX OF DISEASES AXD KEMEDIES. 



Bubo. 



Mercury, 591. As local application after 
opening bubo, when syphilitic infection is 
great. 

Nitric Acid, 480. As local application to in- 
dolent bubo. 

Silver Nitrate, 575. Lightly applied to sur- 
face in indolent bubo. 

Sulphides, 498, 554. To check suppuration. 

Tartar Emetic, 325, 326. When inflammation 
acute and fever considerable. 



Bunion. 

Iodine, 472. Painted on in indolent forms. 

Best. When thickened and painful. Pres- 
sure is removed by thick plasters with a 
hole in the centre. 



Burns and Scalds. 

Boracic Acid, 486. Saturated watery solu- 
tion. 

Carbolic Acid, 687-690. One to six of olive 
oil, locally. 

Collodion, 736. Flexible ; to protect from air. 

Cotton Wool. To protect from irritation and 
lessen pain. 

Lead Carbonate, 597. As white paint for 
small burns. 

Lime, 550. As lin. calc, or lime water with 
linseed oil. 

Phytolacca, 859. To relieve pain. 

Salicylic Acid, 692, 693. 1 to 60, olive oil. 

Turpentine, 882. Local, to severe burns. 

Warm Bath, 401. Keep whole body, with 
exception of head, totally immersed for 
some days in very extensive burns or 
scalds. It relieves pain, although it may 
not save life. 



Bursitis. 

Blisters, 305. Most useful. 

Fomentations. To relieve pain. 

Iodine, 471. When chronic, lin. iodi. may be 
used as a blister, or the liquor, alter blister- 
ing or aspiration. 



Cachexle. 



Air. Fresh. 

Aliment. Nutritious. 

Arnica, 811. Internally, in bad cases. 

Arsenic, 607, 608. In malarial, also in can- 
cerous, cachexise. 

Bath, 404. Turkish hath useful. 

Cholagogues, 340, 353. Most useful before, or 
along with other remedies. 

Eucalyptus, 781. 

EuiiMin min, 340. As cholagogue. 

( rrape Cure. 

Hydrastis, 705. In malaria. 

Iron, 628. In all anaemic conditions. 

Lime Phosphates, 553. In scrofulous phthisis 
and mal-nutrition. 

Mangauese, <;i f) . Along with iron and iodine. 

Massage, 128, K)6. Exceedingly useful. 

Mercury, 340. In syphilitic cases. See Cho- 
lagogues. 

Nitric Acid, iso. In debility after acute dis- 
ease. 

Oil and Fats, 226, 227, 922. Cod liver oil very 
useful. Cream us an addition to food. 

Phosphates, 353, 530, 558, 638. in cachexia? 
attended with much discharge. 

Podophyllin, 339, 703. As cholagogue. 

Potasslc Iodide. 519. in syphilitic and re- 
sulting conditions. 

Purgatives, Saline, 339. A.s adjuncts to cho- 
lagogues. 

Barsaparilla, 888. in syphilis. 



Calculi, Biliary. 

Aliment. Absence of starch and fat recom- 
mended. 

Alkalies. Yichy water useful. 

Carlsbad Water, 530. Useful as prophylactic. 

Chloral, 672. To relieve pain during par- 
oxysm. 

Chloroform, 680, 681. Inhalation from tum- 
bler, most useful to relieve paroxysm. 

Counter-irritants, 403. Mustard poultices to 
relieve pain during paroxysm. 

Morphia, 715. y± gr. with T ^ gr. atropia, 
subcutaneously to relieve pain and vom- 
iting in paroxysm. 

Nitro-muriatic Bath, 377, 403. To cause ex- 
pulsion of calculus, and to relieve pain. 

Salicylate of Soda, 693. As prophylactic. 

Sodium Phosphate, 351. In 20 or 30 gr. doses 
before each meal as prophylactic. Should 
be given in plenty of water. 

Turpentine and ether, 374, 882. Equal parts 
to relieve pain during paroxysm ; also oc- 
casionally as prophylactic along with a 
course of Carlsbad or Vichy water. 



Calculi, Renal and Vesical. 

Alkalies, 501. To resolve calculi, potash and 

soda to be used. 
Alkaline Mineral Waters. Especially Vichy. 
Ammonium Benzoate, 545. To resolve phos- 

phatic calculi. 
Anaesthetics 189, 190. To relieve pain during 

passage of calculus. 
Calumba, 706. To relieve vomiting. 
Castor Oil, 339, 868. As purgative. 
Chloroform, 680, 681. As in biliary calculi. 
Cotton Root, 734. As decoction to relieve 

gravel and strangury. 
Counter-irritants. To lessen pain during 

passage of calculus. 
Mineral Waters. Especially Wildungen. 
Morphia, 711. Hypoderrnatically, as in bil- 
iary calculi. 
Nitric Acid, 480. Dilute, as injection into 

the bladder to dissolve calculi. 
Potassium Citrate, 373. In hematuria with 

uric acid crystals. 
Water, Distilled. As drink. 



Cancer. 

Acetic Acid, 481. As injection into tumors. 

Arsenic, 605. As local application, causes 
cancer to slough out. .Sometimes success- 
ful when the knife fails, but is dangerous. 
Internally, in cancer in stomach, lessens 
vomiting.' Supposed to retard growth of 
cancer in stomach and other parts. 

Belladonna, 840. Locally relieves pain. Used 
internally also. 

Bismuth, 622. To relieve pain and vomiting 
in cancer of stomach. 

Bromine, 469. As caustic to use round can- 
cer. 

Carbolic Acid, 688-691. As application or in- 
jection into tumor to lessen pain, retard 
growth, and diminish foetor. 

Carbonic Acid, 487. To relieve pain in ute- 
rine cancer. 

Charcoal Poultices, 459. To relieve pain and 
foetor. 

Chloral, 673. To lessen pain. 

Chloroform, 680, 681. Vapor as local applica- 
tion to ulcerated cancer. 

Chromic Aciii, 804. As caustic. 

Citric Acid, 185. As lotion to allay pain, jfo. 

Condurango, 828. 

Conium, 786. As poultices to relievo pain. 
I'sed internally also. 

Glycerine of Tannin, 820. Mixed with iodine, 
tn check discharge and remove smell in 
uterine cancer. 



INDEX OF DISEASES AND REMEDIES. 



983 



Cancer. 

Hydrastis, 705 

Hyoscyamus, 841. Bruised leaves locally 

applied. 
Iodoform, 186, 877. Locally, to lessen pain 

and fcetor. 
Iron and Manganese, 633, 640. Internally, as 

tonics. 
Opium, 183, 184. Locally and generally, to 

relieve pain. 
Papain, 777. As local application or injection. 
Pepsin, 916. As injection into tumor. 
Potassa Fusa, 509. As escharotic. 
Poultices, 402. To relieve pain. 
Salicylic Acid, 692. Locally applied as powder 

or saturated solution. 
Vienna Paste, 509 
Warm Enemata. To lessen pain in cancer 

of rectum. 
Zinc Chloride, 304 , 569. As caustic. 
Zinc Sulphate, 304, 567. As caustic. 

Cancrum Oris. 

Arsenic, 608, 609. Internally. 

Nitric Acid, 480. Undiluted as local caustic. 

Quinia, 801. As syrup or enema. 

Carbuncle. 

Belladonna Extract, 836. With glycerine, 
as local anodyne. 

Calcic Sulphate, 554. ^ gr. hourly useful. 

Carbolic Acid, 690. As wash and injection 
after spontaneous discharge, or on lint 
after opening. 

Collodion, 735. Round base, leaving opening 
in centre. 

Iodine, 471. Locally, to lessen pain and in- 
flammation. 

Opium, 183. Locally, mixed with glycerine. 

Poultices, 402. To relieve pain. 

Strapping. Concentrically, leaving centre 
free, lessens pain. 

Caries. 

Cod-liver Oil, 226, 922 

Gold, 640. In syphiloma of bone. 

Iodine, 471. Locally and internally. 

Phosphates of Lime and Iron, 553. Useful. 

Phosphoric Acid, 483. Diluted, 1 in 8 of 

water, locally. 
Potassic Iodide, 518. In syphilitic cases. 
Sarsaparilla, 888. 
Villate's Solution — Cupri. sulph. zinc, sulph. 

aa partes xv, liq. plumb, subacetat part xxx, 

acid acet. part c.c. as injection. 

Catalepsy. 

Turpentine, 882. As enemata and embroca- 
tions to spine during paroxysms. 

Cataract. 

Codeia, 714. In diabetic cases. 

Diet and Regimen. Nutritious in senile 

cases. Sugar and starch to be avoided in 

diabetic cases. 
Galvanism. In early stage. 
Mydriatics, 198-201. To dilute pupil as a 

means of diagnosis. 

Catarrh, Acute Nasal. 

Aconite, 215, 698. Internally at commence- 
ment. 

Aconite and Belladonna, 835. In sore throat 
and cold, one drop of tinct. aconite to two 
of belladonna every hour. 

Aconite Liniment, 701. To outside of nose 
in paroxysmal sneezing and coryza. 

Ammonia, 177. As inhalation in early stage. 



Catarrh, Acute Nasal. 

Ammonium Iodide, 545. 1 gr. every two 
hours. 

Arsenic, 608, 609. Internally or as cigarettes 
in paroxysm and chronic cases. 

Baths. Hot foot bath, 401. Turkish at com- 
mencement, 404; cold bath is prophylactic, 
400. 

Belladonna, 835. 5 m. of tinct., and after- 
wards one or two every hour, to throat, dry 
in acute nasal catarrh, with profuse watery 
secretion, and in ordinary sore throat. 

Bismuth, as Ferrier's Snuff— Bismuth subnit. 
5ii, acacia pulv. 5ii, morph. hydrochlor. 
gr. ii. 

Camphor, 862. As inhalation. 

Carbolic Acid, 688-691. As inhalation, or 
much diluted as spray. As gargle, 1 in 100, 
when catarrh tends to spread from nose 
into throat and chest, or to ascend from 
throat into nose. 

Cimicifuga, 703. In coryza accompanied by 
rheumatic or neuralgic pains in head and 
face. 

Cold Powder— Camph. partes v, dissolved in 
ether to consistence of cream, add amnion, 
carbonat. partes iv, and pulv. opii pars j. 
Do^e, grs. iij.-x. To break up or modify 
cold. 

Cubebs, 871. Powder as insufflation; also 
smoked. 

Eucalyptus, 781. 

Ferrier's Snuff, vide Bismuth. 

Hydrastis, 705. Externally and internally. 

Iodine, 471. As inhalation. 

Iodoform, 681, and Tannin, 877. As insuffla- 
tion. 

Ipecacuanha, 802. 

Nux Vomica, 227. In dry cold in the head. 

Oil, 820. Inunction to whole body to lessen 
susceptibility. Locally to nose. Sometimes 
ointment may be used instead. 

Potassic Bichromate, 516. Solution locally, 
1 to 10 gr. in 4 oz. 

Potassic Chlorate, 513. Eight or ten lozenges 
a day to check. 

Potassic Iodide, 518. 10 gr. at bedtime to 
avert acute coryza. 

Pulsatilla, 702. Warm lotion applied to 
interior of nares. 

Quinia, 215, 799. 10 gr. of quinia to % gr. 
morphia at commencement. 

Salicylic Soda, 532. 2J4 gr. every half hour to 
relieve headache and neuralgia associated 
with coryza. 

Sanguinaria, 725. Internally, and powder 
locally. 

Sea-water Gargle. 

Senega, 730. 

Spray. Useful means of applying solutions 
already mentioned. 

Sulphurous Acid, 477. As inhalation, spray, 
or fumigation. 

Tartar Emetic, 325, 326. J<j to f 2 gr. at com- 
mencement. 

Veratrum Viride, 893. If arsenic fails. 

Catarrh, Chronic Nasal. 

Alum, 556, 557. In powder, insufflation, or 

in solution by douche. 
Ammonia, 540. Inhalation. 
Bromine, 469. As powder. 
Carbolic Acid, 687. 1 to 100 as spray, or 1 to 

200 as douche. 1 part with 4 of iodine tine. 

as inhalation. 
Cod-liver Oil, 226. 

Cerebral Anosmia. 

Amyl Nitrite, 666, 667. To act on vessels. 
Camphor, 174, 862. 

Chloral, 672, 673. In small doses, with stim- 
ulants. 
Digitalis, 180. 



984 



IXDEX OF DISEASES AND REMEDIES. 



Cerebral Anemia. 

Electricity. 

Glvcerine, 820. Like Nitrate of Arnyl. 

Iron, 633. 

Nux Vomica, 294, 821. 

Phosphorus, 361, 605. To supply nutriment. 



Cerebral Concussion. 

Rest. Absolute to be enjoined. 
Stimulants. To be avoided. 
Warmth. To extremities. 

Cerebral Congestion. 



Aconite, 701, 702. In acute 

Arsenic, 606, 607. In commencing atheroma 
of cerebral vessels and tendency to drowsi- 
ness and torpor. 

Belladonna, 837, 839. Very useful. 

Bromides, 520, 530. Very useful. 

Cathartics, 339 et seq. To lessen blood-pres- 
sure. 

Chloral, 672, 673. When temperature high. 

Colchicine, 898, 899. In plethoric cases. 

Colocynth, 782,783. As purgative. 

Diet, moderate, animal food sparingly, and 
stimulants to be avoided. 

Galvanism of head and cervical sympathetic. 

Hydrocyanic Acid, 493. 

Venesection, 363. 

Water, 399, 401. Cold douche to head, and 
warm to feet, alternately hot and cold to 
nape of neck. 

Cerebritis. 

Ammonium Chloride, 539. Locally. 
Ice, 401. 

Chancre. 

Carbolic Acid, 688-691. Locally. 

Caustics, 305, 591. Chromic acid, bromine, 

and acid nitrate of mercury. 
Hydrogen Peroxide, 458. Constantly applied 

to destroy specific character. 
Iodoform, 681. One of the best remedies. 
Mercury, 581, 582, 588. Internally. Black 

wash locally. 



Chancroid. 

Carbolic Acid, 688-691. As injection and 

local application. 
Caustics, 305. Sometimes necessary. 
Ferric Iodide, 470. Internally in phagedenic 

cases, or debility. 
Ferrum Tartaratum, 511, 631. Like Ferric 

Iodide. 
Iodoform, 631. Very useful. 
Mercury, 590, 591. Acid nitrate as local 

application. 
Nitric Acid, 480. Locally as caustic. 

Chapped Hands and Lips. 

Benzoin, 816. Compound tincture, 1 part to 

4 of glycerine. 
Collodion, "•■'>'>. 
Glycerine, 820. Saturated with half the 

quantity of eau do cologne. 

Bydrasi 18, 705. As lotion. 
Sulphurous A<i.L 177. As lotion orasfumi- 
gatlon. 



Chest Pains. 

Belladonna, s ::7, 889. In pleurodynia, as 
plaster or ointment. 

!■ nlinc. 471. In myalgia. 



Chicken Pox. 

Aconite, 698. 

Ammonia, Acetate of, 282, 743. 

Bath, 396, 401. Cold in hyperpyrexia. Warm, 

as diaphoretic. 
Compress, Cold, 400. If sore throat. 
Laxatives, 338. 



Chilblains. 

Arnica, 304, 811. Useful. 

Balsam of Peru, 759, 760. As ointment when 
broken. 

Basilicon, 885. Ointment. 

Cajuput Oil, 304, 780. 

Capsicum, Tincture, 835. Locally, when un- 
broken. 

Carbolic Acid, 688. With tincture of iodine 
and tannic acid as ointment. 



Chlorosis. 



Arsenic, 361. In place of, or along with, 
iron. 

Benzoin, 816. 

Cocculus Indicus, 706. In amenorrhcea and 
leucorrhoea. 

Ergot, 911. In chlorotic amenorrhcea. 

Galvanization. 

Hypophosphites of Lime, or Sodium, 530, 554. 

Iron, 630. Carbonate, useful form. Some- 
times best as chalybeate waters. 

Manganese, 390, 640. In amenorrhcea. 

Massage, 128. Useful. 

Nux Vomica, 294, 821. Useful. 

Oils and Fats. As inunction. 

Pepsin, 321, 916. When digestion imperfect. 

Purgatives, 338. Useful; often indispensable. 



Choking. 



Potassic Bromide, 186. In children who 
choke over drinking, but who swallow 
solids readily. 



Cholera Asiatica. 

Alcohol, 655, 657. Iced brandy, to stop vom- 
iting. 

Arsenic, 606. In small doses, has been used 
to stop vomiting. 

Camphor, 864. 5 m. of strong tincture every 
ten minutes, while the symptoms are vio- 
lent. 

Carbolic Acid, 689. ]4 gr. along with 2 m. of 
iodine every hour. 

Chloral. 672. Subcutaneously, alone, or with 
morphia. 

Chloroform, 6S0, 681. 2 or 3 m., either alone 
or with opium, every few minutes. 

Copper Salts, 573. Sometimes used to stop 
vomiting. 

Corrosive Sublimate, 590. 

Lead Acetate, 597. Has been used as an 
astringent in early stages. 

Naphthalin, 691. May be useful. 

Opium, 334, 835. In subcutaneous injection 
iVi gr. to check the preliminary diarrhoea 
and arrest t he collapse. 

Spinal Ice Bag. lias been used to relieve 
cramps. 

Strychnia, 167,824,825. Has been used during 
the preliminary diarrhoea, and also as a 
stimulant to prevent collapse. 

Sulphuric Acid, 477. Alone, or with opium, 
Is very effective in checking the prelimi- 
nary diarrhoea. 

Transfusion of Milk, lias been used in col- 
lapse. 

Turpentine, 883, 884. Has sometimes ap- 
peared serviceable in doses of 10-20 m. 
every two hours. 



INDEX OF DISEASES AND EEMEDIES. 



985 



Cholera Infantum. 



Aliment. Milk, 915. 

Arsenic, 606. For vomiting in collapse. 

Caffeine, 743. 

Camphor, 864. 

Carbolic Acid, 688-691. With bismuth. 

Ipecacuanha, 803. When stools greenish or 
dysenteric. 

Lead Acetate, 597. Very useful. 

Mercury, 585. % g r - °f S ra J powder hourly, 

Potassic Bromide, 186, 521. In nervous irri- 
tation. 

Silver Nitrate, 328, 575. After acute symp- 
toms are past. 

Zinc Oxide, 568, 569. With bismuth and 
pepsin. 



Cholera Simplex. 

Alcohol, 658. Dilute and iced. 

Arsenic, 606. To stop vomiting. 

Cajuput Oil, 780. Used in India. 

Calumba, 706. As anti-emetic. 

Camphor, 864. Very useful. 

Carbolic Acid, 688-691. With bismuth. 

Chloral, 672. Subcutaneously, very useful. 

Copper Salts, 308, 573. As astringent. 

Ipecacuanha, 803. Very useful. 

Lead Acetate, 597. At commencement. 

Mustard, 326, 390. Internally, as emetic, 

poultice over chest, 
Opium, 723. Hypodermically. 
Sumbul, 195, 791. 
Veratrum Album, 219. 



Chordee. 

Aconite, 700. 1 m. every hour. 
Belladonna, 839. With camphor and opium, 

internally, very useful. 
Camphor, 864. Internally, useful. 
Cannabis Indica, 879. 
Cantharis, 925. One drop of tincture three 

times a day as prophylactic. 
Colchicum, 899. £ dr. at night, 
Lupulin, 881. As prophylactic. 
Morphia, 714. Hypodermically, in perinseum 

at night, most useful. 



Chorea. 

Arsenic, 608. Useful sometimes; must be 

pushed till eyes red or sickness induced, 

then discontinued and then used again. 
Chloral, 672. Sometimes very useful in large 

doses carefully -watched. 
Chloroform, 680, 681. As inhalation in severe 

cases. 
Cimicifuga, 703. Often useful, especially when 

menstrual derangement. 
Cocculus, Picrotoxine, 707. In large doses. 
Cod-liver Oil, 921. 
Conium, 786. Sometimes useful, must be 

given in large doses. 
Copper, 826, 572. In increasing doses till 

sickness produced. 
Iron, 633. In anaemia. 
Morphia, 714. Subcutaneously, in severe 

cases. 
Musk, 914. 
Physostigma, 127. 
Strychnia, 120, 139. Useful at puberty, or in 

chorea from fright. 
Valerian, 194, 806. 
Veratrum Viride, 279, 281. 
Water. Cold affusion to spine useful. 
Zinc, 281. Like Copper. 



Climacteric Disorders. 



Choroiditis. 

Mercury, 584. 
Opiates, 181, 182. 



Aconite, 701. 1 m. hourly for nervous palpi- 
tations and fidgets. 

Ammonia, 177. As inhalation. 

Ammonium Chloride, 540. Locally in head- 
ache. 

Camphor, 174, 864. For drowsiness and 
headache. 

Change of air and scene useful adjunct. 

Cimicifuga, 703. For headache. 

Iron, 627, 634. For vertical headache, giddi- 
ness, and feeling of heat. 

Nitrate of Amyl, 704. Where much flushed. 

Nux Vomica, 294, 821. Useful. 

Potassic Bromide, 186, 520-523. Very useful. 

Warm Bath, 401. 

Zinc Valerianate, 571. 



COCCYGODYNIA. 

Belladonna, 839. Plaster useful. 

Chloroform, 680, 681. Locally injected. 

Counter-irritation. 

Electricity. 

Surgical Treatment in obstinate cases. 



Coldness. 

Cold Water, 399. 
friction. 

Strychnia, 824, 825. 



As prophylactic with 



Colic, Intestinal. 



Ammonia, 541, 542. 

Arsenic, 59, 612. When pain is neuralgic in 
character. 

Asafoetida, 330, 787. To remove flatulence. 

Belladonna, 839. Especially in children. 

Chamomile Oil, 809. In hysterical women, 
809 

Chloral, 337, 672. 

Chloroform, 680, 681. To remove pain and 
flatulence. 

Cocculus, 707. During pregnancy. 

Essential Oils. Aniseed, 705, 882. Carda- 
mom, 901. Cinnamon, 861. Peppermint, 
853. Eue, 747. Spearmint, 853. All useful. 

Lime Water, 550. In children. 

Milk Cure, 915. In enteralgia. 

Morphia, 715. Very useful. 

Nux Vomica, 294, 821. Useful. 

Potassic Bromide, 186, 520-523. 

Poultices, 402. Large and warm, of great 
service. 

Tobacco, 843. Dangerous. 



Colic, Lead. 



Alum, 556, 557. 

Castor Oil, 869. Given twice a day to elimi- 
nate. 

Iodide of Potassium, 518. Most useful in 
eliminating lead from the system, and 
combined with mag. sulp. to evacuate it. 

Magnesium Sulphate, 339. Most useful along 
with iodide of potassium. 

Opium, 723. 

Sulphur, 463. To aid elimination. 

Sulphur Baths, 403. 

Sulphuric Acid, 477. 

Tobacco, 843. Dangerous. 



Colic, Renal and Hepatic, vide 
also Calculi. 

Aliment. Abstain from starches and fats. 
Alkalies. Alkaline waters very useful. 
Bath, 401. Warm, to remove pain. 
Chloroform, 680, 681. Inhalation from tum- 
bler during fit. 



986 



IXDEX OF DISEASES AXD REMEDIES. 



Colic, Rexal axd Hepatic, vide 
also Calculi. 

Counter-irritation, 301. See Irritants, &c. 
Ether, 660. Like chloroform. 
Opium, 723. In small doses frequently re- 
peated, or hvpodermatically. 
Turpentine, 374, 884. 

Coma. 

Cold Douche, 399. In drunkenness of opium, 
care must be taken not to chill, and it is 
best to alternate the cold with warm water. 

Croton Oil, 339. As a purgative. 

Potassic Bitartrate, 339. Purgative. 

Mustard. 725. To surface, to stimulate. 

Turpentine, S84. Enema as stimulant. 

COXDYLOMATA. 

Arsenic, 608, 609. As caustic. 

Carbolic Acid, 688-691. Locally. 

Chromic Acid, 3(J4. 1-4 of water, locally, as 

caustic. 
Mercury, 5S7. "Wash with chlorine water, 

or chlorinated soda, and dust with calomel. 
Nitric Acid, 481. As caustic, or twenty per 

cent, oleate. 
Thuja, 886. Strong tincture, locally, small 

doses internally, useful. 
Zinc, 304. Locally, as a caustic or astringent. 

COXJUXCTIVITIS. 

Alum, 556. After acute symptoms have sub- 
sided. 

Belladonna, 837-839. Locally and internally. 

Bismuth, 621, 622. Locally, in chronic cases. 

Blisters, 305. Behind ear. 

Cadmium, 308. As a wash. 

Castor Oil, 869. A drop in eye to lessen irri- 
tation from foreign body. 

Copper Sulphate, 573. As collyrium. 

Euphrasia. As a mild astringent. 

Mercury, 587. As citrine ointment, very 
useful. 

Opium, 183, 1S4. Liquid extract in eye re- 
lieves pain. 

Silver Nitrate, 328, 575. Local application. 

Tannin, 877. As collyrium. 



COXSTIPATIOX. 



Aloes, vide Pinner Pill. 
Alum, 556-558. 

Ammonium Chloride, 540. In bilious dis- 
orders. 
Apples. :;.!9. Stewed or roast. 
Arsenic, 358. In small doses. 
Belladonna Extrari, 835. ^-\ gr. 
Cascara Sagrada, 753. 
Castor oil, 869. 10-20 m. in a teaspoonful of 

brandy and peppermint water before 

breakfast. 
Cocculus, 707. When motions hard and 

lumpy, and much flatus. 
Colocynth Compound, 779, 7S3. Colocynth 

pill at night. 
Croton Oil, 868. When no inflammation is 

present, very active. 
Dinner 1'ills. Abies and myrrh; aloes and 

iron: with mix vomica and belladonna or 

hyOSCyamus, taken just before dinner. 
Enemata, 115. Soap and water, or castor oil. 
Ergot, 911. To give tone. 

. One before breakfast. 
Honey, 923. With breakfast. 
Hydrastis, 705. Useful in biliousness. 
Ipecacuanha, 804, One grain in the morning 

before breakfast. 
Liquorice Powder, Compound, 757. A tea- 

Bpoonful at night or in the morning. 

la, 561. Solution of bicarbonate, u>e- 

ful for children and pregnant women. 



COXSTIPATIOX. 

Mercury, 585. In bilious disorders, stools 
light. 

Kux Vomica, 821. 5-10 m. in a glass of cold 
water before breakfast or before dinner. 

Physostigma, 351. 10 m. of tincture along 
with belladonna and nux vomica. 

Podophyllum, 339. Very useful, especially in 
biliousness; ten drops of the tincture at 
night alone, or the resin along with other 
purgative pills, specially when stools are 
dark. 

Prunes, 339. Stewed, often efficient. If 
stewed in infusion of senna they are still 
more active. 

Rhubarb Compound Pill, 351. At night. 

Saline "Waters. In morning, before breakfast ; 
Friedrichshall, Hunyadi Janos, or Pullna. 

Senna, 766, 767. As confection, &c. 

Stillingia, 358, 867. 10 m. fluid extract. 

Sulphur, 339, 463. Sometimes very useful as 
a good addition to compound liquorice 
powder, as in that of the Prussian Phar- 
macopoeia. 

Treacle, 906. "With porridge, useful for chil- 
dren. 

Turpentine, 883, S84. In atonic constipation 
with much gaseous distention of colon. 

Water. Draught in the morning before 
breakfast. 



COXVALESCEXCE. 

Alcohol, 656. With meals. 
Bitters. 

Coca, 733. Either extract, or as coca wine. 
Cod-liver Oil, 922. 
Cream. 

Eucalyptus, 782. A tonic. 
Guarana, 732. 
Koumiss, 915. 

Lime, 550. As lime water or carbonate. 
Opium, 181, 1S3. As enema for insomnia. 
Surubul, 195, 791. Where great nervous ex- 
citability. 

COXVULSIOXS, IXFAXTILE. 

Aconite, 701. 

Alcohol. A small dose of wine or brandy 
arrests convulsions from teething. 

Asafcetida, 788. A small dose in an enema 
arrests convulsions from teething. 

Baths, 401. Warm, with cold effusions to the 
head. 

Belladonna, S39. Very useful. 

Bromide of Potassium, 194. Exceedingly use- 
ful; children bear it in large doses; 5 gr. 
three times a day or oftener, for a child a 
year old in convulsions from teething. 

Chloral, 672. In large doses, 5 gr., per mouth 
or rectum. 

Chloroform, 680, 681. To arrest fit. 

Ignatia, S21. When intestinal irritation. 

Morphia, 724. Hypodermically. 

Potassium Bitartrate, 339, 511. 

Spinal Ice Bag. 

Valerian, 194, 195, 806. When due to worms. 

Veratrum, 279, 281. 

Corneal Opacities. 

Cadmium, 308. 

Iodine, 471. Internally and locally. 
Mercury, 585. Internally and locally. 
Silver Nitrate, 575. Locally. 
Sodic Chloride, 525. Injected under con- 
junctiva. 



Corns. 



Acetic Acid. 304. 
Chromic Acid,4S7. 
Iodine, 471. 



INDEX OF DISEASES AND KEMEDIES. 



987 



Corns. 



Poultices, 402. And plaster with hole in 

centre to relieve pressure. 
Silver Nitrate, 575. 

Cough. 

Aconite, 209, 215, 700. In throat cough and 
emph sema. 

Alum, 556, 557. As spray or gargle. 

Apomorphia, 215, 226. In bronchitis, with 
deficient secretion. 

Asafcetida, 788. In the after-cough from 
habit, and in the sympathetic whooping- 
cough of mothers. 

Belladonna, 839. 

Blue Pill, 585. In gouty or bilious pharyn- 
geal irritation. 

Camphor, 863. Internally or locally, painted 
over the larynx with equal parts of alcohol. 

Chloral, 672. 

Chloroform, 680, 681. 

Cod-liver Oil, 226, 922. One of the most 
useful of all remedies in cough. 

Conium, 787. 

Gelsemium, 827. In convulsive and spas- 
modic cough. 

Griudelia, 813. In habitual or spasmodic 
cough. 

Hydrocyanic Acid, 493. For irritable cough, 
and in phthisis. 

Hyoscyamus, 183. In tickling night coughs. 

Iodine, 472. As inhalation. 

Ipecacuanha, 804. Internally and as spray, 
locally. 

Ipecacuanha and Squill Pill, 803. In chronic 
bronchitis at night, 

Lactucarium, 811. 

Laurocerasus, 777. Substitute for hydrocy- 
anic acid. 

Linseed, 729. In throat cough. 

Liquorice, 227, 757. In throat cough. 

Lobelia, 814. 

Nasal Douche, 410. In nasal cough, 221. 

Opium, 181, 183. Morphia locally to the 
throat, and generally. 

Plasters, 228, 433. Calefaciens and picis to 
the chest. 

Potassic Bromide, 521. In reflex coughs. 

Primus Virginiana, 339. 

Pulsatilla, 702. Anemonine, 3^-1 gr. dose in 
asthma and whooping-cough. 

Sanguinaria, 725, 726. In nervous cough. 

Tannin, 876. As glycerine to the fauces. 

Tar Water, 227, 886. In winter cough, bron- 
chitis, and phthisis. 

Valerian, 194, 195. In hysterical cough. 

Croup. 

Alum, 326, 556. Teaspoonful, with honey or 
syrup, every % or % hour until vomiting 
is induced ; most useful emetic. 

Copper Sulphate, 573. 1-5 grs., according to 
age of child, until vomiting is induced. 

Ipecacuanha, 804. Must be fresh ; if it does 
not succeed, other emetics must be taken. 

Lactic Acid, 493. To dissolve membrane (1 
in 20). 

Mercury Subsulphate, 587. One of the best 
emetics ; 3-5 gr. given early. 

Sanguinaria, 725. A good emetic. ~fy syr. 
ipecac, Sij ; pulv. sanguin. gr. xx ; pulv. 
ipecac, gr. v; mix a teaspoonful every 
quarter hour till emesis, then half a tea- 
spoonful every hour. 

Senega, 731. As an auxiliary. 

Sulphurous Acid, 479. As spray. 

Tannin, 876. As spray. 

Tartar Emetic, 227. Too depressant. 

Zinc Sulphate, 326, 570. 



Cystitis. 



Aconite, 701. When fever present. 
Alkalies, 501. When urine is acid. 



Cystitis. 



Belladonna, 839. Most useful to allay irrita- 
bility. 

Buchu, 384, 748. Especially useful in chronic 
cases. 

Cantharides, 926. In small doses long con- 
tinued. 

Chimaphila, 815. In chronic cases. 

Copaiba, 385. Useful. 

Cubebs, 374, 872. 

Eucalyptus, 781. Extremely useful in chronic 
cases. 

Iodoform, 683. As suppository. 
* Opium, 181, 183. As enema, or suppository,. 
to relieve pain. 

Pareira, 707. In chronic cases. 

Quinine, 801. In acute cases. 

Sulphites, 533. To prevent putrefaction of 
urine. 

Turpentine, 374, 882, 883. 

Uva Ursi, 815. In chronic cases. 



Cysts. 



Chloride of Gold, 641. In ovarian dropsy. 
Galvano Puncture. 

Iodine, 471. As an injection after tapping. 
Silver Nitrate, 575. As an injection. 



Deafness. 

Cantharides, 819. As ointment behind the 

ear. 
Colchicum, 899. In gouty persons. 
Gargles, 413. In throat deafness. 
Glycerin, 820. Locally. 
Quinine, 801. In Meniere's disease. 
Tannin, 876, 877. In throat deafness. 



Debility. 

Alcohol, 656. Along with food often very 
useful. Liable to abuse— not to be con- 
tinued too long. 

Arsenic, 109,361. In young ansetnic persons,, 
alone or with iron, and in elderly, with 
feeble circulation. 

Bitters. Useful as tonic. 

Cholagogue Purgatives, 353. When debility 
is due to defective elimination of waste. 

Cinchona, 801, 802. 

Digitalis, 850. When circulation is feeble. 

Eucalyptus, 782. In place of quinine. 

Hydrastia, 705. The same. 

Iron, 634. Anaemia. 

Lime Salts, 553. Phosphates, if from over- 
work and town life; hypophosphites in 
nervous debility. 

Manganese, 640. In place of iron. 

Nux Vomica, 821. Most powerful general 
tonic. 

Sanguinaria, 358, 725. When gastric digestion 
is feeble. 
• Sarsaparilla, 889. When syphilitic taint is 
present. 

Sea Bathing, 395. 



Delirium. 



Alcohol, 656. When delirium is due to ex- 
haustion. 

Antimony, 616. Along with opium in fever. 

Bath, Cold, 396. In fever. 

Belladonna, 839. 

Bromide of Potassium, 521, 522. In fevers. 

Camphor, 863. In 20-gr. doses every two or 
three hours in low-mutteringdelirium. 

Cannabis Indica, 879, 880. In nocturnal 
delirium occurring in softening of the 
brain. 

Morphia, 716. Hypodermically. 

Opium, 181, 183. With tartar emetic. 



988 



INDEX OF DISEASES AND REMEDIES. 



Delirium Tremens. 

Alcohol, 654. Sometimes necessary. 
Ammonium Carbonate, 543. In debility. 
Beef Tea, 656. Most useful. 
Belladonna, 837,839. In insomnia when coma 

Tigil. 
Bromides, 521, 536. 544, 553. In large doses. 
Cannabis Indica, 879, 8S0. Useful, and not 

dangerous. 
Capsicum, 835. 20-30 gr. doses, repeated after 

three hours, to induce sleep. 
Chloral, 672. At commencement requires 

caution. 
Cimicifuga, 703. As a tonic. 
Coffee, 304 

Conium, 787. As an adjunct to opium. 
Digitalis, 850. In large doses has had some 

success 
Enemata, 415. Xutritive, when stomach does 

not retain food. 
Food, nutritious, more to be depended upon 

than anything else. 
Hyoscyamus, 181-183. Useful, like belladonna. 
Ice, 328. To check vomiting. 
Lupulin, 881. 

Opium, 722. To be given with caution. 
Potassium Bromide, 521. 
Quinine, 801. 

Stramonium, 842. More powerful than bella- 
donna. 
Sumbul, 195, 791. In insomnia. 
Tartar Emetic, 227. Along with opium. 

Dentition. 

Belladonna, 839. In convulsions. 

Bromide of Potassium, 521. To lessen irrita- 
bility and to stop convulsions. 

Calumba, 706. In vomiting and diarrhoea. 

Hypophosphites, 531, 554, 639. A tonic. 

Phosphates of Lime, 553, 554. When delayed 
or defective. 

Diabetes Insipidus. 

Alum. 556. 557. 

Atropia, 839. 

Creasote, 691. 

Ergot, 911. 

Gallic Acid, 877. Combined with opium. 

Jaborandi, 749. 

Krameria, 731. To lessen the quantity of 

urine. 
Nitric Acid, 481. 
Opium, 719. Most useful; large doses, if 

necessary. 
Valerian, 806. In large doses. 

Diabetes Mellitus. 

Alkalies. Alkaline waters are useful. 

Ammonium Carbonate, 543. 

Ammonium Citrate, 623. 

Ammonium Phosphate, 544. 

Arsenic, 608. 

Belladonna. 903. Full doses. t 

Calcium Sulphide. 555. 

Codeia,715. A most efficient remedy. Some- 
times requires to be pushed to the extent 
of 1*- gr-. or inure per diem. 

Creasote, 691. 

Glycerin, B20. As remedy, and as food in 
place of sugar. 

Hydrogen Peroxide. 458. 

Iron, 634. Most useful along with morphia. 

.lab'U audi, 749. 

Krameria. 731* 

Lactic Acid, -i'x>. 

Opium, 719. Most useful. 

Phosphoric Add. 183. To lessen thirst. 

Potassium Bromide, 521. 

Quinine, 800, 801. 

Quinine Bromide. With morphia. 

Quinine Sulphate, 796. 

Rhubarb, 



Diabetes Mellitus. 

SalicvlicofSoda, 532. 

Skim Milk Diet. 

Sodium Citrate, 322. 

Sodium Phosphate, 530. As purgative. 

DlABBHCEA. 

Aconite, 701. In high fever and cutting 
abdominal pains. 

Alkalies, 499, 500. In small doses in diarrhoea 
of children. 

Alum, 556, 557. 

Ammonium Carbonate, 543. 

Arsenic, 608, 609. 

Bael, 741. 

Bismuth, 621, 622. 

Calcium Carbolate, vide 691. 

Calcium Carbonate, 553. 

Calcium Phosphate, 553. 

Camphor, 863. In summer diarrhoea at com- 
mencement. 

Capsicum, 835. From eating fish. 

Carbolic Acid, 689, 690. 

Cascarilla, 867. 

Castor Oil and Opium, 869. Most useful at 
commencement. 

Catechu, 770. 

Copper Sulphate, 573. In chronic cases. 

Corrosive Sublimate, 107, 589. In small doses 
for children. 

Creasote, 691 

Dulcamara, 835. In diarrhoea of children 
from teething or exposure. 

Ergot, 911. 

Erigeron Canadense. 

Galls, 875. 

Haematoxylon, 765. 

Iron Pernitrate, 634. 

Iron and Potash Tartrate, 635. 

Kino, 759. 

Krameria, 732. 

Lead Acetate, 597. By mouth or suppository. 

Matico, 872. 

Naphthalin, 694. 

Kitrous uxide, 186. 

Nux Vomica, 821. In chronic cases. 

Oak Bark, 308, 874. 

Opium, 722. Most useful. 

Potassium Chlorate, 514. In chronic cases 
with mucilage-like stools. 

Pulsatilla, 702. 

Rhubarb, 858. In early stages. 

Bumex Crispus, 436, 859. In morning diar- 
rhoea. 

Salicin, 873. In chronic cases along with 
ipecacuanha. 

Salicylic Acid, 693. In summer diarrhoea 
and in diarrhoea of phthisis. 

Tannin with Opium, 877. 

Zinc Oxide, 569. 

Zinc Sulphate, 30S, 570. 

Diphtheria. 

Alcohol, 655, 656. Freely given, very useful. 

Ammonium Chloride, 540. 

Apomorphia, 714. As an emetic. 

Arsenic, 60S, 609. Internally. 

Belladonna, 839. At commencement, espe- 
cially useful when tonsils much swollen. 

Bromine, 469. As inhalation. 

Carbolic Acid, 6S8-C90. As spray or painted 
on throat, internally with iron. 

Chloral, 672. 

Chlorinated Lime, 467, 468. Locally as gargle 
or wash. 

Chlorine Water, 467. Internally. 

Copper Sulphate, 573. As emetic. 

Gualacum, 7 16. Internally. 

Hydrochloric Acid, 479. Dilute as gargle, or 
Btrong as caustic. 

Iodine, 471. As inhalation. 

[ron Perchloride, 633. 

Iron Persulphate, 631. 



IXDEX OF DISEASES AXD REMEDIES. 



989 



Diphtheria. 



Lactic Acid, 493. As solvent of false mem- 
brane. 

Lemon Juice, 740. As gargle. 

Mercury, 585. Internally as calomel or 
cyanides, oV~ ^ of a grain. 

Papain, 778." As solvent of false membrane. 

Potassium Bichromate, 517. As emetic. 

Potassium Chlorate, 514. Internally in large 
doses frequently repeated, and locally as a 
gargle. 

Potassium Liquor, 509. Internally. 

Potassium Permanganate, 515. As gargle. 

Salicylic Acid, 693. Locally as gargle, or 
internally. 

Sanguinaria, 725. As emetic. Vide Croup. 

Sassafras, Oil of, S64. As local application. 

Soda Chlorate, 530. 

Soda, Chlorinated, 530. In a solution as 
gargle. 

Soda Sulphites, o33. Internally and locally. 

Strychnia, 824. Subcutaueously for paralysis. 

Sulphurous Acid, 478. 

Dropsy. 

Ammonium Benzoate, 546. In hepatic dropsy. 

Ammonium Chloride. 540. In hepatic dropsy. 

Arsenic, 608, 609. From fatty heart, debility, 
and old age. 

Asclepias Syriaca, 829. 

Asclepias Syriaca and Apocynum, 828. 

Blatta, 373." 

Broom, 375, 758. One of the most useful 
diuretics, especially in scarlatinal, renal, 
and hepatic dropsy. 

Byronia, 7S5. As "drastic, purgative, and 
diuretic. 

Cannabis Indica, SS0. As diuretic. 

Chenopodium Anthelminticum, S59. In scar- 
latinal dropsy. 

Chiniaphila, 815. In renal dropsy. 

Colchicum, 899. In hepatic, cardiac, and 
scarlatinal dropsy. 

Copaiba, 375. Especially in hepatic dropsy. 

Digitalis, 375, 850. In all dropsies, but espe- 
cially in cardiac dropsy; infusion is the 
best "form. 

Elateriuin, 340, 784. Useful hydragogue 
cathartic. 

Erythrophlceum, 375. In cardiac dropsy. 

Hellebore, 894. In post-scarlatinal dropsy. 

Iron, 634. Along with saline purgatives." 

Juniper, 375, 887. Exceedingly useful. 

Nitrous Ether, 374, 375. Useful alone, or 
with other diuretics. 

Potassium Bitaitrate, 374. With compound 
jalap powder, most useful of the hydragogue 
cathartics. 

Potassium Nitrate, 374. As diuretic. 

Senega, 731. In renal dropsy. 

Squill, 375. In cardiac dropsy. 

Strophanthus, 374. In cardiac dropsy. 
* Taraxacum, 374. 

Turpentine, 374. In albuminuria. 

Duodexal Catarrh. 

Arsenic, 608, 609. 
Bismuth, 622. 
Ipecacuanha, 804. 
Nitro-rnuriatic Acid, 377. 
Podophyllum, 704. 
Rhubarb, 858. 

Dysentery. 

Aconite, 701. With much fever. 
Arnica, 811. With much depression. 
Arsenic, 60S, 609. 
Belladonna, S39. 
Benzoin, 817. In chronic cases. 
Carbolic Acid, 689, 690. 

Castor Oil, S69. In small doses, with opium. 
Corrosive Sublimate, 107. In small doses in 
chronic cases. 



Dysextery. 

Creasote, 691. 
Ergotine, 911. 
Glycerin, 820. With linseed tea to lessen 

tenesmus. 
Hamamelis, 874. Where much blood in 

motions. 
Iodine, 472. 
Ipecacuanha, 804. In 30-gr. doses on empty 

stomach, with complete rest. 
Iron, 634. Internally, or as enemata. 
Lead Acetate, 597. By mouth, or as enemata 

or suppusitory. 
Lemon Juice, 740. 

Magnesium Sulphate, 560. In acute cases. 
Xux Vomica, 821. In epidemic cases, and 

where prune-juice stools and much depres- 
sion. 
Opium. 723. 
Potassium Bitartrate, 340, 511. In advanced 

stages where much mucus. 
Potassium Chlorate, 514. As enema. 
Quinine Sulphate, 797. In large doses in 

malarious cases, followed by ipecacuanha. 
Soda, Chlorinated, 530. As enema. 
Sulphur, 463. In chronic cases. 
Tannin, 876. 
Zinc Oxide, 569. 
Zinc Sulphate, 30S, 570. By mouth or enema. 



Dysmenorrhea. 



Aconite, 701. 

Ammonium Acetate, 544. 

Aniyl Nitrite, 666. In neuralgic form. 

Apiol .Oil of Parsley). As emmenagogue in 
neuralgic form. 

Arsenic, 608, 609. When membranous dis- 
charge from uterus. 

Belladonna, S39. In neuralgic form. 

Borax, 391, 529. In membranous form. 

Cajuput Oil, 780. 

Camphor, 863. Frequently repeated. 

Cannabis Indica, 879, 880. Very useful. 

Cimicifuga, 703. In congestive "cases at com- 
mencement. 

Croton Chloral, 673. In neuralgic form. 

Ergot, 911. In congestive cases at commence- 
ment. 

Gelsemium, 827. 

Guaiacum, 390. In rheumatic cases. 

Ipecacuanha, 804. As an emetic. 

Iron, 634. 

Xux Vomica, 821. In neuralgic form. 

Opium, 723, 724. Exceedingly useiul in small 
doses, of 3 to 5 m. of tincture alone or 
along with 3 or 4 gr. of chloral. 

Pulsatilla, 702. 

Rue, 391, 747. 

Sumbul, 791. 



Dyspepsia. 

Acids, 480. Before or after meals, especially 
nitro-muriatic acid. 

Alcohol, 656. Along with food. 

Alkalies, 500. Very useful before meals, or 
two hours after. " 

Alkaline Mineral Waters. 

Aloes, 892. As dinner pill. 

Arsenic, 608, 609. 1 m. of liquor before meals 
in neuralgia of the stomach, or diarrhoea 
excited by food. 

Asafcetida, 788. 

Belladonna, 839. To lessen pain and consti- 
pation. 

Berberine, 865. 

Bismuth, 622. When stomach irritable. 

Bryonia, 785. In bilious headache. 

Calumba, 706. Very useful. 

Capsicum, S35. In atonic dyspepsia. 

Cardamom, 901. 

Castor Oil, 869. 

Cerium Oxalate, 558. 

Chamomile, 809. 



990 



INDEX OF DISEASES AND REMEDIES. 



Dyspepsia. 

Charcoal, 460. For flatulence. 

Cholagogues, 340. Often verv useful. 

Cinchona, SOI, 802. 

Gallic Acid, 877. In pyrosis. 

Hydrastis, 705. In chronic dyspepsia. 

Hydrocyanic Acid, 493. In irritable cases. 

Ipecacuanha, 804. Useful adjunct to dinner 

pill. 
Kino, 759. In pyrosis. 
Lactic Acid, 493. In imperfect digestion, 
Lime Water, 550. 
Magnesium Sulphate, 560. 
Manganese, 640. In gastrodyrjia and pyro. 
Mercury, 585. As cholagogue. 
Nux Vomica, S21. Exceedingly useful. 
Pancreatin, 321. 1% or 2 hours after meals, 

very useful. 
Pepsin, 321. Sometimes very useful with 

meals. 
Potassium Iodide, 518. 
Potassium Sulphide, 506. 
Quassia, 752. 
Rhubarb, 351, 858. 

Sanguinaria, 725. In atonic dyspepsia. 
Silver Nitrate, 575. In nervous aud neuralgic 

cases. 
Silver Oxide, 577. 
Sulphurous Acid, 47S. In acid pyrosis and 

vomiting. 
Tannic Acid, 308. 
Taraxacum, 810. 
Xanthoxylin, 749. As stomachic tonic. 

Dysphagia. 

Bromide of Potassium, 521, 522. In hyster- 
ical dysphagia, or dysphagia of liquids in 
children. 

Cajuput Oil, 780. In nervous dysphagia. 

Iced Fluids. Slowly swallowed in spasmodic 
dysphagia. 

Dyspncea. 

Vide Asthma, Bronchitis, Cioup, Emphysema, 
Phthisis. 



Dystjria. 

Alkalies, 501-503. When urine very acid. 

Belladonna, 839. 

Camphor, 863. In strangury. 

Cannabis Indica, S79, S80. In hematuria. 

Cantharides Tincture, 926. 

Chimaphila, 374, 815. 

Ergot, 911. In paralysis, when bladder feels 

imperfectly emptied. 
Gelsemium, 827. 
Nitrous Ether, 374. 
Opium, 723, 724. 

Earache. 

Almond Oil, 776. 

Blisters, 305. I'.chind the ear. 

Glycerin, 820. 

Lead Acetate and Opium, 598. As wash. 

Opium. 722. 

Pulsatilla, 702. 



El CHYMOSBS. 

Alcohol, 655. Externally. 

Arnica, 811. Internally and externally. 

ECTIIYM \. 

Cod-liver Oil, 921. Internally and locally. 
Grape Cure. I Useful. 
Lead, 596. Locally. 
Quinine, 799 301, " 
Zinc Oxide, 588. Locallv. 



ECTROPIUM AND EnTROPIUM. 



Collodion, 736. 
Silver Nitrate, 



Eczema. 

Alkalies. Weak solutions of, as constant 
dressing. 

Anacardium Orientale, vide Cashew Nut Oil. 

Arsenic, 608, 609. Most generally useful. 

Benzoin, 817. Compound tincture locally, to 
allav itching. 

Bismuth, 622. Locally. 

Carbolic Acid, 689, 690. Internally and ex- 
ternally. 

Carron Oil, 551. To allay irritation. 

Cashew Nut Oil. As ointment in chronic 
cases. 

Citrine Ointment, 591. Locally, alone or 
mixed with tar ointment. 

Croton Seeds, 867. Tincture of, as ointment. 

Electricity. In obstinate cases. 

Glycerin, 820. 

Hamamelis, 874. Locally to allay itching. 

Iris Versicolor, 902. In chronic gouty cases. 

Lead Salts, 597. Locally. 

Lime Water, 550. Alone, or with glycerin or 
oil. 

Mercury, 585. 

Milk Cure, 915. Sometimes useful. 

Phytolacca, 859. In obstinate cases. 

Ehus Toxicodendron, 755. Internally and 
externally. With much burning and itch- 
ing, and in chronic eczema of rheumatism, 
worse at night-time. 

Sulphides, [ 403, 463, 516, 555. Internally, 

Sulphur, j and as baths. 

Tannin, 876. Glycerin of, most useful appli- 
cation. 

Viola Tricolor, 729. Iufusion along with 
senna. 



Elephantiasis. 

Anacardium Orientale. 

Arsenic, 60S, 609. Along with five or six 

times as much black pepper. 
Cashew Nut Oil. 
Gurjun Oil. 
Sarsaparilla, SS9. 



Emaciation. 

Arsenic, 608, 609. 
Cinchona, 801, 802. 
Cod-liver Oil, 358, 921. 
Iodine, 471. 
Iron, 634. 
Pancreatin, 321. 
Pepsin, 321. 
Phosphate of Lime, 554. 



Emphysema. 

Apomorphia, 713, 714. When secretion is 
scanty. 

Arsenic, 608, 609. 

Bleeding, 363. When right side of heart 
engorged. 

Chloral, 672. In acute. 

Cod-liver Oil, 358, 921. One of the best rem- 
edies. 

Ether, 662. Internally as inhalation. 

Grindelia, 812. 

Bypophosphites, 531, 554,639. 

Iodide of Ethyl, 669, 670. As inhalation. 

Iron, 634. 

Oxygen, 456. 

Senega, 731. 

Stramonium, 842. 

Turpentine, Oil of, 883, 8S4. 



INDEX OF DISEASES AND REMEDIES. 



991 



Empyema. 

Aspiration, or free incision 
Carbolate of Iodine, 471. 
Carbolic Acid, 689, 690. 
Chlorine Water, 467. 
Iodine, 471. 
Quinine, 799-802. 
Salicylic Acid, 693. J 



All used as in- 
jections to wash 
out cavity. 



Endocarditis. 

Aconite, 300, 699, 701. In small doses fre- 
quently at commencement. 
Blisters, 305. 
Bryonia, 785. 

Mercury, 582. To prevent fibrinous deposits. 
Opium, 722. 
Quiuia, 801. 
Salicylic Acid, 693. 

Endometritis. 

Carbolic Acid, 689, 690. Locally. 

Chromic Acid, 304. 

Ergot, 911. Subcutaneously. 

Glycerin, 820. Locally. 

Hot Water Injections. 

Iodine, 471. 

Iodoform, 683. 

Iodo-tannin. Solution of iodine in tannic 

acid. 
Nitric Acid, 481. 
Ustilago Maydis, 911. 

Enteritis. 

Aconite, 701. In acute cases. 

Arsenic, 608, 609. 

Castor Oil, 869. Very useful along with 

opium. 
Iron, 634. 
Opium, 723. 
Podophyllum, 704. 
Poultice, Hot, 402. 
Skim Milk. As diet, alone or with lime 

water. 

Enuresis. 

Atropia, 837. 

Belladonna, 839. Very useful for children, 

but the dose must be large. 
Buchu, 748. In chronic cases. 
Cantharides, 925, 926. Internally very useful. 
Chloral Hydrate, 672. Jn children. 
Collodion, 736. To form a cap over prepuce. 
Ergot, 911. In paralytic cases. 
Iodine of Iron, 637. 
Lupuline, 881. 
Rhus Aromatica, 756. 
Rhus Toxicodendron, 755. 
Santonin, 808. When worms present. 
Strychnia, 825. Very useful. 
Turpentine, 883. 

Epididymitis. 

Aconite, 701. In small doses frequently re- 
peated. 

Mercury and Morphia, 585. Locally as oleate. 

Pulsatilla, 702. In very small doses along 
with aconite. 

Silver Nitrate, 575. Strong solution locally 
applied to abort. 

Epilepsy. 

Arsenic, 608, 609. In epileptiform vertigo. 

Asafcatida, 788 

Belladonna, 839. Jn petit mal. 

Blisters, 303, 304, 305. Over seat of aura. 

Bromides of Potassium, Sodium, Lithium, 
and Iron, 521, 531, 536. Most generally use- 
ful ; dose should be large. 



Epilepsy. 

Bryonia, 785. 

Camphor, 863. 

Cautery. Frequently and lightly repeated. 

Chloroform, 680, 681. As inhalation in 
hystero-epilepsy. 

Cod-liver Oil, 922. 

Conium, 787. 

Copper Salts, 573. 

Hvdrobromic Acid, 494. 

Ignatia, 821. 

Nitrite of Amy], 666. As inhalation at com- 
mencement of aura. 

Nitrite of Soda, 524. 

Nitro-glycerin, 668, 669. 

Phosphorus, 361, 605. 

Picrotoxin, 707, 708. 

Quinia, 801. 

Rue, 747. When seminal emissions present. 

Seton at back of neck. 

Strychnia, 825. 

Turpentine, 355, 884. When worms present. 

Valerian, 806. 

Zinc Oxide, 569. 



Epistaxis. 

Aconite, 701. 

Alum Powder, 556, 557. Snuffed or blown up 
the nostrils. 

Arnica, 811. In traumatic cases. 

Belladonna, 839. 

Digitalis, 850. 

Ergot, 911. 

Gallic Acid, 877. Alone with ergot and dig- 
italis. 

Hamamelis, 874. 

Ice over nose and head. 

Ipecacuanha, 803. 

Iron, 634. As spray. 

Plugging anterior and posterior nares neces- 
sary, if epistaxis obstinate. 

Turpentine, 884. Internally. 

Warm Bath, 401. To feet and hands. 

Warm Water Bag. To spine. 



Erysipelas. 

Aconite, 701. At commencement. 

Ammonium Carbonate, 543. When tendency 
to collapse. 

Belladonna, 839. 

Collodion, 736. Locally. 

Digitalis, 850. Locally. 

Iodine, 471. 

Iron, 634. Large doses frequently. 

Quinine, 801. In large doses. 

Khus Toxicodendron, 304, 756. 

Silver Nitrate, 575. Strong solution locally 
applied. 

Sulphurous Acid, 478. Equal parts with gly- 
cerin locally. 

Tartar Emetic, 616, 617. Small doses fre- 
quently. 



Erythema. 

Acids. In cases of indigestion. 

Belladonna, 839. 

Bismuth, 622. Locally. 

Quinia, 801. In erythema nodosum. 

Rhus Toxicodendron, 304, 756. 

Zinc, 304. Locally. 



Exophthalmos. 

Belladonna, 839. 

Digitalin, 850. 

Galvanism of the cervical sympathetic and 

pneumogastric. 
Iron, 634. 



992 



IXDEX OF DISEASES AND KEMEDIES. 



Exostosis. 

Aconite, 701. 

Iodide of Potassium, 519. 

Mercury, 585. 

Fever. 

Acids, 475-477. To allay thirst. 

Aconite, 701. Small doses frequently, in all 
sympathetic fevers. 

Alcohol, 655. Often useful. 

Ammonium Acetate, 544. Very useful as 
diaphoretic. 

Ammonium Carbonate, 543. In scarlet fever 
and measles. 

Antipyrin, 696. 

Arnica, 811. 

Arsenic, 608, 609. In malarious fevers. 

Belladonna, 839. In eruptive fevers and deli- 
rium. 

Camphor, 863. In adynamic fevers. 

Cimicifuga, 703. 

Cinchona, 801, 802. 

Cocculus, 706. In typhoid, to lessen tym- 
panitis. 

Coffee, 804. In place of alcohol. 

Digitalis, 850. 

Gelsemium, 827. 

Hydrastia, 705. 

Mercury, 58o. Small dnses at commence- 
ment of typhoid or scarlet fever. 

Opium, 181," 183. In sleeplessness, alone or 
with tartar emetic. 

Quinine, 109, 802. In hyperpyrexia. 

Rhus Toxicodendron, 304, 812. In rheumatic 
fever and scarlet fever with typhoid symp- 
toms. 

Salicin, 873. "] In rheumatic fevers, 

Salicylate of Soda, 532. v or in hyperpy- 

Salicylic Acid, 693, J rexia. 

Tartar Emetic, 616, 617. In small doses, with 
opium. 

Turpentine, 374. As stimulant in typhoid, 
puerperal, and yellow, and to stop haemor- 
rhage in typhoid. 

Yeratrum Viride, 894. In delirium ferox. 

Fistula. 

Capsicum, S35. As weak infusion locally. 
Pepper, 870. The confection as laxative. 
Sanguinaria, 358, 725. As injection. 

Flatulence. 

Alkalies, 320, 501. Before meals. 

Asafcetida, 787. 

Calumba, 706. 

Carbolic Acid, 689, 690. 

Carminatives, 329. 

Charcoal, 330. 

Creasote, 691. 

Mercury, 585. When liver sluggish. 

Nux Vomica, 821. 

Physostigma, 351. in women at change of 

life. 
Potassium Permanganate, 515. In fat people. 
Turpentine, 882. lew drops internally, or as 

enema. 

Flushing and Heat. 

Iron, 634. .Most useful. 
Nit rile of Amy], 666. 
Nux Vomica, 821. 

Potassium Bromide, 521, 531. 
Valerian, 806. 
Valerianate of Zinc, 572. 

Fb lctures and Dislocations. 

Aconite, 701. if febrile symptoms are pres- 
ent. 
Arnica, 811. Internally and locally. 



Fractures and Dislocations, 



Iodine, 471. 
Opium, 723. 
Phosphate of Lime, 553. 



Freckles. 



Quickens union. 



Benzoin, 817. 

Borax, 529. 

Iodine, 471. 

Lime Water, 550. 

Mercuric Chloride, 82, 588. Locally with gly- 
cerine, alcohol, and rose water, % of gr. to 
the oz. 

Olive Oil, 819, 820. 

Potassium Carbonate, 322, 508. 



Gangrene. 

Balsam of Peru, 760. 

Bromine,*469. 

Charcoal, 459. As poultice. 

Cinchona, 801, 802. 

Creasote, 691. 

Lime Juice and Chlorine Water in hospital 

gangrene. 
Nitric Acid, 481. 
Opium, 723. 

Oxygen, 456. As a bath. 
Potassium Chlorate, 374, 514. 
Salicylic Acid, 693. Locally. 
Sanguinaria, 725. 



Gastralgia. 



Acupuncture. Sometimes gives great relief. 

Alum, 556, 557. 

Arsenic, 608, 609. In small doses. 

Atropia, 839, 840. 

Bismuth, 329. 

Chloroiorm, 680, 681. Two or three drops on 
sugar. 

Creasote, 691. 

Ergot, 911. 

Galvanism. 

Hydrocyanic Acid, 329. 

Milk Cure, 915. 

Morphia, 715. Subcutaneously, in epigas- 
trium. Very useful, or with bismuth and 
milk before each meal. 

Nux A'omica, 821. 

Pancreatine, 321. 

Pepsine, 321. 

Silver Nitrate, 575. 

Silver Oxide, 577. 

Zinc Oxide, 568. 



Gastric Ulcer. 

Arsenic, 60*, 609. 

Atropia, 839. 

Bismuth, 622. 

Cannabis Indica, 879, 880. 

Carlsbad Salts, 529. Before meals. 

Castor Oil, 869. 

Charcoal, 460. 

Ice Bag. To epigastrium. 

Lead Acetate, 597. To check lnematemesis. 

Lime Water, with Milk, 550. 

Mercuric Chloride, 82, 588. Small dose before 

meals. 
Milk, 915. 
Morphia, 713,715. 
Nutritive Knemata. 
Opium, 72:;. 
Pepsine, 821. 
Potassium Iodide, 518. With bicarbonate, to 

lessee flatulent dyspepsia. 
Silver Nitrate, 575. 
Silver Oxide, 577. 
Turpentine, 882, 883. Frequently repeated 

to check haemorrhage. 



INDEX OF DISEASES AND KEMEDIES. 



993 



Gastritis. 



Along with opium. 



Alum, 556, 557. When vomiting of glairy- 
mucus. 

Ammonium Chloride, 540. 

Arsenic, 608, 609. 

Atropia, 839. In chronic cases. 

Bismuth, 622. 

Caffeine, 742, 743. Especially when associated 
with migraine. 

Calumba, 706. 

Cinchona, 801, 802. 

Eucalyptus, 781. 

Hydrastis, 705. 

Ipecacuanha, 803. 

Lead Acetate, 597. 

Nux Vomica, 821. 

Opium, 723. 

Pulsatilla, 702. 

Silver Nitrate, 575. 

Silver Oxide, 577. 

Tannic Acid, 876. 

Glanders. 

Ammonium Carbonate, 543. Every hour in 
concentrated solution, followed by opiate. 
Arseniate of Strychnia, 825. 
Carbolic Acid, 688-690. Locally. 
Chlorinated Soda, 468. Locally. 
Creasote, 691. 
Iodine, 471. 
Iodide of Sulphur, 470. 
Potassium Bichromate, 98. 
Sulphites, 533. 

Glandular Enlargements. 

Ammonium Chloride, 540. 

Arsenic, 608, 609. 

Barium Chloride, 246. 

Belladonna, 839. 

Cadmium Chloride, 246. 

Calcium Sulphide, 555. For glands behind 

jaw, with deep-seated suppuration. 
Carbolic Acid, 688-690. Injections, a 2 per 

cent, solution. 
Gold Chloride, 641. 
Guaiacum, 746. 
Hydrastis, 705. 
Iodine, 471. 
Iodoform, 682. 

Mercury, 585. Internally and locally. 
Sulphides, 516, 555. 
Valerian, 806. 



Has caused this disease. 
Like Atropia. 

Lowers intra-ocular tension. 
The only cure. 



Glaucoma. 

Atropia, 839. 
Dubosia, 198. 
Eserine, 761. 
Iridectomy. 

Gleet. 

Aloes, 892. 

Blisters, 305. To perinaeum useful. 

Cantharides, 376, 926. Minim doses of tinc- 
ture. 

Copaiba, 385, 768. Internally and locally 
smeared on a bougie and introduced. 

Copper Sulphate, 573. As injection. 

Iron, 634. 

Juniper Oil, 887. Like Copaiba. 

Kino, 759. 

Peru, Balsam of, 760. 

Piper Methysticum, 871. 

Sandal Wood Oil, 759. Useful both locally 
and generally. 

Tannin, Glycerine of, 876. As injection. 

Tolu, Balsam of, 760. 

Turpentine, 374, 883. 

Glossitis. 

Bismuth, 622. As lotion. 
Purgatives, 339. 

63 



Glottis, (Edema of. 

Ammonium Carbonate, 543. As emetic. 
Inhalations, 412, 453, 468. 
Scarification especially useful. 
Tracheotomy. 

Goitre. 

Iodine, 471. Internally and locally, as oint- 
ment or tincture, and as injection. 
Mercuric Biniodide, 592. As ointment. 
Potassic Iodide, 518. 
Aconite, 839. In acute stage. 

Gonorrhoea. 

Alkaline salts or waters. 

Alum, 555-557. As an injection. 

Cannabis Indica, 879, 880. To relieve pain 
and lessen discharge. 

Cantharides, 926. In small doses. 

Colchicura, 374, 890. 

Copaiba, 385, 768. 

Cubebs, 871. Either alone or mixed with 
copaiba. 

Hydrastis, 705. As injection. 

Kaolin, 385, 554. 

Lead Salts, 595. As injection. 

Mercuric Chloride, 588. Weak solution, lo- 
cally. 

Pulsatilla, 702. 

Sandal Wood Oil, 759. Internally and locally. 

Silver Nitrate, 575. As injection. 

Turpentine, 379, 884. 

Zinc talts, 568. As injection. 



Gout. 



Aconite, 701. 

Alkalies, 499-502. 

Arsenic, 608, 609. 

Belladonna, 839. 

Colchicum, 362. 

Iodine, 471. 

Lithium, 535, 536. 

Manganese, 640. 

Strychnia, 826. 

Sulphides, 516, 554. In chronic cases. 

Sulphur Baths, 403. 

Veratria, 895. As ointment. 



Gums, Spongy. 



Alum, 556. 

Areca, 903. 

Iodine Tincture, 518. Locally. 

Krameria, 732. 

Myrrh, 757. 

Pomegranate Bark, 782. 

Potassium Chlorate, 513. 



H^MATEMESIS. 



Alum, 555, 558. 

Ammonium Chloride, 540. 

Ergot, 911. Hypodermically. 

Gallic Acid, 308. 

Hamamelis, 873. 

Ice. Exceedingly useful. 

Ipecacuanha, 804. 

Iron Perchloride, or Pernitrate, 718, 720. 

Lead Acetate, 597. 

Magnesium Sulphate, 339. 

Sulphuric Acid, 477. 

Tannic Acid, 876. 

Turpentine, 279, 883, 884. 



HEMATURIA. 



Alum, 555-557. Internally, or as injection 

into the bladder. 
Bitartrate of Potash, 511. 
Chimaphila, 815. 
Copaiba, 768. 
Creasote, 691. 



994 



IXDEX OF DISEASES AXD REMEDIES. 



HEMATURIA. 

Digitalis, 850. 

Gallic Acid, 877. 

Hamamelis, 874. 

Ipecacuanha, S04. 

Iron Perchloride, or Pernitrate, 634. 

Krameria, 732. Extract in large doses. 

Lead Acetate, 597. 

Matico, ^72. 

Tannic Acid, 876, 877. 

Turpentine Oil, 883, 884. 

HEMOPTYSIS. 

Acetic Acid, 473, 481. 

Aconite, 209, 215, 701. 

Alum, 555-558. 

Ammonium Chloride, 540. 

Arnica, 811. 

Chloroform, 6S0, 681. Outside of chest. 

Copaiba, 768. 

Copper Sulphate, 573. 

Digitalis, S50. 

Drv Cups to chest. 

Ergot, 908. 

Ferric Acetate, 632. Added to water, so as 

to take away the taste ; a little constantly 

sipped. 
Gallic Acid, 877. Very useful. 
Hamamelis, 374. Very useful. 
Ipecacuanha, S03. 
Iron, 633. And absolute rest. 
Lead Acetate, 597. Very useful. 
Matico, 309. 
Phosphoric Acid, 483. 
Potassium Nitrate, 512. "When fever present, 

along with digitalis or antimony. 
Silver Oxide, 577. 

Sodium Chloride, 524. In drachm doses. 
Tannin, 309. 

Hemorrhage, Intestinal. 

Belladonna, S39. For rectal ulcers. 

Castor Oil, 868. 

Ferric Chloride, 309. 

Iodine, 471. 

Sulphuric Acid, 477. 

Turpentine, 374, SS2. Very useful. 

Hemorrhage, Postpartum. 

Acetate Acid, 473, 481. 

Achillea. 

Capsicum, 835. 

Cimicifuga, 703. 

Digitalis, 850. 

Enemata, Hot. 

Ergot, 911. Most efficient. 

Ether Spray, 146, 661-663. 

Gallic Acid* 877. 

Hamamelis, 874. For persistent oozing. 

Hot Water, 180-133. Injection into uterus. 

Hydrastis, 705. 

Ice, 398. To abdomen, uterus, or rectum. 

Iodine, 471. 

Ipecacuanha, 802. An emetic dose ; good. 

Iron Perchloride, Diluted, 633. 1-4 injected 

into uterus. 
Xux Vomica, 821. Along with ergot. 
Opium. 722. 1 dr. dose of tincture, with 

brandy, in profuse bleeding. 
Pressure over Uterus. 

Hemorrhoids. 

Alkaline Mineral Waters. Useful. 

Aloe-. :;:::». B90. A- purgative. 

Alum, 566-558. in bleeding piles, powder, 

ci ystal, oi- ointment. 
Carbolic Add, 688-691. Injection into piles. 
Ergot, 911. 
'.alls Ointment, S77. With opium very 

useful. 
Grape Cure. 



HEMORRHOIDS. 

Hamamelis, 874. Internally and locally, as 
lotion, injection, enema, or suppository. 

Hydrastis, 705. As lotion and internally. 

Hyoscyamus, 840. Bruised leaves or ointment 
locally. 

Iodoform, 682. As ointment or suppository. 

Iron Protosulphate, 639. As lotion. 

Leeches, 927. 

Nitric Acid, 480. As caustic ; dilute as lotion. 

Nux Vomica, 821. Yery useful. 

Senna, 766. As confection, or better, com- 
pound liquorice powder of Prussian Phar- 
macopoeia. 

Stillingia, 867. In constipation and hepatic 
disease. 

Sulphur, 463. As confection. 



Hay Fever. 

Aconite, 701. 

Arsenic, 60S, 609. As cigarette. 

Coffee, Strong, 804. 

Iodide of Potassium, 518, 519. Internally and 

locally. 
Ipecacuanha, 802. 
Quinia, 801. Locally, as injection or douche. 



Headache. 

Aconite, 701. When circulation excited. 

Ammonia, 542. Aromatic spirits in ]A-2 dr. 
doses. Ptaspail' s lotion very useful ;" often 
relieves nervous headache. 

Ammonium Chloride, 540. 10-15 gr. doses in 
hemicrania. 

Arsenic, 608, 609. In brow ague. 

Atropia, 836. Locally to eye in migraine. 

Belladonna, 836. Frequently given in fron- 
tal headache, especially at menstrual pe- 
riod, or from fatigue. 

Bicarbonate of Soda, 527. "With bitters be- 
fore meals in frontal headache at the junc- 
tion, for pain in upper part of forehead 
without constipation. As wash to the 
mouth when headache depends on decayed 
teeth. 

Bromide of Potassium, 179, 521. In large 
doses. 

Bryonia, 785. In bilious headache. 

Caffeine, 178, 742. 

Cajuput Oil, 730. Locally. 

Camphor, 862. Internally, and saturated so- 
lution externally. 

Cannabis Indica, 879, 880. In neuralgic head- 
ache. 

Chamomile, s09. 

Chloroform, Spirits of, 6S0. In nervous head- 
ache. 

Cimicifuga, 703. In nervous and rheumatic 
headache, especially at menstrual period. 

Croton Oil, 867. 

Digitalin, 850. B \j of a grain twice a day for 
congestive hemicrania. 

Ether Spray, 146, 219. Locally, for frontal 
headache after illness or fatigue. 

(in a ran a, 732. 

Heat, 305, 402. As hot water bag or poultice 
to nape of neck. 

Hydrastis, 705. In congestive headache with 
constipation, 

Ignatia, 821. In hysterical headaches. 

Iodide of Potassium, 518-520. In rheumatic 
headache, with tenderness of Bcalp. 

Iris, 902. In supra-orbital headache, with 
nausea. 

Magnesia Sulphate, 560. For frontal head- 
ache with constipation. 

Menthol, 194. As local application. 

M. rcury, 585. [n bilious headache. 

Mustard, 805,890. As foot bath, or poultice 
to nape of Deck. 

Nitrite of Amyl, 666, 667. As inhalation 
when face pale. 



INDEX OF DISEASES AND REMEDIES. 



995 



Headache. 

Nitro-hydrochloric Acid, 481. For pain just 
above eyeballs without constipation, also 
for pain at back of neck. 

Nux Vomica, 821. Frequently repeated in 
nervous or bilious headache. 

Picrotoxine, 707. In periodical headache. 

Podophyllum, 704. When constipation. 

Potassium Cyanide, 506. As local applica- 
tion. 

Salicylate of Soda, 532. 3-gr. dose every half 
hour, exceedingly useful. 

Sanguinaria, 725. In gastric derangement. 

Skull-cap as prophylactic. 

Sodium Phosphate, 351, 529. As laxative in 
bilious headache. 

Spectacles. Where the headache depends on 
inequality of focal length or astigmatism. 

Tea, 742. Strong black or green, often re- 
lieves nervous headache quickly. 

Valerian, 805. In nervous and hysterical 
cases. 

Zinc Oxide, 569. 



Heartburn. 

Capsicum, 835. 

Nux Vomica, 294, 821. Very useful. 

Podophyllum, 703. 

Pulsatilla, 702. 

Heart, Dilated. 

Digitalis, 293, 295, 850. 

Iron, 633. 

Morphia, 713. 

Nitrite of Aniyl, 666, 667. 

Nitrite of Soda, 524. 

Nitro-glycerin, 668. 

Heart, Fatty. 

Arsenic, 608, 609. 
Belladonna, 839. 
Cimicifuga, 703. 
Cod-liver Oil, 226. 
Ergot, 300. 
Iron, 633. 
Strychnia, 822. 

Heart, Hypertrophied. 

Aconite, 701. To be used with care when 

valvular disease is present. 
Camphor, 292. In palpitation and dyspnoea. 
Digitalis, 293. In small doses. 
Ergot, 300. 

Lead Acetate, 597. In palpitation. 
Nitrite of Amy], 666. 
Veratrum Viride, 279, 281, 300. 



Heart, Palpitation of. 

Aconite, 300, 701. Internally. 

Belladonna, 839. Internally, useful in car- 
diac strain. 

Bromide of Potassium, 520-523. In fluttering 
heart. 

Camphor, 291, 292. 

Cimicifuga, 703. 

Digitalis, 294. 

Eucalyptus, 781. 

Hot Bath, 292. 

Hyoscyamus, 279, 840. In nervous palpita- 
tion. 

Milk Cure, 915. In gouty persons. 

Posture. Head hung forward, body bent, 
arms by the sides, and breath held for a 
few seconds. 

Senega, 326, 731. 

Valerian, 805. In nervous cases with dyspnoea. 

Veratria, 430, 895. As ointment to chest. 



Heart, Valvular Disease of. 

Aconite, 300, 699, 701. To quiet action ; to be 
used with caution. 

Digitalis, 293-297. In mitral disease, to be 
avoided in purely aortic disease, but useful 
when this is complicated with mitral. 

Morphia, 713, 714. To relieve pain and 
dyspnoea. 

Nitrites, 293. To lessen vascular tension. 

Purgatives, 338. To lessen tension and re- 
move fluid. 

Strychnia, 294, 822. As cardiac tonic. 

Hectic. 

Anti pyrin, 695. 

Calumba, 706. 

Digitalis, 850. 

Gelsemium, 827. 

Ipecacuanha, 802. 

Iron, 634. Especially mistura ferri com- 

posita. 
Lime Phosphate, 553. 
Prunus Virginiana, 777. To lessen cough. 
Salicin, 873. To lessen perspiration. 
Salicylate of Soda, 532. 
Strychnia, 294, 822. To lessen night sweats. 

Hemeralopia. 

Blisters, 303, 305. Small, to external canthus 

of the eye. 
Electricity. 

Mercury, 585. Locally. 
Quinine, 799-801. In large doses internally. 

Hepatitis. 

Ammonium Chloride, 540. 

Bryonia, 785. 

Chelidonium, 726. 

Iodine, 472. As enemata. 

Leeches, 927. 

Nitro-hydrochloric Acid, 481. 

Tartar Emetic, 615, 616. With opium. 

Hernia. 

Chloral, 672. As enema. 
Chloroform, 680, 681. 
Coffee, 804. 
Ether Spray, 146. 
Opium, 722. 

Herpes Zoster. 

Aconite and Opium, 183, 701, 722. Locally. 

Alcohol, 655. Locally. 

Celandine, 726. 

Dulcamara, 834. 

Galvanism. 

Morphia, 712, 713. 

Bhus Toxicodendron, 304, 755. 

Silver Nitrate, 575. Strong solution locally. 

Veratria, 895. As ointment. 

Hiccough. 

Amber, Oil of, 884. 

Belladonna, 839. 

Bismuth, 621. 

Camphor, 864. 

Cannabis Indica, 879, 880. 

Chloral, 672. 

Chloroform, 680, 681. 

Ether, 215, 660-663. 

Iodoform, 681. 

Jaborandi, 749. 

Laurel Water. 

Morphia, 713, 714. Hypodermicallv. 

Musk, 914. 

Mustard and Hot Water. 

Nux Vomica, 821. 



996 



INDEX OF DISEASES AND REMEDIES. 



Hiccough. 

Pepper, 330, 871. 

Pressure over Phrenic, Hyoid, or Epigas- 
trium. 
Quinine, 799-801. In full doses. 

Hydrocephalus, Acute. 

Blisters, 305. To the nape of the neck, useful. 

Bromide of Potassium, 178, 520. 523. 

Croton Oil, 867. Liniment. 

Elaterium, 784. 

Ergot, 911. 

Iodide of Potassium, 517, 518. 

Iodoform, 681. Dissolved in collodion, or as 
ointment to neck and head; along with 
small doses of calomel as enemata. 

Leeches, 927. 

Mercuric Chloride, 587. Small doses inter- 
nally. 

Tartar Emetic, 615. Ointment. 

Turpentine, 884. By mouth or as enema, at 
commencement. 

Hydrocephalus, Chronic. 

Blisters, 305. 

Cod-liver Oil, 921, 922. 

Iodide of Iron, 637. 

Iodide of Potassium, 517, 518. 

Iodine, 471. 

Mercury, 585. 

Hydrophobia. 

Actual Cautery, comhined with excision, is 

best. 
Acupuncture. To wound immediately. 
Belladonna, 839. 
Bromide of Potassium, 520-523. 
Chloroform, 680, 681. To control spasms. 
Excision of bitten part. 
Morphia, 713, 714. 
Permanganate of Potash, 515. As lotion to 

wound. 
Quinine, 801. 
Silver Nitrate, 575. To wound, no use, even 

though applied immediately. 



Hydrothorax. 



Blisters, 303, 304, 305. 

Broom, 758. 

Digitalis, 850. As diuretic. 

Elaterium, 784. 

Iodine, 471. Injections after tapping. 

Jaborandi, 749. 

Sanguinaria, 725, 726. 

Hypochondriasis. 

Alcohol, 698. As temporary stimulant. 

Arsenic, 60S, 009. In the aged. 

Asafoetida, 787. 

Bromide of Potassium, 520-523. 

Caffeine, 741-743. 

Cimicifuga, 703. In puerperal, and sperma- 
torrhoea, 

Creasote, 690, 091. 

Gold Chloride, 641. When giddiness and 
cerebral anaemia, 6 11. 

Byoscyamus, 840. In syphiliphobia. 

Ignatia, 821. 

Musk, 913, 914. 

Opium, 722 725. Small doses. 

Ox Gall, 916. 

Sumbul, 791. 

Hysteria. 

Aloes, 889, 892. In constipation. 
Ammonia, Aromatic Spirits of, 543. 
Amy] Nitrite, 666. 
Apomorphia, 713, 714. 
Arsenic, COM, 609. 



Hysteria. 

Asafoetida, 787. 

Atropia, 839. In hysterical aphonia. 

Belladonna, 839. 

Bromide of Camphor, 191. 

Bromide of Potassium, 520-523. 

Camphor, 864, In hysterical excitement. 

Cimicifuga, 703. In hysterical chorea. 

Cold Water. Poured over mouth to cut short 

attack. 
Electricity. To cut short attack. 
Ether, 660-663. 
Galbanum, 788. Internally, and as plaster 

to sacrum. 
Garlic, 889. To smell during the paroxysm. 
Ignatia, 821. 

Ipecacuanha, 802. As emetic. 
Iron, 633. 

Lupulin, 881. When sleepless. 
Musk, 913, 914. 

Opium, 722-724. In small doses. 
Pellitory, 807. For globus. 
Phosphorus, 361, 605. In hysterical paralysis. 
Santonin, 355. If worms present. 
Spiritus Etheris Nitrosi, 662. To relieve 

spasm. 
Tartar Emetic, 615, 617. 
Valerian, 805. 
Zinc, Valerianated, 571. 

Ichthyosis. 

Baths, 395 et seq. 

Cod-liver Oil, 922. 

Elm Bark Decoction, 878. Useful. 

Glycerin, 820, 821. 

Zinc Oxide, 569. 

Impetigo. 

Arsenic, 608, 609. 
Boracie Acid, 486 
Calcium Chloride, 552. 
Cod-liver Oil, 921-923. 
Grape Cure. 
Gutta Percha, 816. 

Hydrocyanic Acid, 473, 490. To relieve itch- 
ing. 
Laurel Water. To relieve itching. 
Mercury, 585. Locally. 
Nitric Acid, 480. Internally. 
Oil of Cade. 

Potassium Chloride, 246. 
Quinine, 799-801. 
Sulphur, 464. Internally. 
Tannin, 877. Locally. 
Tar, 886. 
Zinc Ointment, 452. 

Impotence. 

Arseniate of Iron, 638. 

Cannabis Indica, 879. 

Cantharid.es, 925, 926. 

Cubebs, 871. 

Ergotine, 911. Hypodermically about dorsal 

vein of penis, when it empties too rapidly. 
Gold Chloride, 641. To prevent decline of 

sexual power. 
Nux Vomica, 821. Very useful. 
Phosphoric Acid, 483. 
Phosphorus, 361, 605. 
Sanguinaria, 725. 
Serpentaria, 865, 866. 
Zinc Phosphate, 572. Very useful. 

Inflammation. 

Aconite, 701. At the commencement of all 
inflammations, superficial or deep-seated; 
best given in small doses frequently re- 
peated until pulse and temperature are 
reduced. 

Alcohol, <;.">('>. As antipyretic and stimulant, 
especially useful in blood-poisoning. 



INDEX OF DISEASES AND EEMEDIES. 



997 



Inflammation. 

Antimony, 616. 10-15 m. of vini antimonii 
frequently repeated at commencement. 

Arnica, 811. 

Belladonna, 836. In gouty and rheumatic 
inflammation and cystitis. 

Bryonia, 785. In serous inflammations after 
heart or pulse lowered by aconite. 

Chloral, 672, 673. When temperature is high 
and much delirium. 

Cod-liver Oil, 922. In chronic inflamma- 
tions. 

Digitalis, 850. . 

Fomentations, 302. 

Ice, 302. Locally applied. 

Iodine, 470. Locally. 

Mercury, 585. In deep-seated inflammations, 
especially those of serous membranes and 
iritis, and in syphilitic cases. 

Opium, 723, 724. Exceedingly useful to check 
it at commencement, and relieve pain 
afterwards. 

Pack, 181. 

Poultices, 402. 

Pulsatilla, 702. In inflammation, when pur- 
ulent discharge from eyes, ears, and nose, 
and in epididymitis. 

Purgatives, 339 et seq. 

Quinine, 108, 799-802. In peritonitis and in 
acute inflammations along with morphia. 

Salicine, 873. 

Salicylate of Soda, 532. Most useful, espe- 
cially in rheumatic affections. 

Salicylic Acid, 693. Most valuable. 

Sulphides, 516, 555. To abort or to hasten 
maturation. 

Veratrum Viride, 893. 

Influenza. 

Ammonium Acetate, 554; with Nitrous or 
Chloric Ether, 373. 

Carbolic Acid, 688-691. As spray and gargle. 

Cimicifuga, 703. 

Opium, 183, 723, 724. With ipecacuanha, 
useful for cough. 

Potassium Nitrate, 513. Freely diluted, as 
lemonade. 

Quinine, 799-801. Useful, especially in later 
stages. 

Sanguinaria, 725. Sometimes very useful. 

Spiritus Etheris Nitrosi, 446. 

Sulphurous Acid, 477. By fumigation or in- 
halation. 

Turkish Baths, 404. Useful. 

Insomnia. 

Aconite, 701. 1 m. every quarter of an hour, 
when skin dry and harsh. 

Alcohol, 656. Sometimes very useful. 

Atropia, 836. With opium, tJo-too g r - atro- 
pia, to y± or % gr. morphia. 

Camphor, 863. 

Cannabis Indica, 181, 879. Alone, or with 
hyoscyamus. 

Chloral, 181, 673. Most useful alone, or with 
bromide of potassium ; the addition of a 
small quantity of opium to the chloral and 
bromide assists their action. 

Chloroform, 680, 681. 

Coffee, 804. Causes insomnia, but has been 
recommended in insomnia from deficient 
nervous power, or chronic alcoholism. 

Croton Chloral, 672. If heart weak. 

Digitalis, 850. When deficient tone of vaso- 
motor system. 

Ether, 660-663. In full dose. 

Gelseinium, 827. In simple wakefulness. 

Humulus, 880. A hop-pillow sometimes 
useful. 

Hyoscyamus, 181, 840. Alone, or with can- 
nabis indica, useful to combine with 
quinine. 

Ignatia, 821. In nervous irritability. 

Lupuline, 881. In aged people. 



Insomnia. 

Musk, 913, 914. In irritable and nervous 

cases. 
Opium, 181, 724. Most powerful hypnotic, 

given alone or in combination. 
Phosphorus, 605. In the aged. 
Potassium Bromide, 186. In full doses, alone 

or with other hypnotics. 
Sumbul, 195, 791. In nervous irritability 

and chronic alcoholism. 
Tartar Emetic, 615, 616. Along with opium, 

when there is a tendency to congestion of 

brain, which opium alone would increase. 
Warmth, 180. Internally and externally. 
Wet Compress, 180. 
Wet Pack, 180. 

Intercostal Neuralgia. 

Is very commonly connected with 
Leucorrhoea, q.v. {Vide also neuralgia.) 

Intermittent Fever. 

Ammonium Carbazotate, %-l gr. in pill. 

Ammonium Chloride, 540. 

Apiol. In mild cases, 15 grs. during an hour, 
in divided doses, four hours before the 
paroxysm. 

Arsenic, 608, 609. Exceedingly useful, espe- 
cially in irregular malaria. 

Atropia, 836. Subcutaneously, to arrest or 
cut short cold stage. 

Berberin, 706. In chronic cases. 

Brucine, 825. 

Camphor, 864. Taken before the fit to pre- 
vent it. 

Capsicum, 835. Along with quinine as adju- 
vant. 

Carbolic Acid, 689-691. 

Chloral Hydrate, 672. As antipyretic when 
fever high ; and. to check vomiting or con- 
vulsions in adults and children during 
malarious fevers. 

Chloroform, 681. To prevent or cut short 
cold stage. 

Cimicifuga, 703. In brow ague. 

Cinchonidine, 798, 799. Like cinchonine. 

Cinehonine, 108, 125. Useful and cheap. 

Cornus Florida, 793. A substitute for qui- 
nine. 

Eucalyptus Globulus, 781. During conva- 
lescence. 

Ferric Sulphate, 630. 

Ferrous Iodide, 470. 

Gelsemium, 827. Pushed until it produces 
dilated pupils or double vision. 

Grindelia Squarrosa, 813. In hypertrophied 
spleen. 

Hydrastis, 705. In obstinate cases. 

Iodine Tincture, 469, 518. To prevent recur- 
rence of ague. 

Ipecacuanha, 803. Most useful as emetic. 

Leptandra Virginica, 851. After disease is 
lessened, by quinine. 

Morphia, 713, 714. Along with quinine an 
adjuvant. 

Narcotin, 711. 2-5 gr. three times a day 
sometimes very useful. 

Nitric Acid, 480. In obstinate cases. 

Nitrite of Amy], 666. By inhalation to re- 
lieve or shorten cold stage.' 

Opium, 723. In full doses, to prevent chill. 

Pepper, 871. Along with quinine. 

Potassium Nitrate, 513. 10 gr. in brandy and 
water, or dry on the tongue to prevent fit. 

Quinine, 109, 800-802. As prophylactic to abort 
fit and to prevent recurrence; its action is 
aided by purgatives, emetics, and aromatics. 

Quinine B omohydrate, 797. Like quinine, 
and less liable to produce cinchonism. 

Salicin, 873. 

Sodium Chloride, 525. Tablespoonful in glass 
of hot water at a draught on empty 
stomach. 



998 



INDEX OF DISEASES AXD REMEDIES. 



Intermittent Fever. 

Sodium Hyposulphate, 531. In mild cases. 

Spider Web. As pill. 

Strychnine. 

Intertrigo. 

Bismuth, 622. Locally. 

Camphor, S63. Added to dusting powders to 

allav heat and itching. 
Carbolic Acid, 6SS-691. 
Fuller's Earth, 555. 
Lead Lotion, 595-597. 
Lime Water, 550. 
Soap, 307. 
Tannin, S75. 

Iritis. 

Atropia, 839. 

Belladonna, 839. Internally and locally. 
Duboisia, 198. Substitute for atropia. 
Mercury, 584. Most serviceable. 
Opium, 716. To lessen pain. 
Turpentine, 884. In rheumatic iritis. 



Irritability. 

Alkaline Waters. 
Bromide of Potassium, 521. 
Chloral, 183, 672. 

Colchicum, 899. With potash in large quan- 
tity of water when gouty. 
Ignatia, 821. In small doses. 
Laxatives, 339. In constipation. 
Strychnia, S25. In small doses. 



Jaundice. 

Alkaline Mineral Waters. In catarrh of duo- 
denum or bile ducts. 

Ammonium Chloride, 540. In scruple doses 
in jaundice from mental emotion. 

Ammonium Iodide, 545. When catarrh of 
bile ducts. 

Arsenic, 607, 608. In malarious cases. 

Benzoic Acid, 817. 

Calomel Purgative, 5S7. Followed by saline, 
often verv useful. 

Carlsbad Salts, 530. Very useful. 

Carlsbad Water, 530. 

Celandine, 726. 

Colchicum, S99. 

Dulcamara, 834. 

Enemata. Cold water, one or two litres once 
a day. 

Enonymine, 340, 351. 

Ether, 660-663. When due to gallstones. 

Hydrastis, 705. In cases of catarrhal ducts. 

Iridin, 340, 351. 

Magnesium Sulphate, 560. 

Manganese, 640. In malarious or catarrhal 
cases. 

Nitro-muriatic Acid, 377. Internally, and as 
local application over liver, or as "bath in 
catarrhal cases. 

Podophyllum, 704. In catarrhal conditions, 
verv useful. 

Potassium Chloride, 346. 

Potassium Sulphate, 618. As laxative. 

Quinine, 801. In malarious cases. 

Rhubarb, 851. Jaundice in children. 

Sanguinaria, 358. 

Sodium Phosphate, 851. Very useful in ca- 
tarrhal bile ducts. 

Btillingia, 858, 867. After ague. 



Lactation, Defective. 

Castor-oil Leaves, 
Jaborandl 749. 
Mustard Poultice, 390. 
Vanilli 



Lactation, Excessive. 

Belladonna, 839. Internallv andlocallv. 
Camphor and Glycerin, 820* 863. 
Chloral, 673. 
Coffee, 804. 
Hemp-seed Oil, 879. 
Iodide of Potassium, 519. 

Laryngismus Stridulus. 

Aconite, 701. 

Belladonna, 839. 

Bromides. Very useful in large doses. 

Chloral, 673. 

Chloroform, 680, 6S1. As inhalation to stop 

spasm. 
Cold Sponging, 363. 
Conia, 786. Pushed until physiological action 

observed. 
Emetics, 323. 

Ipecacuanha, 804. As emetic. 
Morphia, 713, 715. Hypodermicallv. 
Quinine, 801. 

Laryngitis, Acute. 

Acetic Acid, 481. As inhalation. 

Aconite, 701. 

Benzoin, S17. As inhalation. 

Iodine, 471. As inhalation and counter-irri- 
tant over neck. 

Leeches, 363, 927. To larynx, or nape of 
neck. 

Morphia, 713, 715. 

Quinine, 801. 

Scarification of Larynx. 

Silver Xitrate, 575. As spray. 

Sulphurous Acid, 477. As inhalation or spray. 

Zinc Sulphate, 570. As emetic. 

Laryngitis, Chronic. 

Alum, 555-557. As gargle. 

Ammonium Chloride, 540. As spray. 

Bismuth, 622. Locally by insufflation. 

Carbolic Acid, 789-791. As spray. 

Ferric Chloride, 308, 309. As spray, or brushed 
on interior of larynx. 

Guaiacum, 745. As lozenges or mixture. 

Iodine, 471. As counter-irritant. 

Morphia, 713, 715. Mixed with bismuth or 
starch as insufflation, most useful when 
much irritation, as in laryngeal phthisis. 

Silver Nitrate, 575. As solution to interior of 
larynx. 

Sulphurous Acid, 477. As fumigation, inha- 
lation, or spray. 

Tannin, 309. As gargle or spray. 

Uranium Nitrate. As spray. 

Leucorrhcea. 

Alum, 555, 557. As injection. 

Balsam of Peru, 759. Internally. 

Balsam of Tolu, 760. Internally. 

Belladonna, 839. As pessary, for over-secre- 
tion, and pain. 

Bismuth, 621. As injection or pessary. 

Borax, 529. As injection. 

Carbolic Acid, 789-791. As injection. 

Cimicifuga, 703. 

Copaiba, 769. 

( '■ >pper Sulphate, 573. As injection. 

Ergot, 911. 

Glycerin, 820. 

Hydrastis, 705. Locally. 

Iodoform, 682. As local application, alone, or 
mixed with tannic acid. 

Iron, 634. Internally. 

Myrrh, 756. Internally. 

Phosphate of Lime, 654. Internally. 

Potassium Bicarbonate, 510. Dilute solution 
as injection. 

Potassium, Permanganate of, 515. 

Sumbul, 791. 

Tannin, 809. As injection or suppository. 



INDEX OF DISEASES AND REMEDIES. 



999 



Lichen. 

Arsenic, 608, 609. 

Mercury, 585. Locally. 

Silver Nitrate Solution, 575. Locally. 

Sulphides. 

Sulphur, 461. 

Tar Ointment, 886. 

Thymol, 854. 



Locomotor Ataxia. 

Belladonna, 760. 

Cannabis Indica, 879. 

Electricity. 

Ergot, 911. 

Hyoscyamus, 840. 

Nitro-muriatic Acid, 377. 

Phosphorus, 605. 

Physostigma, 761-765. 

Potassium Iodide, 517. For syphilitic taint. 

Silver Nitrate, 575. 

Strychnia, 825. 



Lumbago. 

Aconite, 700, 701. Small doses internally, and 

liniment locally. 
Acupuncture. 

Aquapuncture. Sometimes very useful. 
Capsicum, 835. Locally. 
Chloroform, 675, 819. Liniment. 
Cimicifuga, 703. Sometimes very useful 

internally. 
Carbolic Acid, 789-791. Hypodermically. 
Cautery. 

Ether Spray, 146, 660. 
Eucalyptus Oil, 781. As liniment. 
Guarana, 732. In large doses. 
Hot Douche, 401, 402. Or hot poultice. 
Ice, rubbed over back. 
Iodide, Potassium, 517. 
Morphia, 713, 715. Hypodermically. 
Quinine, 801. 

Rhus Toxicodendron, 755. 
Turpentine, S83. Internally and locally. 

Lupus. 

Arsenic, 608, 609. 

Carbolic Acid, 789-791. 

Cautery. 

Chalmugra Oil. 

Chromic Acid, 486. 

Creasote, 691. 

Iodide of Potassium, 470. 

Iodide of Starch. 

Iodide of Sulphur, 470. Externally. 

Iodine, 471, 820. In glycerine. 

Iodoform, 682. 

Lead Lotion, 595, 597. 

Mercury, 584. Internally and locally. 

Phosphorus, 605. 

Pyrogallic Acid. 

Salicylate of Soda, 532. 

Silver Nitrate, 575. 

Sodium Acetate, 322, 502. 

Sodium Ethylate. 

Zinc Chloride, 570. 



Mania. 



Belladonna, 839. Useful. 

Bromide of Potassium, 520, 522. 

Camphor, 864. 

Cannabis Indica, 879. 

Chloral, 673. As narcotic and carminative. 

Conia, 787. Alone, or with morphia. 

Croton Oil, 339, 868. As purgative. 

Daturin, 280. 

Digitalis, 850. In acute and chronic mania, 

especially when complicated with general 

paralysis and epilepsy. 
Duboisia, 198. As calmative. 



Mania. 



Ergot, 911. In recurrent mania. 

Ether, 660. In maniacal paroxysms. 

Galvanism, to head and cervical sympathetic. 

Gelsemium, 827. With much motor excite- 
ment and wakefulness. 

Hyoscyamus, 841. In hallucinations and 
hypochondriasis. 

Iron, 634. 

Opium, 723. Alone or with tartar emetic. 

Physostigma, 761-765. 

Stramonium, 183, 842. 

Veratrum Viride, 894. 

Wet Pack, 181, 401. 



Mastitis. 

Ammonium Chloride, 539. As lotion, locally. 

Belladonna, 839. Locally as liniment or oint- 
ment. 

Calcium Sulphide, 554. Internally, if abscess 
is forming. 

Digitalis, Infusion, 850. Locally as fomenta- 
tion. 

Friction, with oil. 

Hyoscyamus, 841. As plaster to relieve pain- 
ful distention from milk. 

Iodine, 471. 

Mercury and Morphia Oleate, 585. Locally, 
in mammary abscess. 

Phytolacca, 859. To arrest inflammation, 
local application. 

Plaster, 443. To support and compress 
mammee. 

Stramonium, 842. Fresh leaves as poultice. 

Tartar Emetic, 325. In small doses fre- 
quently repeated at commencement. 

Tobacco Leaves, 843. As poultice. 



Measles. 

Aconite, 701. 

Ammonium Acetate, 544. 

Ammonium Carbonate, 542. 

Antimony, 615, 616. 

Camphor, 864. 

Carbolic Acid, 6S8-691. Internally at com- 
mencement. 

Digitalis, 850. 

Ipecacuanha, 804. 

Mustard Bath, 403. When retrocession of 
rash. 

Potassium Bromide, 521, 
lessness. 

Potassium Chlorate, 513. 

Pulsatilla, 702. 

Quinine, 801. 

Veratrum Viride, 893. 



522. When sleep- 
In adynamic cases. 



Melancholia. 



Arsenic, 608, 609. In aged persons, along 

with opium. 
Bromide of Potassium, 520-522. Often very 

useful. 
Caffeine, 742. 
Cannabis Indica, 879. 
Chloral, 672. As hypnotic. 
Cimicifuga, 703, In puerperal or uterine 

despondency. 
Galvanism. 
Gold, 641. 
Ignatia, 821. 
Iron, 634. 

Opium, 722. In small doses especially useful. 
Valerian, 806. In hysterical and suicidal 

cases. 



Meniere's Disease. 

Quinine, 801. 



1000 



INDEX OF DISEASES AND REMEDIES. 



Meningitis, Cerebral. 

Aconite, 701. 

Belladonna, 839. 

Blisters, 305. To nape of neck. 

Bromide of Potassium, 520-522. In convul- 
sions consequent on meningitis. 

Bryonia, 785. When effusion. 

Cold. To head. 

Gelsemium, 827. 

Hyoscyamus, 841. 

Iodide of Potassium, 520. 

Mercury, 585. As ointment, or internally. 

Opium, 722. In small doses, alone or with 
tartar emetic. 

Pulsatilla, 702. In acute cases. 

Purgatives, 338, 587. At commencement; 
calomel and jalap most useful. 

Venesection, 363. When much excitement. 

Meningitis, Cerebro-Spinal. 

Aconite, 701. Along with opium. 

Antimony, 615, 616. Alone, or with opium. 

Belladonna, 839. 

Cautery, 309. Freely to back. 

Cold. To spine. 

Digitalis, 850. In early stage. 

Ergot, 911. Useful. 

Gelsemium, 827. Useful. 

Opium, 723. Very useful in large doses. 

Quinine, 801. At commencement, large 

doses. 
Turpentine, 883. As enema. 
Venesection, 363. 

Menorrhagia. 

Aloes, 892. As adjuvant to iron. 

Ammonium Chloride, 539. For headaches. 

Arsenic, 608, 609. With iron. 

Bromide of Potassium, 520, 522. 

Calcium Phosphate, 553. In angemia. 

Cannabis Indica, 879. Sometimes very use- 
ful. 

Cimicifuga, 703. 

Cinnamon, Oil of, 861. 

Digitalis, 850. Sometimes useful. 

Ergot, 911. Most useful. 

Gallic Acid, 877. Very useful. 

Hamamelis, 873. Useful. 

Hot Water Bag. To dorsal and lumbar 
vertebrae. 

Ipecacuanha, 804. In emetic doses in even- 
ing, followed by acidulated draught in 
morning. 

Iron, 634. 

Magnesium Sulphate, 560. Sometimes useful. 

Quinine, 801. 

Rue, 747. 

Savine, 887. 

Senega, 730. 

Sulphuric Acid, 477. When due to fibroid or 
polypus. 

Mentac-ra. 

Arsenic, 608, 609. 

Canada Balsam, 882. 

Carbolic Acid, 688-691. 

Cod-liver Oil, 922. 

Copper, 572. Locally as lotion. 

Iodide of Sulphur, 470. 

Mercurv, 584. 

Oil of Turpentine, 888. 

Oleate, Bichloride, or Nitrate of Mercury, 

589. As ointment or lotion. 
Petroleum, 647. 
Sulphurous Acid, '177. With glycerin. 



Metritis, Acute. 



Metritis, Acute. 

Aconite, 701. 

Hot Water. Vagina] 

for a length of time. 
Leeches, 925. 



injection frequently 



Opium, 723. As suppository or enema. 
Poultices, 402. 
Turpentine Stupes, 883. 

Milk Deficiency. 

Gossypium. Decoction of seeds, two or three 

times every hour. 
Ricinus, 868. Poultices or infusion of leaves 

to the mammae. 

Muscle Yolitantes. 

Blue Pill, 585. In biliousness. 
Iodide of Potassium, 518. 
Iron, 633. Perchloride in antenna and cli- 
macteric. 
Valerian, 805, 806. 

Myalgia. 

Ammonium Chloride, 540. 

Arnica, 811. Internally and locally. 

Belladonna Liniment, 839. Locally. 

Belladonna Plaster, 819. 

Chloroform Liniment, 680. With friction. 

Cimicifuga, 703. 

Friction, 305, 405. _ 

Gelsemium, 827. .Large Doses. 

Iodine, 471. 

Iodide of Potassium, 520. In rhuematic 



Opium, 722. 
Packing, 181, 398. 
Salicylate of Soda, 693. 
Veratria, 897. Externally. 
Xanthoxylum, 748. Internally and exter- 
nally. 

Myelitis. 

Belladonna, 839. 
Electricity. In chronic cases. 
Ergot, 911. 

Phosphorus, 605. In paraplegia from ex- 
cessive venery. 
Silver Nitrate, 575. Useful. 

N^ivus. 

Chromic Acid, 486. 

Creasote, 691. 

Electrolysis. 

Ferric Chloride, 305, 310. 

Galvano Cautery. 

Nitric Acid, 4S1. 

Zinc Chloride, 570. 



Nails, Ingrowing. 

Glycerin, 820. 

Lead Carbonate, 597. Locally. 

Liquor Potass;e, 509. 

Silver Nitrate, 575. 



Nausea. 

Bismuth, 621. 

Calumba, 706. 

Cinnamon, 861. 

Cloves, 778. 

Hydrocyanic Acid, 493. 

ice, 225. 

Ipecacuanha, 804. In sickness of pregnancy 

and chronic alcoholism; very small dose, 

1 m. of wine. 
Morphia, 712. 
Nutmeg, 860. 
Pepper, 871. 
Peppermint, 853, 
Pimento, 779. 
Pulsatilla, 702. In gastric catarrh. 



INDEX OF DISEASES AND KEMEDIES. 



1001 



Nephritis, Acute. 

Aconite, 698, 701. At commencement. 

Belladonna, 839. 

Cannabis Indica, 879, As diuretic, especially 

in hseinaturia. 
Cantharides, 925. 1 m. of tincture every 

three hours to stop h hematuria after acute 

symptoms have subsided. 
Digitalis, 850. As diuretic. 
Eucalyptus, 781. Given cautiously. 
Gallic Acid, 877. 
Hyoscyamus, 841. 
Jaborandi, 749. 
Juniper, 887. 

Poultices, 402. Over loins, very useful. 
Turpentine, 883. 34-1 m. doses, every two to 

four hours. 

Nervousness. 

Aconite, 698, 701. 1 m. of tincture at bed- 
time for restlessness and fidgets. 

Bromide of Potassium, 520-523. Over-work 
and worry. 

Caffeine, 743. Where much debility. 

Camphor, 863. 

Chamomile, 809. 

Chloral, 673. 

Chloroform, 680, 681. 

Hops, 880. Internally and as pillow. 

Ignatia, 821. 

Musk, 914. In uterine derangement. 

Strychnine, 825. Where wandering. 

Sumbul, 791. In pregnancy, and alter acute 
illness. 

Neuralgia. 

Aconitia, 698. As ointment. 

Acupuncture. 

Alcohol, 655. 

Ammonium Chloride, 540. 3^-dr. doses. 

Ammonium Valerianate, 545. 

Amyl Nitrite, 666. 

Aquapuneture. 

Atropine, 839. As liniment, or hypodermi- 
cally near the nerve. 

Belladonna, 839. 

Bebeeru Bark, 865. 

Blisters, 305. 

Bromide of Potassium, 521 , 522. 

Caffeine, 743. 

Cannabis Indica, 879. 

Capsicum, 835. Locally. 

Carbonic Acid, 487. Locally, for uterine 
neuralgia. 

Chalmugra Oil. 

Chamomile, 809. 

Chelidonium, 726. 

Chloral and Camphor, 672, 863. Equal parts 
locally applied. 

Chlorate of Potash, 504. In facial neuralgia. 

Chloroform, 680, 681. Locally and by inha- 
lation, when pain very severe. 

Cimieifuga, 703. In neuralgia of fifth nerve, 
and ovarian neuralgia. 

Cod-liver Oil, 921. 

Croton Chloral, 279, 673. For neuralgia of 
the fifth nerve. 

Digitalis, 850. 

Electricity. 

Ergot, 911. In visceral neuralgia. 

Gelsemium, 827. 

Ignatia, 821. In hysterical cases and in in- 
tercostal neuralgia. 

Iodides, 520. Especially when nocturnal. 

Iodoform, 681. 

Iron, 633. 

Morphia, 712. Hypodermically. 

Mustard Poultice, 390, 402. 

Narcein, 711. 

Nitro-glycerin, 668. 

Nux Vomica, 821. In visceral neuralgia. 

Peppermint, 853. Locally. 

Pulsatilla, 702. 

Pyrethrum, 807. As masticatory. 



Neuralgia. 

Quinine, 801. In periodical cases. 

Salicylic Acid, 692. 

Stavesacre, 701. 

Sumbul, 791. Sometimes very useful. 

Thermo-cautery. 

Valerian, 806. 

Valerianated Zinc, 571. 

Vibration, 185. 

Neuralgic Pains. 

Cold Sponging, 363. 

Friction, 305, 405. Along back or on limbs. 

Kubefacients, 304. Useful. 

Valerian, 805. 

Warm Sponging. 

Nightmare. 

Bromide of Potassium, 520-522. 
Camphor Water, 863. 

Nipples, Sore. 

Alcohol, 655. Locally. 

Arnica, 811. 

Balsam of Peru, 759. 

Balsam of Tolu, 760. 

Benzoin, 816. 

Borax, 528. Saturated solution locally. 

Carbolic Acid, 688-691. 

Collodion, 735. 

Ferrous Subsulphate, 630. Locally. 

Lead Salts, 595. 

Bhatany, 731. 1 part extract to 15 of cacao 

butter. 
Shield. 

Silver Nitrate, 575. 
Sulphurous Acid, 477. 
Tannin, Glycerin of, 877. 



Nodes. 

Mercury Oleate, 584. With morphia, locally. 
Potassium Iodide, 520. Internally and exter- 
nally. 
Stramonium Leaves, 842. As poultice. 

Nyctalopia. 

Blisters, 302, 308, 305. Small, to external 

canthus. 
Quinine, 801. 
Strychnine, 825. 

Nymphomania. 

Bromide of Potassium, 384, 520-522. In large 

doses. 
Camphor, 862. In large doses. 
Lupuline, 881. 

Sulphur, 463. When due to haemorrhoids. 
Sulphuric Acid. Internally. 
Tobacco, 336. So as to cause nausea, effectual, 
' _ but depressing. 

Obesity. 

Alkaline Waters. Especially those of Ma- 

rienbad. 
Ammonium Bromide, 544. 
Banting's System— living on meat and green 

vegetables, and avoiding starch, sugars, and 

fats. 
Potassium Permanganate, 515. 
Sulphurous Waters, 477. 
Vinegar, 483. Very injurious. 

Onychia. 

Carbolic Acid, 186, 688-691. As local anses- 

thetic. 
Chloral, 183, 184, 672. Locally. 
Iodoform, 681. Locally. 
Lead Nitrate, 599. 



1002 



INDEX OF DISEASES AND REMEDIES. 



Onychia. 

Mercury, 584. As ointment, alternately with 

poultices. 
Silver Nitrate, 575 At commencement. 
Tartar Emetic, 616, 617. 

Otitis, vide Earache. 

Ophthalmia, vide Conjuncti- 
vitis. 

Orchitis, vide Epididymitis. 

Otorrhcea. 

Alcohol, 655. 

Alum, 555-557. Insufflation. 

Boracic Acid, 486. 

Cadmium, 308. Locally. 

Carbolic Acid, 688-691. 

Chloral, 672. 

Iodide, 545. 2 grs. to an ounce, locally. 

Iodoform, 681. 

Lead Acetate, 597. 

Liquor Sodse, 440. Locally, when discharge 
is foetid. 

Mercury Ointment ,and Nitrate, 584. 

Permanganate of Potassium, 515. As injec- 
tion or spray. 

Quinine, 801. 

Silver Nitrate, 575. Locally. 

TanDin, Glycerin of, 875. Very useful. 

Zinc Sulphate, 570. 

OXALURIA. 

Nitro-muriatic Acid, 377. 

Oz,ENA. 

Alum, 556. As powder or wash. 

Bromine, 469. As inhalation. 

Carbolic Acid, 688-691. 

Chlorinated Lime, 468. Injections of the 
solutions of. 

Gold Salts, 640. 

Hydrastis, 705. Internally and locally. 

Iodine, 471. As inhalation. Much benefit 
derived from washing out the nose with a 
solution of common salt, to which a few 
drops of the tincture of iodine have been 
added. 

Iodoform, 681. 

Mercuric Oxide, or Ammoniated Mercury, 
590. 

Potassium Permanganate, 515. 

Tannin, Glycerin of, 875. 

Parotitis. 

Aconite, 701. 

Emetics, 323. 

Jaborandi, 749. 

Mercury, 584. % gr. of gray powder three or 

four times a day. 
Poultice, 402. 

Pediculi. 

Anise, 789. 

Bake Clothes. To destroy ova. 

Cocculua [ndicus, 70o. 

Mercury, 58 I As ointment or wash. 

Pyrethrum, 807. 

Staresacre, 701. 

Pemphigus. 

Arsenic, 60*. 609. 

Chlorate of Potash, 513. 
Cod-liver Oil, 922. 
Iodide of Potassium, 520. 



Pemphigus. 

Mercury, 584. 
Phosphorus, 605. 
Silver Nitrate, 575, 
Sulphides, 515, 556. 
Tar, 886. 

Pericarditis. 

Aconite, 300, 701. 

Alcohol, 304, 655. Sometimes verv useful. 
Blisters, 303, 305. Near heart very useful. 
Bryonia, 785. Useful in exudation. 
Calomel and Opium. Formerly much used. 
Digitalis, 850. When heart is rapid and 

feeble with cyanosis and dropsy. 
Opium, 723. In grain doses every three to 

six hours, very useful. 
Quinine, 801. 
Veratrum Viride, 300, 893. 

Periostitis. 

Iodide of Potassium, or Ammonium, 520, 544. 

Iodine, 471. Locally. 

Mercury, 584. Internally. 

Mercury and Morphia Oleate, 589. Exter- 
nally. 

Mezereum, 304. In rheumatic and scrofulous 
cases. 

Poultices, 402. 

Stavesacre, 701. "When long bones affected. 



Peritonitis. 



Aconite, 701. At commencement. 

Bryonia, 785. When exudation. 

Cocculus Indicus, 706. For tympanites. 

Iron, 634. To abdomen. 

Leeches, 927. 

Mercury, 584. When there is a tendency to 

fibrous exudation. 
Opium, 724. Freely, most useful. 
Poultices, 402. 
Quinine, 801. 
Steam. Applied to the abdomen under a cloth 

when poultices cannot be borne. 
Turpentine, 226, 8S4. For tympanites. 

Perspiration. 

Agaric. In phthisis. 

Aromatic Sulphuric Acid, 47S. In phthisis. 

Atropia, 839. In sweating of phthisis, inter- 
nally. 

Belladonna, 836. As liniment for local sweats. 

Carbolic Acid, 688-691. With glycerin, locally, 
for foetid sweat. 

Ergot, 911. 

Gallic Acid, 877. In phthisis. 

Jaborandi, 749. 

Neat's Foot Oil. Rubbed over the surface. 

Opium, 286, 293, 364. As Dover's powder in 
phthisis. 

Permanganate of Potash, 515. Locally for 
foetid perspiration. 

Quinine, 801. 

Salicin, 873. In phthisis. 

Salicylic Acid, 693. With borax in foetid 
perspiration. 

Sponging. Very hot. 

Strychnine, 825. In phthisis. 

Vinegar, 483. Locally. 

Zinc Oxide, 596. In phthisis. 



Pertussis. 



Aconite, 701. 
Alum, 555-557. 
Belladonna, 836. 
Bromide of Ammonium, 5 1 1. 
Bromide of Potassium, 520-522. 
Carbolic Acid, 688. As spray. 
( lastanea Vesca, 878. 
Cerium Oxalate, 558. 



INDEX OF DISEASES AND REMEDIES. 



1003 



Pertussis. 

Cheken,779. 

Chloral 672. In spasmodic stage. 

Chloroform, 680. As inhalation during 
paroxysm. 

Cod-liver Oil, 226, 922. 

Coffee, 804. 

Croton Chloral, 279. 

Decoction of Chestnut Leaves, ad. lib., 878. 
Sometimes useful. 

Ergot, 911. 

Gelsemium, 827. In spasmodic stage. 

Hydrocyanic Acid, 493. In habitual cough 
when the true whooping-cough has ceased. 

Ipecacuanha, 804. Sometimes very useful 
alone, or combined with bromide of ammo- 
nium. 

Lobelia, 814. In spasmodic stage. 

Monobromide of Camphor, 281. 

Opium, 723. In convulsive conditions. 

Salicylic Acid, 693. As spray. 

Silver Nitrate, 575. 

Tannin, 877. 

Tar, 886. For inhalation. 

Tartar Emetic, 616. 

Valerian, 805. 

Zinc Sulphate, 570. 

Pharyngitis. 

Aconite, 701. 

Alcohol, 655. Dilute as gargle. 

Alum, 556. As gargle. 

Belladonna, 836. 

Capsicum, 835. As gargle. 

Cimicifuga, 703. Internally when pharynx 
dry. 

Copper Sulphate, 326, 573. Locally. 

Cubebs Powder, 872. Locally applied. 

Ferric Chloride, 308, 309. Locally as astrin- 
gent, internally as tonic. 

Glycerin, 820. Locally, alone, or as glycerin 
and tanin. 

Hydrastis, 705. Internally and locally. 

Ipecacuanha, 803. As spray. 

Pomegranate Bark, 782. As gargle. 

Potassium Chlorate, 514. Locally. 

Quinine, 801. As tonic. 

Silver Nitrate, 575. In solution locally. 

Strychnine, 825. As tonic. 

Tannin, 877. As powder or glycerine, locally. 

Zinc Sulphate, 570. As gargle. 

Phimosis. 

Belladonna, 836. Locally. 
Lupulin, 881. After operation. 

Phlebitis. 

Hamamelis, 873. 
Hot Fomentations. 
Opium, 723. To allay pain. 
Rest. Absolute. 

Phlegmasia Alba. 

Ammonium Carbonate, 543. In full doses, 

when much prostration. 
Belladonna Extract, 836. With mercurial 

ointment locally. 
Blisters, 303, 305. In early stage. 
Creasote, 691. As enemata. 
Hamamelis, 873. 
Hydrochloric Acid, 479, 513. With potassic 

chlorate, in barley water. 
Leeches. 927. During active inflammation. 
Opium, 723. Internally and locally to allay 

pain. 



Photophobia. 



Belladonna, 839, 840. To eye. 
Bromide of Potassium, 521. 



Photophobia. 

Calabar Bean, 198. 

Chloroform Vapor, 185, 680, 681. 

Cold. 

Conia, 787. In scrofulous photophobia, locally. 

Croton Chloral, 672. 

Mercuric Chloride, 395. By insufflation. 

Potassium Chloride, 588. In large doses. 

Tonga. 

Phthisis. 

Alcohol, 655. Along with food or cod-liver 
oil, 226, 922. 

Antipyrin, 695. To reduce temperature. 

Arsenic, 609. To remove commencing con- 
solidation, and also when tongue is red and 
irritable. 

Atropia, 223, 839. To check perspiration. 

Belladonna, 839. Locally for pain in muscles. 

Benzoin, 816. As inhalation to lessen cough 
and expectoration. 

Blisters, 305. 

Chloral, 181. As hypnotic. 

Chloroform as Linctus, 680, 681. To check 
cough. 

Coca'ine, 733. Solution 4-20 per cent, locally 
to tbroat and mouth to relieve irritation, 
soreness and aphthae, especially in the 
latter stages. 

Cod-liver Oil, 921, 922. Most useful as nu- 
trient. 

Creasote, 691. As inhalation. 

Croton Chloral, 279. To check cough. 

Croton Oil, 868. To chest as counter-irritant. 

Gelsemium, 827. 

Glycerin, 820. As nutrient in place of cod- 
liver oil, locally to mouth in the last stages 
to relieve dryness and pain. 

Hypophosphites, 355, 377, 640. Very useful 
in early stage. 

Inulin, 813. Possibly useful. 

Iodine Liniment, 472. As a counter-irritant 
to remove consolidation in early stage, and 
to remove pain and cough later ; as inhala- 
tion to lessen cough and expectoration. 

Iodoform, 683. As inhalation. 

Ipecacuanha, 804. As spray to the throat to 
relieve bronchial asthma and emphysema, 
combined with fibroid phthisis. 

Mercuric Chloride, 82. In minute doses for 
diarrhoea 

Morphia, with Starch or Bismuth, 713, 714. 
Locally to larynx, and in laryngeal phthisis 
most useful. 

Mustard Leaves, 305. Most useful to lessen 
pain and prevent spread of subacute inter- 
current inflammation. 

Opium, 722. To relieve cough, and, with 
ipecacuanha and Dover's powder, to check 
sweat, 

Oxygen, 457. 

Phosphate of Lime, 553. As nutrient, and to 
check diarrhoea. 

Picrotoxin, 708. To check perspiration. 

Pilocarpin, 379, 380, 397. To check sweats. 

Quinine, 801. As tonic to lessen temperature, 
to check swBUt 

Salicylic Acid, 693. When breath foul and 
expectoration offensive. 

Silver Nitrate, 575. 

Sulphurous Acid, 478. As fumigation. 

Pityriasis. 

Arsenic and Mercury, 585, 607. Internally. 
Borax, 353. Saturated solution or glycerin, 

locally. 
Carbolic Acid, 689, 690. With glycerin and 

water, locally. 
Chrysarobinum, 766. 
Lead, 595. Locally. 
Mercuric Ointment, 914. Locally. 
Sulphides, 516, 554. Locally. 
Sulphurous Acid, 477. 



1004 



IXDEX OF DISEASES AND REMEDIES. 



Pleurisy. 

Aconite, 701. In early stage. 

Antimony, 616. 

Belladonna Plaster, 839. Most useful to re- 
lieve pain in old adhesions. 

Blisters, 305. 

Bryonia, 785. After aconite. 

Cod-liver Oil, 226, 921, 922. 

Digitalis, 850. When much effusion. 

Iodide of Potassium, 519. To aid absorption. 

Iodine, 471. As a liniment externally, to 
assist absorption, or as a wash, or injection, 
to cavity after tapping. 

Leeches, 927. 

Local Wet Pack, 396. To chest. 



Pleurodynia. 

Belladonna, 839. Plaster or liniment very 
useful. 

Chloral, 672, 863. With camphor, locally. 

Croton Oil, 868. Locally in obstinate cases. 

Ether, 660. As spray, locally. 

Iodine, 470. Locally. 

Iron, 634. When pleurodynia associated with 
leucorrhcea. 

Mustard Leaves, 305. 

Opium, 709. Liniment rubbed in after warm 
fomentations or hypodermic injections. 

Opium, 722. Most useful to cut short attack 
and relieve pain. 

Plasters, 228. To relieve pain and give sup- 
port. 

Poultices, 402. 

Quinine, 801. 

Strapping, 597. 

Veratrum Viride, 894. 
• Wet Cupping, 366. When pain severe and 
fever high. 

Pleuro-Pneumonia. 

Byronia, 785. 

Carbolic Acid, 689, 690. 2 per cent, solution 

injected locally. 
Sanguinaria, 725. 
Turpentine, 883. Locally. 



Pneumonia. 

Aconite, 701. Very useful, especially at com- 
mencement. 

Ammonium Carbonate, 542. As stimulant. 

Belladonna, 839. At commencement. 

Blisters, 305. At beginning to lessen pain. 

Bryonia, 785. When pleurisy present. 

Copper Acetate, 574. 

Digitalis, 850. To reduce temperature. 

Iodide of Ammonium, 545. 

Phosphorus, 605. 

Poultices, 402, 404. To lessen pain. 

Quinine, 802. To lower temperature. 

Salicylate of Soda, 532. As antipyretic. 

Senega, 731. As expectorant. 

Serpentaria, 865. With carbonate of ammo- 
nia as stimulant. 

Turpentine, 883. As stimulant at crisis. 



Polypus. 

Alum. 566-558. As Insufflation. 

Tannin, 876. As insufflation. 



Prolapsus A.m. 

Alum, 557, 568. In solution locally. 
Bydrastis, Tor,. As enema or lotion. 

38. When prolapsed parts inflamed. 
Pepper, 871. Confections. 
Podophyllum, 704 [n small d 
Strychnia. 826. As adjunct to laxatives, 
j annin, 801. As enemata. 



Prolapsus Uteri. 

Alum, 557, 558. As hip bath and vaginal 

douche. 
Cimicifuga, 703. To prevent miscarriage and 

prolapsus. 
Galls, 875. Decoction of, as injection. 
Ice, 328. Locally when part inflamed, and to 

spine. 
Oak Bark, 875. As injection. 
Tannin, 877. 

Prostate, Enlarged. 

Alkalies, 501. When irritation of the bladder 

with acid urine. 
Ammonium Benzoate, 545. For cystitis with 

alkaline urine. 
Ammonium Chloride, 540. 
Conium, 786. 
Ergot, 911. 

Iodine, 471. Apply to rectum. 
Iodoform, 682. As suppository very useful. 



Prostatitis. 

Blisters, 303-305. To perinseum in chronic 

cases. 
Buchu, 748. 

Cantharides, 926. Small doses of tincture. 
Cubebs, 871. 
Hot Injections. 

Hydrastis, 705. Internally and locally. 
Iron, 634. 

Silver Xitrate, 575. Locally. 
Turpentine, 883. 



Prurigo and Pruritus. 

Aconite, 701. Externally. 

Alum, 557, 558. A strong solution for pruri- 
tus vulvae. 

Arsenic, 608, 609. Internally. 

Atropine, 839. 

Balsam of Peru, 760. 

Boracic Acid, 486. 

Borax, 528. Saturated solution. 

Calomel, 5S8. Ointment very useful in pruri- 
tus ani. 

Carbolic Acid, 688-690. Internally and lo- 
cally, especially in prurigo senilis. 

Chloral, 672, and Camphor, 863. 

Chloroform Ointment, 680, 681. 

Cod-liver Oil, 922. As inunction. 

Corrosive Sublimate, 108. For pruritus vulva?. 

Cyanide Potassic, 506. As lotion or ointment 
to be used with care. 

Galvanism. 

Gelsemium, 827. 

Glycerin, 820. 

Glyeerole of Tar, 886. 

Hydrocyanic Acid, 493. Locally. 

Iodoform, 683. As ointment. 

Liquor Carbonis Detergens. 

Mercury, 585. Locally. 

Opium, 722. 

Oil of Cade. 

Petroleum Oil, 647. 

Pilocarpi n, 749. 

Potassium Carbonate, 508. 

Silver Nitrate, 575. 

Sodium ( larbonate, 526. 

Stavesacre, 702. 

Sulphate of Zinc, 570. 

Sulphides, 516, 554. 

Sulphites,."):;:}. 

Tar Ointment. 

Tobacco, 843. Useful but dangerous. 



Psoriasis. 



Aconite, 701. 
Akaline Bath, 103. 
Ammonium Carbonate, 542. 
Ammonium Chloride. 



INDEX OF DISEASES AND REMEDIES. 



1005 



Psoriasis. 



Arsenic, 607-609. 

Baths, 388 etseq. 

Berberine, 865. 

Bleeding, 363. 

Calomel, 588. Locally as ointment. 

Carbonic Acid, 487. 

Chromic Acid, 486. 10 grs. to the ounce in 
psoriasis of tongue. 

Chrvsophanic Acid, 765. 

Cod-liver Oil, 922. 

Copaiba, 769. 

Copper Sulphate, 573. 

Creasote Baths, 691. 

Cupric Sulphate, 573. 

Electricity. Constant current rapidly applied. 

Glycerin, 820. 

Hepar Sulphuris. 

India-rubber Solution. 

Iodine, 471. 

Iris, 902. 

Lead Iodide, 599. Locally. 

Mercury, 585. Locally as ointment. 

Mezereon, 304. 

Nitric, 480, and Nitro-hydrochloric, 481, 
Acids. When eruption is symptomatic of 
indigestion. 

Phosphorus, 605. As substitute for arsenic. 

Potassium Acetate, 510. 

Potassium Iodide, 518. 

Silver Nitrate, 575, In psoriasis of tongue. 

Sulphur Iodide, 470. Internally and exter- 
nally. 

Sulphur, 464. Internally. 

Tar, 886. As ointment. 

Thymol, 854. 

Ulnius, 878. 

Vaseline, 647. 

Ptosis. 

Arseniate of Soda, 612. 

Ergot, 911. 

Paregoric Acid, 710. 

Salicylic Acid, 693. 

Veratria, 897. Locally to the eyelids and 

temples. 
Zinc Chloride, 570. 

Ptyalism. 

Acids. In small doses internally and as gar- 
gles. 

Alcohol, 657. Dilute as gargle. 

Atropia, 839. Hypodermically. 

Belladonna, 183, 184, 839. Very useful. 

Calabar Bean, 198. 

Chlorate of Potash, 514. As gargle. 

Iodide of Potassium, 519. 

Iodine, 471. As gargle, 1 of tincture to 30 of 
water. 

Tannin, 876. 

Puerperal Convulsions. 

Aconite, 701. In small doses frequently. 

Belladonna, 839. Useful. 

Chloral, 672. In full doses. 

Chloroform, 680, 681. 

Dry Cupping over Loins. 

Ice, 328. To head. 

Morphia, 711, 712, Hypodermically very 

useful. 
Mustard, 304. To feet. 
Nitrite of Amyl, 666. Of doubtful utility. 
Veratrum Viride, 894. Pushed to nausea, 

very useful. 

Puerperal Fever. 

Aconite, 701. Useful at commencement. 
Alkaline Sulphate, 504. In early stages. 
Calumba, 449. As tincture. 
Opium, 723. For wakefulness and delirium, 
very useful. 



Puerperal Fever. 

Permanganate of Potash, 515. 

Quinine, 801. In large doses. 

Stramonium, 842. When cerebral excite- 
ment. 

Turpentine, 882. When much vascular de- 
pression and tympanites. 

Puerperal Mania. 

Aconite, 701. With much fever. 

Anaesthetics, 146. During paroxysm. 

Bromide of Potassium, 521, 522. 

Chloral, 672. 

Cimicifuga, 703. Useful in hypochondriasis. 

Hyoscyamus, 841. In mild cases. 

Iron, 634. In anaemia. 

Opium, 723. 

Poultices, 402. 

Quinine, 801. When much sickness. 

Stramonium, 842. When delirium furious 
but intermittent, or suicidal, or when im- 
pulse to destroy child. 

Tartar Emetic, 616, 617. Frequently re- 
peated. 

Puerperal Peritonitis. 

Aconite, 701. At commencement. 

Antimony, 616. 

Cimicifuga, 703. In rheumatic cases. 

Laxatives, 338. Useful combined with Do- 
ver's powder and hyoscyamus. 

Opium, 723. Very useful. 

Quinine, 801. In large doses. 

Turpentine, 882. As stimulant, 10 m. fre- 
quently repeated. 

Purpura. 

Alum, 557, 558. Locally with brandy. 

Ergot, 911. Very useful. 

Gallic Acid, 877. 

Iron, 634. Internally. 

Nitrate of Potash, 513. 

Nux Vomica, 821. 

Quinine, 801. 

Tannic Acid, 877. 

Turpentine, 882. 



Pyemia. 



Boracic Acid, 486. 

Oil of Cloves, 779. Locally. 

Permanganate of Potash, 515. Internally. 

Quinine, 801. In large doses. 

Salicin, 873. 

Salicylic Acid, 693. 

Turpentine, 882. As stimulant. 

Pyelonephritis. 

Eucalyptus, 781. 
Hydrastis, 705. 

Pyrosis. 

Bismuth, 622. 

Camphor, 863. 

Carbolic Acid, 689, 690. 

Creasote, 691. 

Gallic Acid, 877. 

Glycerin, 820. 

Manganese Oxide, 640. 

Mineral Acids. 

Nux Vomica, 821. 

Pulvis Kino Compositus, 710. 

Sulphur Oxide and Nitrate, 463. 

Sulphuric Acid, 477. 

Relapsing Fever. 

Laxatives, 338. 

Leeches, 927. As cupping for headache. 

Quinine, 801. 



1006 



INDEX OF DISEASES AND EEMEDIES. 



Remittent Fever. 

Aconite, 701. 
Emetics, 327. 

Gelsemium, 827. In bilious remittents. 
Morphia, 711. Hypodermically. 
Packing, 181. Useful. 

Quinine, 801. 20-30 grs. for a dose, once or 
twice daily. 

Renal Calculi, vide Calculi. 

Alkaline Waters. 
Ammonium Benzoate, 515. 
Chalybeates. 
Wild un gen Water. 



Rheumatic Arthritis. 

Aconite, 701. Locally. 
Arnica, 812. Internally and externally. 
Arsenic, 608, 609. 

Cimicifuga, 703. When pains and nocturnal. 
Cod-liver Oil, 358, 922. 
Colchicum, 899. 
Guaiacum, 745. 

Iodine, 465. Internally as tonic. 
Lithium, 535. Internally and locally. 
Potassium Bromide, 521, 522. Sometimes re- 
lieves pain. 
Sulphur, 464. 
Turkish Bath, 405. 

Rheumatism, Acute. 

Aconite, 701. 

Alkalies, 501. 

Ammonium Bromide, 544. 

Arnica, 812. 

Blisters, 305, 363. Very efficient around joints 
near to the cardiac region. 

Bryonia, 785. 

Cimicifuga, 703. 

Colchicum, 899. 

Cold Baths, 396. 

Digitalis, 850. 

Dulcamara, 834. In persons liable to catarrh. 

Iron, 634. 

Lime Juice, 740. 

Lithium Bromide, 536. Especially when in- 
somnia and delirium present. 

Opium, 723. One gr. every 2 or 3 hours, es- 
pecially when cardiac inflammation. 

Permanganate of Potash, 515. 

Quinine, 109, 801. As antipyretic. 

Rhus Toxicodendron, 755. Exceedingly use- 
ful in after stage and subacute forms. 

Salicin, 873. 

Salicylate of Soda, 532. Relieves pain most 
quickly. 

Sulphurous Acid, 478. Fumigation. 

Trimethylaniine. 

Veratrum Viride, 894. 



Rheumatism, Chronic. 

Aconite, 701. 
Arnica, 812. 
Belladonna, 839. 
Bryonia, 786. 

Burgundy Pitch, 886. As plaster locally. 
Cajupul Oil, 780. internally and externally. 
Chimaphila, 815. 
< imicifuga, 708. 

Cod-liver Oil, 358, 921. Internally and exter- 
nally. 
Colchicum, 899. 
Dulcamara, 885. 

i .uaiiic, 710. 

[odide of Potassium, 519. Especially when 

pain worse at night. 
Iodine, 171, ~>V->. Locally. 
Lithium Bromide, 586. When smaller joints 

affected. 
Lupulin, 881. 



Rheumatism, Chronic. 

Mercury and Morphia, 584, 713. Oleate lo- 
cally. 

Mezereon, 305. 

Phytolacca, 850. 

Quinine, 801. When much debility and night 
sweats. 

Rhus Toxicodendron, 755. Internally and 
locally. 

Sulphur, 463. Locally and as sulphides or 
sulphur waters internally. 

Thuja Occidentalis, 886. 

Turkish Baths, 404. 

Xanthoxylum, 748. 

Rickets. 

Calcium Phosphate, 453. If child is sucking 

it may be given to nurse. 
Cod-liver Oil, 358, 921. 
Cold Sponging, 364. 
Ferric Iodide, 470. 
Nitro-hydrochloric Baths, 403. 
Quinine, 801. 

Sarcin^e. 

Carbolic Acid, 689. 

Creasote, 691. 

Gastric Syphon. To wash out stomach. 

Sulphitis. 

Sulphuric Acid, 477, 

Scabies. 

Anise, 789. As ointment. 

Arsenic, 608, 609. 

Baking of clothes. To destroy ova. 

Balsam of Peru, 769, 770. Locally, agreeable 

and effective. 
Benzoic Acid, 817. As ointment or lotion. 
Carbolic Acid, 689. Dangerous. 
Coal Tar Naphtha, 699. 
Cocculus Indicus, 706. As ointment. 
Copaiba, 768. 
Copper Sulphate, 573. 
Hog's Lard, 918. 
Kaniala, 869. As ointment. 
Mercury, 585. White precipitate ointment. 
Oil, 818. Inunction. 
Petroleum, 647. 
Soft Soap, 819. 

Stavesacre, 702. As ointment. 
Storax, 874. With almond oil, when skin 

cannot bear sulphur. 
Sulphide of Calcium, 554. 
Sulphur, 461. As ointment. 
Sulphuric Acid, 477. Internally as adjuvant. 
Sulphurous Acid, 477. 
Tar, 886. Ointment. 
Vaseline, 647. 

Scarlet Fever. 

Aconite, 701. 

Arsenic, 608, 609. If tongue remains red and 
irritable during convalescence. 

Belladonna, 839. 

Carbolic Acid, 690. As gargle. 

Carbonate of Ammonium, 542. Greatly recom- 
mended in frequent doses given in milk or 
cinnamon water. 

Chlorine Water, 468. As gargle. 

Cold Compress to throat, 405. 

Cold Affusion, 396. 

Digitalis, 850. 

Fat. As inunction to hands and feet during 
the rash, and over the whole body during 
desquamation. 

Ferric Perchloride, 633. In advanced stage 
with albuminuria and hematuria, very 
useful. 

Ice, 328. To suck, especially at commence- 
ment. 

Juniper Oil, 887. As diuretic when dropsy 
occurs. 



INDEX OF DISEASES AND KEMEDIES. 



1007 



Scarlet Fever. 

Mercury, 585. ^ of a gr. of gray powder 
every hour to lessen inflammation of 
tonsils. 

Mineral Acids, 476. Internally and as gargle. 

Mustard Bath, 403. When rash recedes. 

Packing, 396. Useful and comforting. 

Potassium Permanganate, 515. As gargle to 
throat. 

Purgatives, 338. More useful to prevent al- 
buminuria. 

Ehus Toxicodendron, 755. 

Salicylate of Soda, 532. As antipyretic. 

Salicylic Acid, 693. 

Strychnine, 825, Hypodermically in para- 
lysis. 

Sulphurous Acid, 477. Inhalation when 
throat much affected. 

Veratrum 7iride, 893. 



Sciatica. 

Aconite, 698. As ointment or liniment. 

Acupuncture. 

Aquapuncture. 

Atropia, 839. 

Belladonna, 839. 

Blisters, 302-305. 

Cautery. Exceedingly useful, slight applica- 
tion of Paquelin's therm o-cautery. 

Chloride of Ammonium, 451. 

Chloroform, 328, 680. Locally as liniment, in- 
halation when pain excessive. 

Croton Oil, 868. Internally as purgative. 

Electricity. 

Ether, 146, 661. As spray. 

Iodide of Potassium, 519. 

Morphia, 714. Hypodermically most useful. 

Poultices, 402. 

Stramonium, 842. Internally pushed until 
physiological action appears. 

Sulphur, 463. Tied on with flannel over 
painful spot. 

Turkish Bath, 404. 

Turpentine, 882. In }4-oz. doses internally 
for 3 or 4 nights successively. 

Veratria, 895, 896. As ointment ' 



Scrofula. 

Blisters, 305. To enlarged glands. 

Calcium Phosphate, 552. 

Chloride of Calcium, 552. 

Cod-liver Oil, 358, 922. Exceedingly ser- 
viceable. 

Iodides, 519. 

Iodide of Iron, 637. 

Iodine, 476, 471. Locally to glands and in- 
ternally. 

Sulphides, 516, 554. 

Scurvy. 

Acids, 485. As preventive in the absence of 
lime juice. 

Aconite, 701. In acute stomacace with saliva- 
tion in scorbutic conditions. 

Alcohol, 653. Diluted as gargle. 

Alum, 556. Locally with myrrh for ulcerated 
gums. 

Ammonium Carbonate, 542. In scorfcmtic 
diathesis. 

Arsenic, 607, 608. In some scorbutic symp- 
toms. 

Atropia, 839. Hypodermically when saliva- 
tion. 

Cinchona, 801, 8C2. As decoction, or diluted 
with myrrh as gargle. 

Citric Acid, 485. As substitute for lime juice. 

Lemon Juice, exceedingly useful as preven- 
tive and curative. 

Liberal Diet. -Often sufficient. 

Liquor Sodse Chlorinatse, 440. Locally to 
gums. 



Scurvy. 

Oranges. Useful. 

Quinia, 801. With mineral acids internally. 

Silver Nitrate, 606. 

Tartar Emetic, 616, 617. 

Vegetable Charcoal, 459. As tooth-powder to 

remove foetid odor. 
Vinegar, 483. Substitute for lime juice. 

Sea- Sickness. 

Apomorphia, 713, 714. 

Arsenic, 608, 609. 

Atropia, 839. Hypodermically in epigastrium. 

Bromide of Potassium, 521. Very useful in 

large doses. 
Bromide of Sodium, 531. 
Calumba, 706. 
Cannabis Indica, 879. 
Capsicum, 835. 
Champagne, Iced. 
Chloral, 672. 15 to 30 grs. every four hour* 

most useful. 
Chloral Hydrate, 673. 
Chloric Ether, 662. 

Chloroform, 680. Pure, 2-5 ms. on sugar. 
Creasote, 691. 
Ice, 328. To spine. 
Magnetic Belt. 

Morphia, 714. Hypodermically. 
Nitrite of Amyl, 666. Inhalation. 
Nitro-glycerine, 668. 
Nux Vomica, 821. When indigestion, with 

constipation. 
Petroleum, 647. 
Quinine, 801. 

Seborrhea. 

Borax, 528, with Glycerin, 820, and Lead Ace- 
tate, 597. 

Glycerin, 820. 

Iodine, 471. 

Lead Acetate. With borax and glycerine, as 
above. 

Phosphorus, 605. 

Sodic Chloride, 524. 

Zinc Oxide, 596. 

Sneezing. 

Arsenic, 608. In paroxysmal sneeziDg. 

Belladonna, 839. 

Chamomile Flower, 809. In nares. 

Camphor, 863. As powder, 

Cotton Plug. In nares. 

Gelsemium, 827. In excessive morning sneez- 
ings with discharge. 

Iodine, 471. Inhalation. 

Mercury, 585. Heaviness of head and pain in 
limbs. 

Potassic Iodide, 519. 10-gr. doses frequently 
repeated. 

Pressure beneath nose, 220. 

Somnambulism. 

Opium, 722. 

Potassic Bromide, 521. 

Spasmodic Affections. 

Aconite, 839. Externally and internally. 

Ammonia, 543. 

Amyl Nitrite, 666. 

Arnica, 811. 

Belladonna, 839. 

Camphor, 863. 

Cardamoms, 901. 

Chamomile Oil, 809. 

Chimaphila, 815. 

Chloroform, 680. 

Cimicifuga, 703. 

Colocynth, 784. 

Conium, 787. 



1008 



INfDEX OF DISEASES ANTD REMEDIES. 



Spasmodic Affection; 



Copper Sulphate, 573. In chorea. 

Electricity. 

Gelsernium, 827. 

Hyoscyamus, 840. 

Ice, 32S. Ice to spine. 

Ipecacuanha, S04. 

Leeches, 927. 

Lohelia, 815. 

Local Pressure, 155, vide Sneezing. Over the 

ovary in hysteria. 
Lupuline, 881. 
Nux Vomica, 821. 
Opium, 722. 
Oxygen, 457. 
Physostigma, 764. 
Plumbum, 642. 
Potassium Bromide, 521. 
Poultices, Mustard, 402. 
Secale, 911. 
Silver Nitrate, 575. 
Strychnia, 825. 
Sulpho Carbolate, 463. 
Sulphur, 464. 
•Sumbul, 791. 
Tobacco, 843. 
Veratria, 896. 
Yeratrum Viride, 894. 

Spermatorrhea. 

Arsenic, 608. 
Atropia, 839. 
Belladonna, 839. 
Bromides, 521. 
Camphor Bromide, 864. 
Cannabis Indica, 879. 
Cantharides, 926. 
Cimicifuga, 703. 
Digitalis, 850. 
Electricity. 
Ergot, 911. 
Ferric Bromide. 
Ferric Iodide, 470. 
Gold Chloride, 641. 
Hvdrastis. 705. 
Iron, 634. 

Nitrate of Silver, 575. 
Nux Vomica, 821. 
Phosphorus, 605. 
Physostigma, 764. 
Potassic Bromide, 521. 
Quinia, 801. 
Silver Xitrate, 575. 
Strychnia, 825. 
Sulphur, 463. 
Turpentine, 883. 

Spina Bifida. 

Collodion, 735. As means of compression. 

Cotton Wool. Over tumor. 

Glycerin, 820. Injection after tapping. 

Iodine, 171. Injections. 

Lime Phosphate, 554. 

Potassic Iodide, 519. 

Spinal Concussion. 

Arnica, 811. 

Bleeding, 363. To relieve heart. 
Lead Water and Opium. As lotion. 
Leeches, 927. 
Vinegar, 483. To restore consciousness. 

Spinal Congestion. 

Aconite, 889. 

Antiphlogistic Treatment. 
( old Lffusions, 894. To spine. 
Ergot, 911. 
Gewemium 

Niix Vomica, B21. 
Turpentine, 883. 
Wei Cuppin 



Spinal Irritation. 

Aconite Ointment, 698. Locallv. 

Arsenic, 608. 

Atropia, 839. 

Belladonna, 839. 

Blisters, 305. 

Cimicifuga, 703. 

Cocculus Indicus, 706. 

Conium, 786. 

Counter-irritation, 301-306. 

Digitalis, 850. 

Electricity. 

Ergot, 911. 

Ignatia, 821. 

Leeches, 927. 

Nux Vomica, 821. 

Opium, 722. Small doses. 

Oxalic Acid, 485. 

Phosphoric Acid, 604. 

Phosphorus, 605. 

Picrotoxin, 707. 

Siuapis, 305. 

Sodium Hypophosphite, 506. 

Strychnia, 825. 

Yeratrum Viride, 893. 

Spinal Paralysis and 
Softening. 

Belladonna, 839. 
Electricity. 
Ergot, 911. 
Oxalic Acid, 485. 
Phosphorus, 605. 
Plumbic Iodide, 599. 

Splenic Affections. 

Aconite, 701. 

Ammonium Iodide, 545. 

Bryonia, 786. 

Ferrum, 634. 

Grape Cure. 

Iodine, 471. 

Iodide of Ammonium, 545 

Mercuric Biniodidi, 592. 

Quinia, 801. 



Sprains. 



Aconite, 701. 

Ammonium Chloride, 540. 

Arnica, 811. 

Bandaging. 

Cold Douche, 399. 

Collodion, 735. 

Hot Fomentations, 401. 

Inunction, 406. 

Iodine, 471. 

Massage, 12S. 

Oil of Bay. 

Rest. 

Rhus Toxicodendron, 755. 

Shampooing. 

Strapping. 

Turpentine, S83. 

Stammering. 

Hyoscyamus, 841. 
Stramonium, 842. 
Vocal Training. 

Sterility. 

Alkaline Injections, 488. 

Aurora, 640. When the result of chronic 
metritis or amenorrhcea. 

Borax, r,2'.). 

Cantharides, 926. 

Cimicifuga, 703. 

Conium, 786. 

Dilatation, of os and cervix when obstruc- 
tion, with dysmenorrhea. 



INDEX OF DISEASES AND KEMEDIES. 



1009 



Sterility. 

Gossypiurn, 734. 
Guaiacum, 746. 
Intra-uterine Stems. 
Iodine, 471. 
Metallic Bougies. 
Potassic Iodide, 519. 

Stings and Bites. 

Aconite, 701. 

Allium, 889. 

Ammonia, or Alkalies, 543. 

Aqua Calcis, 550. 

Aqua Potassae, 509. 

Arsenic, 608, 609. 

Camphor, 863. 

Carbolic Acid, 688-690. 

Chloroform, 680. On lint. 

Fennel, 789. Keep away fleas. 

Ipecacuanha, 802. 

Liquor Ammonise, 541. 

Peppermint, 853. Soap scented with it and 

rubbed over face keeps off mosquitoes. 
Rosemary, 851. 
Sage, 856. 

Silver Nitrate, 575. 
Stimulants, 905. 
Sugar, 906. 
Tobacco, 842. Moistened and squeezed on 

spot. 

Stomatitis. 

Acids, Mineral. 
Alcohol, 655. 
Alum, 556. 

Carbolic Acid, 6S9-691. 
Chlorate of Potassium, 513. 
Copper Sulphate, 573. 
Cornus, 793. 
Eucalyptus, 781. 
Glycerin of Tannin, 877. 
Hydrastis, 705. 
Iris, 866. 
Mercury, 585. 
Nitric Acid, 480. 
Phytolacca, 859. 
Potassium Chlorate, 513. 
Salicylic Acid, 693. 

Strabismus. 

Atropia, 836. 
Belladonna, 836. 
Bryonia, 785. 
Electricity. 
Hyoscyamus, 840. 
Operation. 
Spigelia, 827. 

Strophulus. 

Antimonium Crudum, 616. 
Carbonate of Lime, 553. 
Chamomile, 809. 
Glycerin, 820. 
Lancing the Gums. 
Pulsatilla, 702. 



Sunstroke. 

Apomorphia, 713. 
Artificial Respiration. 
Belladonna, 836. 
Bleeding, 363. 

Brandy, 655, 658. In small doses. 
Camphor, 862. 
Chloroform, 680, 681. 
Ergot, 911. 
Gelsemium, 827. 
Hot Bath, 401. 
i Leeches, 363, 927. 
Nitrite of Amyl, 666. 
Nitro-glycerin, 668. 



Sunstroke. 



Potassic Bromide, 521. 

Quinine, 801. 

Scutellaria, 856. ■ 

Tea, 742. 

Veratrum Yiride, 893. 

Water, Cold, 363. Affusion. 

Wet Sheet, 181. 

Suppuration. 

Alcohol, 655. 
Arnica, 811. 
Bark, 776, 777. 
Calendula, 812. 
Chamomile, 809. 
Hypophosphites, 530, 553, 6; 
Iodide of Iron, 637. 
Iodide of Manganese, 640. 
Mercury, 584. 
Phosphates, 538, 553, 63S. 
Quinia, 801. 
Sarsaparilla, 888. 
Sulphides, 339, 353, 516, 555. 

Surgical Fever. 

Aconite, 701. 
Chloral, 672. 
Cinchona, 794, 795. 
Salicylic Acid, 693. 

Sycosis. 

Arsenic and Mercury, 585, 
Carbolic Acid, 688-691. 
Chloride of Zinc, 569. 
Cod-liver Oil, 921. 
Nitric Acid, 480. 
Sodic Sulphite, 533. 
Sulphurous Acid, 477. 
Thuja, 8S6. 
Turpentine, 882. 



Syncope. 



Aconite, 701. 

Alcohol, 655. 

Ammonia, 541. 

Arsenic, 608. 

Belladonna, 836. 

Camphor, 862. 

Chamomile, 809. 

Chloroform, 680. 

Cinnamon, 862. 

Cocculus Indicus, 706; 

Cold Water over face and volatile substances 

to the nose. 
Counter-irritation to Epigastrium. 
Digitalin, 850. 
Galvanism. 
Heat, 185. 
Iodine, 471. 
Lavandula, 852. 
Musk, 914. 

Nitrite of Amyl, 666. 
Position. Head between knees. 
Veratrum Album, 219. 

Synovitis. 

Aconite, 701. 

Alcohol and Water, 655. Equal parts. 

Arnica, 811. 

Bandage or Strapping. 

Blisters, 305. 

Bryonia, 785. 

Calcic Sulphide, 554. 

Carbolic Acid, 688-691. Injections. 

Carbonate of Lime, 553. 

Cod-liver Oil, 358, 922. 

Colocynth, 783. 

Heat. 

Iodine, 471. Injection. 

Mercury, 584. 



64 



1010 



IXDEX OF DISEASES AND REMEDIES. 



Synovitis. 



Oleate of Mercury, 494. 

Potassic Iodide, 5*18. 

Pressure. 

Pulsatilla, 702. 

Shampooing and Aspiration, 304. 

Silver Nitrate, 575. 

Splints. 

Sulphur, 463. 

Syphilis. 

Arsenic, 608. 

Aurum, 640. 

Calcic Sulphide, 554. 

Calendula, 812. 

Calomel, 5S8. 

Camphor, 862. 

Carbolic Acid, 6S8-691. 

Cod-liver Oil, 358, 922. 

Creasote, 690. 

Cauterization. Of primary sore. 

Gold, 640. 

Guaiacum, 745. 

Hvdrastis, 705. 

Iodides, 358. 

Iodine, 471. 

Iodoform, 681, 

Iron, 633. 

Manganese, 640. 

Mercury, 584. 

Monsel's Solution, 631. 

Nitrate of Silver, 575. 

Nitric Acid, 480. 

Nitro-muriatic Acid, 377. 

Opium. 723. 

Potassic Bichromate, 516. 

Potassic Chloride, 513. 

Potassic Iodide, 517. 

Salicylic Acid, 693. 

Sanguinaria, 725. 

Sarsaparilla, 888. 

Stillingia, S67. 

Suppositories, 415. 

Turkish Baths, 404. 

Zinc Chloride, 569. 



Tabes Mesexterica. 

Alcohol, 655. 

Arsenic, 60S. 

Barium Chloride, 548. 

Chloride of Lime, 554. 

Cod-liver Oil, 922. 

Diet. Simple and nourishing. 

Fatty Inunction, 405. 

Ferri Pernitrate, 634. 

Gallic Acid, S77. 

Gelsemium, 827. 

Iodine, 471. 

Olive Oil, 819. 

Phosphates, 538, 553, 638. 

Phosphoric Acid, 483. 

Sarsaparilla, 888. 



Teeth, 



Alum, 556, 557. 

Arnica, 811. 

Arsenic, 608. 

Calcium Phosphate, 553. 

Carbonate of Lime, 553. 

Charcoal, 81 1. 

Cinchona, 802. 

Collodion.::;.-,. 

Creasote, 691. 

Iodine, 471. 

Liquor Soda Chlorinate, 440. 

Mercury, 58 1. 

Phosphorus, 605. 

PotaSBiC Iodide, 517. 

Sodium Bicarbonate, 527. 

acre, 70L 
Washing and Unfiling, 310, 



Testicles. 



Belladonna, 836. 

Collodion, 735. 

Compression. 

Conium, 7S6. 

Copaiba, 769. 

Digitalis, 850. 

Gold, 640. 

Hamamelis, 874. 

Heat and Cold. 

Iodine, -171. 

Iodoform, 681. 

Magnesium Sulphate, 560. 

Mercury and Morphia Oleate, 494. 

Nux Vomica, 821. 

Phosphoric Acid, 483. 

Plumbago, 595. 

Potassic Bromide, 521. 

Rest. 

Silver Nitrate, 575. 



Tetanus. 



Aconite, 701. 

Acupuncture. 

Apomorphia, 713, 714. 

Arnica, 811. 

Arsenic, 608. 

Atropine, 836. 

Belladonna, 836. 

Bromides, 489, 520, 531, 536, 553. 

Bryonia, 785. 

Cannabis Indica, 879. 

Chloral, 672. 

Chloroform and Ether, 663, 680. 

Conium, 786. 

Curare, 826. 

Freezing Nerve. 

Gelsemium, 827. 

Hyoscyamus, 840. 

Ice Bag to Spine. 

Nerve Stretching. 

Neurotomv. 

Nicotia, 843. 

Nitrite of Amvl, 666. 

Opium, 722. 

Physostigma, 761. 

Potassic Bromide, 521, 523. 

Quinine, 801. 

Strvchnia, 825. 

Tobacco, 843. 

Vapor Bath, 404. 

Warm Bath, 401. 



Throat, Sore. 



Externally, 
Externally. 



Aconite, 701. 

Alum, 556, 557, 

Apis, 923. 

Arsenic, 608. 

Balsam of Peru, 759. 

Balsam of Tolu, 760. 

Belladonna, 836. 

Capsicum, 835. 

Carbolic Acid, 6S8-691. 

Catechu, 770. 

Cimicifuga, 703. 

Cold Compress, 400. 

Ferri Perchloride, 633. 

Glycerin of Tannin, 876. 

Guaiacum, 7-15. 

Hydrastis. 705. 

[ce,225. Sucked. 

Inhalations, 412. Steam of boiliug'water and 

vapor of hot vinegar. 
Iodine, 471. 
[pecacuanha, 804. 
Mercury, 584. 
Myrrh, 756. 
N i'uht shade. s.*56. 
Nitre, 513. 
Nitric \.-id, 480. 

Phytolacca, 859. Internally and as gargle, 
Podophyllum, 708. 
Pulsatilla, 702. 



INDEX OF DISEASES AND REMEDIES. 



1011 



Throat, Sore. 

Sanguinaria, 725. 
Silver Nitrate, 575. 
Sulphurous Acid, 477. 
Veratrum Viride, 893. 
Zinc Chlorate, 569. 
Zinc Sulphate, 570. 

Tic Douloureux. 

Aconite, 701. 

Anmionii Chloridum, 539, 540. 

Aqua Aninioniee, 431. 

Arsenic, 608. 

Atropia, 836. Hypodermically. 

Beberice Sulphas, 865. 

Caffein, 742. 

Cannabis Indica, 879. 

Croton Chloral, 673. 

Counter-irritation, 301-306. 

Delphinia. Externally. 

Electricity. 

Ergot, 911. 

Ferruni, 631. 

Heat. 

Hyoscyamus, S40. 

Hypodermic Injection, 713. 

Iodides. 

Laurocerasus. 

Morphia, 713, 714. 

Morphia, 713. Hypodermically. 

Neurotomy. 

Nitrate of Silver, 575. 

Oleum Tiglii, 442. 

Phosphorus, 605. 

Physostigma, 761-765. 

Stramonium, 842. 

Sulphur, 463. 

Thuja, 886. 

Yeratria, 894. 

Tinea Circinata. 

Boracic Acid, 486. 
Carbolic Acid, 688-691. 
Carbonate of Lime, 553. 
Chromic Acid, 486. 
Cocculus Indicus, 706. 
Cod-liver Oil, 922. 
Goa Powder, 765. 
Mercury, 584. 
Oil of Cade. 
Sulphur, 463, 
Sulphurous Acid, 477. 

Tinea Decalvans. 

Cantharides, 925. 
Carbolic Acid, 688-691. 
Iodoform, 681. 
Parasiticide Lotions, 760. 
Pilocarpin, 749. 
Raw Onion. Rubbed on. 
Sapo Viridis, 819. 
Tannin, 877. 

Tinea Favosa. 

Arsenic, 608. 
Calcic Sulphide, 554. 
Carbolic Acid, 688-691. 
Cleanliness. 
Dulcamara, 834. 
Epilation. 
Hyposulphites, 533. 
Mercury, 584. 
Nitric Acid, 480. 
Oils, 304. 
Oleander. 
Petroleum, 647. 
Sulphides, 516, 554. 
Sulphurous Acid, 477. 
Turkish Bath, 404. 
Viola Tricolor, 729. 
Zinc Chloride, 569. 



Tinea Tonsurans. 



Arsenic Iodide, 608. 

Carbolic Acid, 688-691. 

Cocculus Indicus, 706. 

Cod-liver Oil, 922. 

Creasote, 690. 

Croton Oil, 867. 

Epilation. 

Goa Powders, 765. 

Iodine, 471. 

Lead, 595. 

Manganese, 640. In porrigo capitis. 

Mercury Oleate, 494. 

Menthol, 194. 

Sulpho-cyanide of Potassium, 512. 

Thymol, 854. 

Turpentine, 882. 

Vaseline, 647. 

Viola Tricolor, 729. 



Tongue. 



Aconite, 701. 

Borax, 529. 

Cinnamon, 862. 

Cloves, 778. As gargle. 

Conium, 786. 

Ginger, 900. 

Hydrastis, 705. 

Iodine, 471. 

Mercury, 584. 

Mezereon. 

Nitric Acid, 480. 

Nux Vomica, 821. 

Pepper, 870. 

Phytolacca, 859. 

Potassic Bromide, 521, 522. 

Potassic Chlorate, 513. 

Potassic Iodide, 517. 

Pyrethrum, 806. 

Rhus Toxicodendron, 755. 

Silver Nitrate, 575. 



Tonsillitis. 

Aconite, 701. 

Alum, 556, 557. 

Apis, 923. 

Arsenic, 608. 

Belladonna, 836. 

Capsicum, 835. 

Carbolic Acid, 688-691. 

Cold Wet Compress, 400. 

Eucalyptus, 782. 

Gallic Acid, 877. 

Guaiac, 745. 

Ice and Wet Pack, 181, 328, 396. 

Iodine, 471. 

Iodides, 519, 531, 545. 

Mercury, 584. 

Milk and Water Gargle. 

Nitrate of Silver, 575. 

Opium, 722. 

Phytolacca, 859. 

Potassic Iodide, 342. 

Quinine, 801. 

Silver Nitrate, 575. 

Steam of Hot Water. 

Tannic Acid, 877. 



Tonsils, Enlarged. 

Ammonia Iodide, 545. 

Belladonna, 836. 

Bryonia, 785. 

Calcic Phosphate, 553. 

Catechu, 770. 

Excision. 

Ferri Tincture, 510. 

Iodine Tincture, 470. 

Massage, 128. 

Ox Gall, 917. Locally. 

Silver Nitrate, 575. 

Tannin, 877. 



1012 



INDEX OF DISEASES AND REMEDIES. 



Tonsils, Ulcerated. 

Ailantlius Glandulosa. 
Cantharides, 925. 
Mercuric Iodide, 592. 
Potassium Iodide, 521. 
Sulphurous Acid, 477. 



Toothache. 



Aconite, 701. 

Alum, 556, 557. 

Arsenic, 608. 

Belladonna, 836. 

Bryonia, 785. 

Camphor, 862. 

Capsicum. 835. 

Carbolic Acid, 688-691. Very useful. 

Caustic Potash, 509. 

Chamomile, 809. 

Chloral, 672. 

Chloroform, 680. 

Coffee, 804. 

Colchicum, 899. 

Collodion, 735. 

Conia, 786. 

Creasote, 690. Very useful. 

Croton Oil, 673. 

Electricity. 

Gelsemium, 827. 

Ginger, 900. 

Mercury, 584. 

Morphia, 713, 714. 

Nitrate of Silver, 575. 

Nitric Acid, 480. 

Nitro-glycerin, 668. 

Nux Vomica, 821. 

Oil of Cloves, 337. 

Opium, 722. 

Pulsatilla, 702. 

Sodium Bicarbonate, 526. 

Staphisagria, 702. 

Tannin, 875. 

Xanthosylum, 748. 

Zinc Chloride, 569. 

Torticollis. 

Aconite, 701. 
Arsenic, 608. 
Belladonna, S36. 
Capsicum, 835. 
Cimicifuga, 703. 
Conium, 786. 
Dulcamara, 835. 
Electricitv. 
Ether Spray, 146. 
Galvanization. 
Local Pressure. 
Mercury,'854. 
Nerve Stretching. 
Nux Vomica, 821. 

Trismus. 

Aconite, 701. 
Amesthetics, 146, 185. 
Belladonna, 836. 
Calabar Bean, 701. 
Cannabis Indica, 879. 
Chloral, 672. 
Conium, 786. 
Ether, 060. 

Gelsemium, 827. 
Opium, 722. 
Pnysostigma, 761-765. 

Tumors. 

Acupuncture. 
a rnlca, 811. 

Barium Carbonate. 
Belladonna, 836. 
Bryonia, 785. 
Carbonate of Lime, 553. 
Chloroform. 680, 861. 
Conium, 788. 



Tumors. 

Electrolysis. 
Galbanum, 789. 
Hyoscyamus, 841. 
Iron, 633., 
Pepsine, 916. 
Plumbago, 595. 
Potassic Carbonate, 508. 



Tympanitis. 

Acids and Alkalies. 

Arsenic, 608. 

Asafcetida, 787. Most useful. 

Aspiration. 

Bismuth, 621. 

Chamomile, 809. 

Capsicum, 835. 

Carbolic Acid, 688-691. 

Chloral, 672. 

Cocculus, 706. 

Colchicum, 899. 

Cubebs, 871. 

Ginger, 900. 

Glycerin, 820. 

Hyoscyamus, 840. 

Iris, 902. 

Nux Vomica, 821. 

Rue, 747. 

Sumbul, 791. 

Turpentine, 882. 

Vegetable Charcoal, 459. 



Typhilitis. 

Arsenic, 608. 

Belladonna, 836. 

Ice Bag. 

Leeches, 927. 

Mercury. 

Opium, "722. Most useful. 

Veratrum Viride, 893. 



Typhoid Fever. 

Aconite, 701. 

Alcohol Aliment, 650, 655, 656. 

Arnica, 811. 

Arsenic, 608. 

Baths, 388 et seq. 

Bismuth, 621. 

Bryonia, 785. 

Calomel, 588. 

Carbonate of Ammonia, 542. 

Cold Compress, 400. 

Digitalis, 850. 

Ergot, 911. 

Hydrastis, 705. 

Hydrochloric Acid, 479. 

Hyoscyamus, 840. 

Lead Acetate, 597. 

Mercury, 584. 

Muriatic Acid, 479. 

Opium, 722. 

Phosphoric Acid, 483. 

Phosphorus, 605. 

Purgatives, 338. 

Quinine, 801. 

llhus Toxicodendron, 755. 

Serpentaria, 865. 

Sodic Chloride, 524. 

Sulphur 463. 

Tartar Emetic, 617. 

Turpentine, 882. 

Veratrum Viride, 893. 



Typhus Fever. 

Aconite, 701. 
Arnica, 811. 

Arsenic, 60S. 
Baths, 888 et seq. 
Belladonna, 836. 



INDEX OF DISEASES AND REMEDIES. 



1013 



Typhus Fever. 

Camphor, 862. 
Chloral, 672. 
Coffee, 804. 
Counter-irritation. 
Diet, Nutritious. 
Digitalis, 850. 
Erythroxylon,732. 
Expectant Treatment. 
Hydrochloric Acid, 479. 
Hyoscyamus, 840. 
Iodine, 471. 
Mercury, 584. 
Mineral Acids. 
Muriatic Acid, 479. 
Musk, 914. 
Opium, 722. 
Phosphoric Acid, 483. 
Phosphorus, 605. 
Podophyllin, 703. 
Potassic Chlorate, 513. 
Potassic Nitrate, 512. 
Quinine, 801. 
Rhatany, 731. 
Rhus Toxicodendron, 755. 
Serpentaria, 865. 
Stimulants, 657. 
Stramonium, 841. 
Strychnia, 825. 
Sulphuric Acid, 477. 
Tar, 886. 

Tartar Emetic, 617. 
Turpentine Oleate, 882. 
Yeast, 912. 



Vomiting. 

Alcohol, 655. 
Ammonia Salts, 538. 
Ammonium Carbonate, 542. 
Apomorphia, 713, 714. ■ 
Arsenic, 608. 
Belladonna, 836. 
Blisters, 305. 
Bromides, 521, 531. 
Bryonia, 785. 
Calumba, 706. 
Carbolic Acid, 688-691. 
Carbonate of Ammonia, 542. 
Cerium Oxalate, 558 
Champagne. 
Chloroform, 680. 
Cinnamon, 861. 
Cloves, 778. 
Cocculus Indicus, 706. 
Conium, 786. 
Creasote, 691. 

Counter-irritation, 301-306. 
Emetics, 326. 
Horseradish, 728. 
Ice,_328. Sucked. 

Iodi, 472. The liquor, administered inter- 
nally, in 3-5 m. doses. 
Ipecacuanha, 804. 
Iris, 902. 
Koumiss, 915. 
Leeches, 927. 
Lobelia, 814. 
Magnesia, 561. 
Mercury, 584. 
Milk and Lime Water, 566. 
Morphia, 713, 714. 
Nutrient Enemata. 
Nux Vomica, 821. 
Opium, 722. 
Pepsin e, 916. 
Pulsatilla, 702. 
Sanguinaria, 725. 
Secale, 911. 
Serpentaria, 865. 
Silver Nitrate, 575. 
Strychnia, 825. 
Sulphites, 533. 
Sulphurous Acid, 477. 
Tartar Emetic, 617. 



Vomiting. 



Veratrum Yiride, 893. 
Zinc, 570. 

Vomiting of Pregnancy. 

Aconite, 701. 

Apomorphia, 713, 714. 

Arsenic, 608. 

Atropia, 838. 

Bismuth, 621. 

Bromide of Potassium, 329. 

Calumba, 706. 

Carbolic Acid, 688-691. 

Cerium Oxalate, 558. 

Champagne. 

Coffee, 804. 

Copper Sulphate, 573. 

Creasote, 691. 

Emetics, 323. 

Hydrocyanic Acid, 493. 

Iodine, 471. 

Tincture of Iodine, 469. 

Ipecacuanha, 804. 

Koumiss, 915. 

Morphia, 713, 714. 

Nux Vomica, 821. 

Pepsine, 916. 

Potassic Bromide, 521, 522. 

Pulsatilla, 702. 

Spinal Ice Bag. 

Staphisagria, 701. 

Strychnia, 825. 

Sulphate of Copper, 573. 



Warts. 



Antimonic Chloride, 619. 
Arsenious Acid, 611. 
Caustic Alkalies. 
Carbolic Acid, 688-691. 
Carbonate of Lime, 553. 
Chloral, 672. 
Chromic Acid, 486. 
Corrosive Sublimate. 
Creasote, 691. 
Dulcamara, 834. 
Magnesic Carbonate, 561. 
Mercuric Nitrate, 591. 
Nitric Acid, 480. 
Permanganate of Potash, 515. 
Phosphoric Acid, 483. 
Poultice, 402. 

Rhus Toxicodendron, 755. 
Rue, 747. 
Savine, 887. 
Silver Nitrate, 575. 
Sodic Carbonate, 526. 
Stavesacre, 701. 
Sulphur, 463. 

Wen. 

Baric Carbonate. 
Calcic Sulphide, 554. 
Carbonate of Lime, 553. 
Conium, 786. 
Extirpation. 
Plumbago, 595. 

Worms. 

Aconite, 701. 

Aloes, 890. 

Alum, 355. As an injection for thread-worms. 

Ammonium Chloride, 355. As an adjunct. 

Areca Nut, 355. For tape-worms. 

Azedarach, 746. 

Castor Oil, 355. 

Eucalyptol, 355. As an injection for thread- 
worms. 

Ferric Perchloride, 633. 

Filix Mas, 355. For tape-worms, 

Ignatia, 821. 

Iron, 355. As an injection for thread-worms, 
and as a tonic. 



1014 



INDEX OF DISEASES AND REMEDIES. 



Worms. 



Karaala, 355. For tape-worms. 

Kousso, 355. For tape-worms. 

Lard or Oil. 

Lime Water, 355. As an injection for thread- 
worms. 

Male Fern, 907. 

Pepo, 7S5. 

Quinia, 801. 

Quassia, 355. 
worms. 

Santonica, 355. 

Santonine, 355. 

Scarnmony, 355, 

Silver Nitrate, 575: 

Sodium Chloride, 355. As an injection for 
thread-worms, 355. 

Tannin, 355. As an injection for thread- 
worms. 

Tonics, 355. To prevent secretion of intesti- 
nal mucus. 

Turpentine, 355. For tape-wornis. 

Valerian, 805. 



As an injection for thread- 

For round-worms. 
For round-worms. 



Wouxds. 



Aconite, 701. 
Alcohol, 655. 
Aloes, 890. 
Arnica, 811. 
Asafcetida, 787. 
Balsam of Peru, 759. 
JBenzoin, 816. 
Blotting-paper. 
Boracic Acid, 311. 
Calendula, 812. 
Carbolic Acid, 688-691. 
Carbonic Acid, 487. 
Chloral, 672. 
Collodion, 735. 
Conium, 786. 
Eucalyptus, 781. 
Glycerine, 820. 
Hamamelis, 873. 
Heat, 185. 
Iodine, 471. 
Iodoform, 681. 
Lead Dressings, 596. 



Wounds. 



Nitrate of Silver, 575. 

Nitric Acid, 480. 

Opium, 722. 

Petroleum, 647. 

Permanganate of Potassa, 515 

Potassic Chloride, 513. 

Poultices, 402. 

Salicylic Acid, 693. 

Sodium Chloride, 524 

Sugar, 906. 

Sulphurous Acid, 477. 

Tannin, 875. 

Turkish Baths, 404. 

Turpentine, 882. 

Zinc Sulphate and Chloride, 570. 

Yellow Fever. 

Aconite, 701. 
Arsenic, 608. 
Belladonna, 836. 
Byronia, 785. 
Calomel, 588. 
Camphor, 862. 
Cantharides, 926. 
Capsicum, 835. 
Charcoal, 459, 460. 
Chlorate of Potash, 513. 
Chlorodyne. 
Cimicifuga, 703. 
Gelsemium, 827. 
Iodide of Potassium, 518. 
Ipecacuanha, 804. 
Lead Acetate, 597. 
Liquor Calcis, 550. 
Mercury, 584. 
Nitrate of Silver, 575. 
Nux Vomica, 821. 
Quinine, 801. 
Salicylic Acid, 693. 
SodaBenzoate, 531. 
Stimulants, 656. 
Sulphur Baths. 
Tannic Acid, 875. 
Tartar Emetic, 617. 
Turpentine, S82. 
Vegetable Charcoal, 460. 
Veratrum Viride, 893. 



£ per cent, solution. 



BIBLIOGRAPHICAL INDEX. 



Acids. 



Bertram, Z. f. Biol., xiv., p. 55S. 

Bobrik, Konigsberger Diss., 1863. 

Brunton and Cash, Phil. Trans., Pt. i., 18S4, 

p. 231. 
Buchheini, Arch. f. pbysiol. Heilk., 1857, p. 

122; Pfl tiger's Arch., Bd. xii., 1876. 
Cvon, Arch. f. Anat. u. Physiol., 1866, p. 416. 
E'delfsen, Centralbl. f. d. med. Wiss., 1S78, p. 

513 (Phosphoric acid). 
Elsiisser, Die Magenerweickung d. Sauglinge, 

1S46. 
Feitelberg, Dorpat. Diss., 1883. 
Gahtgens, Centralbl. f. d. med. Wiss., 1872, 

vol. x., p. 833. 
Gamgee, Centralbl. f. d. med. Wiss., 1879, p. 

253 (different kinds of Phosphoric acid). 
Gaskell, Journ. of Physiol., vol. iv., p. 48. 
Goltz, Virch. Arch,, Bel. xxvi., p. 1. 
Heiss, Zeitschr. f. Biologie, 1876, Bd. xii., p. 

151. 
Hermann, Toxicolog., 1874, p. 160. 
Hertwig, Thierheilkunde. 
Hofbauer, Bossback's Pharmacol. Unters., 

Bd. iii. 
Hofmann, Zeitschr. f. Biologie, 1871, Bd. vii., 

p. 338. 
Hoppener, Dorpat. Diss., 1863. 
Kobert, Schmidt's Jahrb., Bd. elxxix., p. 225. 
Koch, Zeitschr. f. rat. Medicin, 3B.Bd.xxiv., 

p. 264. 
Kiihne, Unters. lib. d. Protoplasma, Leipzig, 

1864. 
Kurtz, Joh., Alkalientzieh. a. d. Thierk. 

Dorpat. Diss., 1S74; u. Centralb. f. d. medi- 
cin. Wiss., 1S74, vol. xii., p. 569. 
Lassar, O., Pfliiger's .Arch., 1874, vol. ix.,p.44. 
Levden u. Muhk, Virch. Arch., Bd. xxii., p. 

237. 
Malv, Liebig's Annal., Bd. clxxiii., p. 227, 

1874. 
Meissener, G., Zeitschr. f. rat. Med., 3 B. Bd. 

xxiv., p. 97. 
Miquel, Arch. f. physiol. Heilk., 1851, p. 479. 
Orisum, Arch. f. path. Anat,, Bd. xxviii. 
Piotrowski, Dorpat. Diss., 1856. 
Quincke, Corr. Blatt f. Schweizer Herzte, iv., 

No. 1, 1874. 
Salkowski, Yirch. Arch., Bd. lviii., p. 460. 
Sieber, N. Journ. f. pract. Chemie, N. F., Bd. 

xix., 1879, p. 433 (Antiseptic action). 
Strassburg, Pfliiger's Arch., Bd. iv., p. 454. 
Striibing, A., f. exp. Path. u. Pharm., Bd. vi., 

266 (Phosphoric acid). 
Szabo, Z., f. physiol. Chern., i., p. 140 (com- 
plete literature of the acids in gastric 
. juice). 

Trachtenberg, Dorp. Diss., 1861. 
Walter, Arch. f. exp. Path. u. Pharm., 1877, 

p. 148. 
Ziilzer, Yirch. Arch., Bd. lxvi., pp. 223 and 

282 (Phosphoric acid). 



ACONITINE. 

Achscharumoff, Keichert u. Du Bois's Archiv., 
1866, p. 255 ; Schmidt's Jahrb., cxxxvi., p. 
157, 1S67. 



ACOXITIXE. 

Berthemot, Pharmaz. Centralbl., 1837, p. 733. 
Bohm u. Ewers, Arch. f. exp. Path. u. Pharm., 

Bd. iii., p. 385. 
Bohm und Wartmann, Yerh. d. physik med. 

Ges. in Wiirtzburg, N. F., Bd. iii. 
Brodie, Phil. Trans., 1811, p. 178. 
Coulson, Schmidt's Jahrb., xix., 285. 
Cramoisy, E. P., Paris, J. B. Bailliere et fils, 

p. 30, 1S65. 
Debout & Gubler, Schmidt's Jahrb., cxxv., 

p. 19, 1864. 
Dyce Duckworth, Brit. Med. Journ., vol. i., 

p. 224, 1861 ; Schmidt's Jahrb., cxi., p. 23, 

1861. 
Ferrand de l'Aconit. Lyon, Chauvine, 1861. 
Fleming, An Inquiry into the Phys. and 

Medicinal Properties of the Aconitum 

napellus. Edinb., 1S45. 
Fothersdll, Digitalis, London, 1871, p. 6. 
FristedTt., Norcl. Med. Ark. iii., 3, No. 18, p. 38, 

1871. 
Geiger, Hesse, Brandes Pharmaz. Centralbl., 

1835, p. 85. 
Grehant & Duquesnel, Bull. gen. de Therap., 

Aug., 1871, p. 492. 
Gubler, Bull. gen. de Therap., lxvi.. p. 3S5, 

May, 1S64. 
Hahn, Essai sur l'Aconit, Strasbourg, 1863. 
Harley, St. Thomas' Hosp. Beports, v., p. 149. 
Hottot et Debout, Bull. Ther., lxvi., p. 360, 

Ap., 1864. 
Janus, Corn, de Man. Spec. Medic, inaug. de 

Aconito Lugd. Batav., 1841, Svo., p. 68. 
Lewin, Prager Yierteljahrs, Bd. cxxxL.p. 20. 
Liegeois & Hottot, Journ. de Phvsiol., iv., p. 

520, Oct., 1861 : Schmidt's Jahrb., cxiv., p. 

291,1862; Bull.de Therap., Paris, lxv., p. 

20S, 1863. 
Mackenzie & A. Guillaud, Arch. d. Phvsiol., 

1875, p. 766. 
Mackenzie, G. H, London Practitioner, xx., 

p. 100. 
Maninii, Dell' Aconito Napello, Keggio, 1S66, 

p. 30. 
Nunneley, F. B., Proceed, of the Eoyal So- 
ciety, vol. xviii., p. 46, 1870. 
Orfila'on Poisons (translated by Waller), 7th 

ed., vol.ii., p. 46. 
Pereira, Elements of Mat, Med., 4th ed., ii., 

pt. ii., p. 684. 
Praag, L. von, Yirchow's Archiv., Bd. vii., 

43S-47S, 1854. 
Einger, S. & W., Murrell, Joarn. of Phvs., i., 

p. 232, Nos. 4, 5. 
Schroff, von, sen., Prager Yierteljahrs, xlii., 

p. 129, 1854 ; Oest Med. Jahrb., xvii., p. 57, 

1861 ; Schm. Jahrb., cxii., 15, 1861. 
Schulz, Marburger Diss., 1846. 
Simon u. Sobernheim, Handb. d. Tox., p. 60. 
Skey, Froriep's Not., ii., 80, 1S37 ; Schmidt's 

Jahrb., xvii., p. 306. 
Soubeiran, Schmidt's Jahrb., xix., p. 285. 
Turnbull, on the Preparations and Medical 

Properties of the Natural Order Banuncu- 

lacea?, London, 1S35 ; Froriep's Not., L, 302, 

ii., 252, 1837 ; Schmidt's Jahrb., xix., 285. 
Weyland, Eckhard's Beitr., v. 1, p. 29. 
Wibrner, Wirkungen, i., p. 33. 



(1015; 



1016 



BIBLIOGRAPHICAL IKDEX. 



Alcohol. 

Anstie, Stimulants and Narcotics, London, 
1864; Lond. Practitioner, viii., p. 148, Mar., 
1S72. July, 1S74; Lond. Med. Review, 1S62; 
reprint, Lancet, ii., Sep. 11, 1865; p. 343. 

Baudot, E.,L'Union Medicale, 1863. 

Becharop, London Lancet, 1S73, vol. i., p. S46. 

Bernard, CI., Lecons sur les Effets des Sub- 
stances toxiques, Paris, p. 397 ; Gaz. Med. 
de Paris, 1S56, p. 295. 

Binz, Virchow's Archiv, 1871, iv., p. 529, Bd. 
liii., Berl. Klin. Woch., xi., 11, p. 129, 1874- 
1876, p. 54; Archiv fiir exp. P. u. Ph., vi., 
287. 

Blair, Glasgow, Med. Journ.,Feb., 1870, p. 204. 

Boeck, v., Unters. iib. d. Zersetz. d. Eiweiss., 
Mimchen, 1871. 

Boeck, v., u. Bauer, Zeitschrift f. Biol., Bd. x., 
p. 361. 

Boeker, Beitr. z. Heilkde., i.. p. 247, 1849. 

Bonwetsch, Dorpat. Diss., 1S69, p. 39. 

Bouvier, Cuny, Pfliiger's Arch., Bd.ii.,p. 370; 
Wirk. der Alcohol auf d. Korpertempera- 
tur, Bonn, 1869 : Centralb. f. d. med. W., 
vol. ix., p. 807, 1871. 

Brodie, Phil. Trans., Lond., 1811, p. 17S. 

Brunton, Lauder, Book of Health, Cassell & 
Co., p. 183. Practitioner, xvi., p. 56; Con- 
temporary Beview, xxxiii., p. 691. 

Carpenter, Alcohol in Health and Disease, 
Lond., 1851, 2d ed. 

Clemens, Theodor, of Frankfort, Deutsche 
Klinik, 1874, 1875. 

Daub, P., Centralb. f. d. med. Wiss., 1873, p. 
466. 

Davies, N. S., Trans, of the American Med. 
Assoc, 1S55; Diction. Ency eloped. , ii. Al- 
cohol, p. 582. 

Dogiel, J., Pfliiger's Arch., 1874, Bd. viii. 

Dupre.The Doctor, Feb. 1, 1873; Lond. Prac- 
titioner, vol. viii., 148, ix., 1872, p. 28, vol. 
xiii., p. 15. 

Edes, B. D., Bost. Med. & Surg. Journ., 1872, 
vol. lxxxvi. 

Flourens, Svsteme Nerveux. Paris, 1842, p. 
400. 

Fokker. Xederlandsch. Tijdschrift vor Ge- 
neeskunde, 1871. 

Fontana, Berlin, 1787, p. 439. 

Ford, N. Y. Med. Journ., Jan., 1872. 

Giacomini, Traite Philos. de Mat. Med. et 
Therap. Paris, 1842. 

Hammond, Phys. Memoirs, Philadelphia, 
1863; Amer. Journ. Med. Sci., Oct., 1856, p. 
305. 

Horwatb, Gaz. des Hopitaux, Sept., 1878. 

Huss, Magnus, Chron. Alkoholkrankh., 
Stockholm, 1852. 

Leuret & Lassaigne, Paris, 1825, p. 200. 

Leudet, Arch. Gcn.de Med., Jan., 1867, vol. 
ix.. pp. 5-39. 

Lichtenfels u. Frohlicb, Denkschr. d. k. k. 
Acad. d. W. in Wien, 1852; Math. Nat. CI., 
Bd. iii., 113. 

Lieben, .\., Ann. d. Chemie u. Pbarm., 1870, 
ii.: Buppl. Bd., p. 236. 

Ludger, Lallemand, Perrin, Duroy, Paris, 
I860, p. 42 1, Chameret edit. 

Magendie, Precis l Lem. de Phys., Paris, 1825. 

Ma-nan, de I'Alcoolisme, Paris, 1874: Gaz. 
Mfed. de Paris, x,,. xl., p. 444, 1871. 

Man asseiD, Centralb. f. a. Med. Wiss.. ix., p. 
689, 1871. 

Marvaud, Paris, Bailliere et fils, Ire ed., 1871, 
I». B9, 169. 

Meihulzen, Arch. d. Ges. Phys.. vii., 4 u. 5, 
1). 201, l-::;. 

Obernier, Pflttger'e Arch., Pd. ii., p. 494. 

Orfila, Tox. Gen., 1818. 

Parkea u. Wollowicz, I 'ion (.'(lings of the 
Royal Society, i s 7<i. 

Percy. Exp. Inquiry on Alcohol in Ventricles 
of Brain, Lond., 1889. 

Perrin, Arch. Generates, 6th series, tome ix. 

Babow, Berl. klin Wocheoschrift, L871,p.257. 

Rabuteaa, TUnlOD M fid. ,1870, pp.154 ana 165. 



Alcohol. 

Bajewsky, Leber das Yorkommen vom Alco- 
hol im Organismus. Pfliiger's Arch. Bd. 
xi., p. 122. 

Riegel, F., Deutsch. Arch, fiir Klin. Med., 
1873. 

Binger and Bickards, London Lancet, 1866, 
vol. i., p. 208. 

Buge, P., Virch. Arch., Bd. xlix., p. 252. 

Sehulinus, Unters iiber die Yertheilung des 
Weingeistes, im Thier Organismus, Diss. 
Dorpat., 1865; Arch. Heilk., 1866, p. 97. 

Smith, E., Brit. Med. Journ., March, 1859, 
255. 

Strauch, Dorpater Diss., 1852. 

Subbotin, Phys. Bedeutung des Alcohols, Z. 
f. Biol., vii., 361 ; Schmidt's Jahrb., 1872, Bd. 
cliv., p. 261. 

Suessarott, Phila. Med. Times, vol. iv., p. 774. 

Sulzynski. Dorpat. Disser., 1865. 

Thudichuin & Dupre, Tenth Report of Med. 
Officer of the Privy Council, London, 1S68. 

Yoit, Zeitschr. f. Biologie, Bd. vii., p. 341. 

Wibmer, Wirk. d. Arzn. u. Gifte, i., 90. 

Complete List of Literature on Alcohol, given 
in the Index Catalogue of the Surgeon- 
General's Library, U. S. Army, vol. i. 

Alkalies. 

Aubert, Z. f. rat. Med., 1S52. p. 225. 
Aubertund Dehn, Pfliiger's Arch., 1S74, Bd. 

ix., p. 115. 
Bernard, CI. u. Graudeau, Journal de l'Anat- 

omie et de Phvsiol., Bd. i., p. 378. 
Bischoff, Zeitschr. f. Biologie, Bd. iii., p. 309. 
Blake, Edinburgh Med. & Surg. Journal, 1838. 
Bohni, A. f. exp. P. u. Ph., viii., p. 68. 
Bouchardat, du Diabete Sucre, Paris, 1852. 
Boussingault, Ann. de Ch. et Phys., Bd. 

xix., p. 117 ; xx., p. 113, xxii.,p. 116. 
Buchheim, Yierordt's Arch. f. Phys. Heilk., 

1853, liv., Iv., lvii.; Arch. f. exp. P. und 

Pharm., Bd. iii., p. 252. 
Bence, Jones, Lect. on Application of Chem. 

and Mechan. to Path, and Therap. Lond., 

Churchill & Sons, 1867, pp. 41, 70, 107, 125; 

Pfltig. Arch., iv., p. 235, 1871. 
Bernard, C, Lecons de Physiol, experiment, 

torn, ii., p. 404. 
Brunton, Lauder. The Praclitioner, London, 

1874, No. 71 & 72, p. 342 and 403, vol. xii. 
Bunge, Z. f. Biologie, 1873, p. 104, and 1874, 

p. ill, Bd. ix. and x. 
Durand-Fardel, Lettres Med. sur Yichy, 

Paris, 1855. 
Falck, Arch. f. Path. Anat., Bd. lvi. 
Forster, Z. f. Biologie, Bd. ix., p. 207. 
Forster, B. Arch. d. Heilk., v. 521, 1864. 
Grandeau et Bernard, L'Institut, 1863, No. 

1555. 
Guttmann, Berl. klin. Wochenschrift, 1S65, 

Nos. 34-36; Virch. Arch., xxxv. 
Heubel, Wirk. wasseranziehender Stoffe auf 

die Linse, Pfliiger's Arch., Pd. xx., p. 114. 
Hirtz, Nou. Die. <lc Med., toin. i. A., p. 594. 
Hoffmann, F. Zeits. f. Biol , vii., p. 338. 
Hoppe-Seyler, .Med. Chem. Unters.; and his 

pu])ils, Sertoli, Kaupp; Arch. f. Phys. 

Heilk., 1S55. 
Kemxnerich, Pfliiger's Archiv, 1869, p. 49. 
Klein u.Yerson, Sitzungsber.d. AVien. Akad., 

Pd. Iv., p. 627. 
Kohler, H. Ccntralbl. f. d. med. Wiss ,1877; 

vol. xv., No. :!S, }>. 673. 
Liebig, V. Ann. d. ("hem. u. Pharm., lx.wii., 

p. 25. 
L&fller, (Saltpeter), Schmidt's Jahrb., IMS Bd. 

Ix. p. 18. 
Loniikowsky, Berl. klin. Woch., 1ST.;, p. 175. 
Magendie, I oion M6d., 1852, p. 198. 
Marchand, Virchow's Arch., lid. lxxvii., 

1879. 
Mauricet, Schmidt's Jahrb., cxviii., 18, i 
Merandon, Act. Phys. des Sels de Potasse, 

These de Paris. 1868. 



BIBLIOGRAPHICAL INDEX. 



1017 



Alkalies. 

Mialhe, Cliimie Applique, Paris, 1S56, p. 5S ; 

Bull. Therap., lxxxiv., p. 154, 2S Feb., 1873. 
Nasse, H. "Wagner's Handworterbuch der 

Phys., i., p. 167 (Blut.) 
Podoeopaw, A T irch. Arch., xxxiii., 505. 
Eanke, F., Eeichert's u. Du Bois-Beyrnond's 

Arch., 1864, p. 320. 
Eabuteau, Gaz. Hebdom., 1871, 43, 46, 48. 
Billiet, Arch. Geo. de Med., iv., 35, 1S48. 
Bohrig, Arch. f. wissensch. Heilk., vi., 3, 4, p. 

396, 1863. 
Salkowski, Arch. f. Path. Anat., Bd. liii. ; 

Centralol. Med. Wiss., xi., 1873, p. 774. 
Schmidt, Al. u. Aronstein, Pfliiger's Archiv., 

Bd. viii., p. 75. 
Setschenow, Centralbl. f. d. med. W., 1873, p. 

355. 
Sertiirner, Ann. f. d. Universal System d. 

Elements, Jahrg., 1826. 
Tilt, Lancet, i., 1861, p. 556, June. 
Traube, Berl. Klin. Wochenschrift, 1864, p. 18. 
Trousseau, Clin. Med. de l'Hotel Dieu., Paris, 

1861. 
Trousseau and Pidoux, Traite de Therap., 

Paris, Asselin, 1868, Se ed., p. 420. 
Voit, Unters. lib. d. Einflus. d. Kochs. auf die 

Stoffweehsel, Miinchen, 1S60; unci Ber. d. 

Miinchen, Acad., 1S69. 
Voit, Z. f. Biol., Bd. i., p. 195 (Glaubersalz, 

StofiVechsel). 
Yoit und Bauer, Zeitschrift f. Biol., 1869, Bd. 

v., p. 536. 
Zuntz, Pfltig. Arch., i., p. 361. 

Alkaline Earths. 

Bence-Jones, Chem. Soc. Quart. Journ., xv. 

Beneke, Pathologie des Stoffwechsels, 1876. 

Boussingault, Ann. d. Chem. u. Pharm. lix., 
(Phosphors, alk. Erden). 

Chossat, Gaz. Med. de Paris, 1842 (Phos- 
phates). 

Diakonow, Centralbl. f. d. med. W., 1S67, vol. 
v., p. 673. 

Dussart, Beneke, & Feissier, Arch. Gen., 6e 
ser. tome xiv., p. 670, xv., pp. 66 and 198. 

Neubauer u. Vogel, on Urine, etc., 1863. 

Piorrv, Journal de Chem. Med., tome ix., 
1863". 

Eoloff, Virchow's Arch., Bd. xlvi., p. 305. 

W f eiske, Zeitschrift, f. Biol., Bd. vii., p. 333. 

Zalesky in Hoppe-Seyler's Med. Chem. Unters. 

Alkaloids. 

Heger, Journ. d. med. Chir. et. Pharm. de 
Bruxelles, 1879 (Sur 1'Absorption des Alca- 
loides dans la Foie, les Poumons et les 
Muscles). 

Eossbach, Verh. d. Wiirzb. phvsiol. med. Ges. 
N.F., Bd. v., l, vi., 162. u. 190, vii., 20; Pflii- 
ger's Arch., x., 438. xxi. 1 (Antagonism) ; 
A'erhandlung d. Wiirzb. phvsiol. med. Ges. 
N. F., Bd. iii., 346, 1872, Bd. Vi., p. 162, 1874 ; 
Pfliiger's Arch., xxi., 213, 1880. 

Aloes, vide Purgatives. 

Buchheim, Die scharfen Stoffe, p. 27. 
Barker, Fordyce, American Practitioner, 1872. 
Gerhard, North American Med. and Surg. 

Journ. 
Groves, Pharm. Journ., xvi. 
Husemann, Pflanzenstoffe, p. 1047. 
Lienau, Oldenb. Corresp. Blatt, 9, 10, 1861. 
Smith, T. and H., Chem. Gaz. 1851, 107. 
Stille, Therapeutics, vol. ii., p. 444. 
Trousseau and Pidoux. 

Alum. 

Barthez, Frank's Magazin, iii. 

Blanc. l'Union, 117, 120, 1873. 

Gamgee, Schmidt's Jahrb.,cli., p. 23, 1871. 



Alum. 



Homolle, Paris, Malteste, 1861, p. 125 ; l'Union, 

15, 17, 1861. 
Mitscherlich, Lehrb. d. Arzneimittellehre, 

1847. 
Paulier, Gaz. Hebd. (2), x., p. 717, 1873. 
Eosenstirn in Eossbach's Pharmakolog. 

Unters, 1874, Bd. ii., p. 78. 
Schreber, Jahrb. f. Kinderheilk., iii., 2, p. 138, 

1860. 
Smith, Curtis, Phila. Med. and Surg. Eeport., 

xxiv., p. 409. 

Ammoniacal Salts. 

Barclay, Med. Times & Gaz., ^ov., 1853, p. 

553. 
Bellini, Lo Sperimentale, 1S72, Giugno, 561. 
Bence-Jones, Philos. Trans., London, 1851, p. 

399. 
Bichlmayr, Z. fur Biol., 1867, 381. 
Billroth, Arch. f. Klin. Chirurg., Bd. vi., p. 

421. 
Blake, St. George's Hosp. Eep., v., p. 73, 1S70. 
Bohm u. Lange., A. f. exp. P. u. Pharm., ii., 

s. 364 ; und Dorpater Diss., 1874. 
Cazenave, Bull. Gen. de Therap., xxxi., 70. 
Cholmelev, St. Andrew's Med. Grad. Assoc'n. 

Trans., iii., 102, 1870. 
Fayrer, Indian Annals of Med. -Science, 1872. 
Delioux, Bull, de l'Acad., xxxv., No. 23, 15 

Dec. 1870, p. 883. 
Feder, Z. f. Biol., xiii., p. 256. 
Feltz, V., and E. Bitter, Journ. d'Anatomie et 

de la Physiol., 1874, p. 326. 
Funke u. Deahna., Pfliiger's Arch., 1874, ix., 

p. 416. 
Gmelin, Apparatus Medicamin., ii., 1, 48. 
Halford, G. B., Melbourne Argus, 1872. 
Hallervorden, A. f. Exp. P. u. Pharm., x.,p. 

125. 
Huxham, On Fevers, p. 299. 
Knieriem, von, Zeitschr. f. Biol., 1874, Bd. x., 

p. 263. 
Knoll, Wein. Acad. Sitzber., 1874, Bd. lxviii. 
Kiihne u. Strauch, Centralbl. Med. Wiss., 1864, 

No. 36, pp. 561, 577. 
Lange, F., Arch. f. Exp. Path. u. Pharm., Bd. 

ii., p. 368. 
Maurecet, Schmidt's Jahrb., clxviii., p. 18, 

1863. 
Mitscherlich, Zeits. des Preuss. Vereins f. 

Heilk., Nos. 43, 44, 45, 46, 1841 ; Lehrb. der 

Arznei., ii. 228. 
Munk, Zeitschr. f. phvsiol. Chem., ii., p. 29. 
Priestlv, On Air, ii., p. 369, 1790. 
Salkovrski, Zeitsch. f. phys. Chem., Bd. i., pp. 

iv., 1, 374. 
Eabuteau, Gaz. Hebd .,43, 46, 48, 1871; Comptes 

Bend., lxx., 25, p. 1356, 1870. 
Schiffer, Berl. Klin. Wochenschr., 1872. 
Schmiedeberg, A. f. Exp. P. u. Pharm., viii., 

p. 1. 
Stevenson, Guy's Hosp. Eep., 3d ser., xvii., 225, 

1872. 
Thirv, Henle u. Pfeufer's Zeits. (3), xvii., p. 

166, 1864. 
Trousseau & Pidoux, Traite, 9th ed. 1, p. 453. 
Walter, A. f. Exp. P. u. Pharm., vii., p. 148, u. 

W T ibmer, Wirk. d. Arzneim. u. Gifie, Mu- 
nich, 1831, pp. 123, 127, 139, 144. 

Aniline. 

Bergmann. Prager Yierteljahrsschr., Bd. 

lxxxviii., p. 109, 1S65. 
Feltz, u. Bitter, Compt. Eend.,lxxxii.,p.l512, 

1S76. 
Schuchhardt, Virch. Arch., Bd. xx., p. 446. 

Antimony. 

Ackermann, Virch. Arch., Bd. xxv., 1862, p. 
531; Eostock, 1S56 (Ader) iv.,p. 44; Henle 
u. Pfeufer's Zeits. f. ration. Med., 3, E. ii., 
Heft. 3, 1S58. 



1018 



BIBLIOGRAPHICAL IKDEX. 



Antimony. 

Balfour, Tartar Emetic in Fever, Inflara., 

Asthma, etc., Lond., 1818. 
Buchheim u. Eisenmenger,Eckhardt's Beitr., 

Bd. v. 
Brinton, Todd's Cyclop, of Anat. and Physiol. 

Suppl., p. 319. 
Bocker, Beitr. z. Heilk., ii., p. 234, 1849. 
Corput.van den, Journ. med.de Brux,xxxv, 

p. 491, Nov., 1863. 
Denny, Brit. Med. Journ., Jan. 28, 89, 1871. 
Daffin, Edin. Med. & Surg. Journ., xix., 3, p. 

354, 1823. 
Eisenmenger, U. d. Einfl. Gifte a. d. Zuck- 

ungscurved. Frosches Muskeln, iv., Giessen, 

1869, p. 7. 
Forget, Bull. gen. de Therap, lviii., June, 

1860, p. 481. 
Fonssagrives, Bull. gen. de Therap., lvii., 

Aug., 1859, p. 145. 
Gianuzzi, Centralbl. med. Wiss., 1865, p. 129. 
Grimm, Pfliig. Arch., iv., p. 205. 
Jankowich, Oesterr. Jahrb. N. F.,xxxviii., p. 

53, 1842. 
Jones, Handfield, Med. Times & Gaz., Dec, 

1852, p. 362. 
Koschlakoff u. Bogomoloff, Centralbl. med. 

Wiss., 1868, p. 628 ; Pfliiger's Arch., v., p. 

2S0, 1872. 
Kleiman u. Simonowitsch, Arch. f. d. ges. 

Phvsiol., Bd. v., p. 280. 
Lange, D., Klinik, 28, 30, 31, 1863; Schmidt's 

Jahrb., cxxiii., 283, 1864. 
Lepelletier, Paris, 1835, p. 171. 
Long, Bull. gen. de Therap., lix., Oct., 1860, p. 

317. 
Magendie, Paris, 1813. 
Mayerhofer, Heller's Arch., iii., 3-5, p. 356, 

1846. 
Mosso, Schmidt's Jahrb., Bd. clxix., p. 236. 
Nobiling, Zeits. f. Biol., Bd. iv., p. 40, 1868; 

Schmidt's Jahrb., cxl., 24. 
Orfila, Memoires de 1' Acad. roy. de Med. viii., 

1840, p. 509. 
Papillaud, Schmidt's Jahrb., clvi., p. 267, 1872. 
Pecholier, Comptes Bend., lvi., 1863, p. 718; 

Gaz. Hebd., 17 Ap., 1863, p. 275. 
Basori, Milano, 1830; Arch. gen. de Med., 

1824, iv., pp. 300, 415. 
Bayer & Bonnet, Diet, de Med. et de Chir., 

iii., 69, Paris, 1829. 
Badziejewski, Arch. f. Anat. u. Physiol., 1871, 

p. 472. 
Bichardson, Med. Times and Gaz., May, 1856, 

]). 473. 
Saikowski,Yirch. Arch., xxxiv., p. 73. 
Solon, Martin, Memoires de 1'Acad. roy. de 

.Med., viii., 1S40, p. 518. 
Stedmann, Med. Times & Gaz., Dec, 1852,641. 
Tavlor, Ouy's Hosp. Bep, 1860, p. 397. 
Traube, Centralbl. med. Wiss., 1864, p. 490. 
Trousseau &. Pidoux, Traite de Therap., et de 

Mat. Med., 9e ed., 1870, ii., p. 954. 
Vibore and Hertwig quoted by Wibmer, 

Wirk. d. Arzneim. u. Gifte, v., 187, 194. 
Witt, .1. II. I), de, Groningae apud Wilkens, 

8, 1847, p. 32. 
Wood, Phila, Med. Times, vol. iii. 

Apiol. 

( rallico ii. Poggeschi, Bull. gen. Therap., 1861, 

ii., ]). 279. 
.lor.i, Bull. Therap.. Feb., 1860, lix., p. 97. 
Jorel a Homolle, Jours, de Pharm. et de 

Chim. 8e Ber., i w iii., 212. 
Marotti, Hull. Therap., lxv., pp. 295 and 341, 

1868, Gaz. Eebd. 45. 

Apomorphia. 

Bourgeois. These de Paris, 1874, No. 19, Bull. 

-ii de Th6rap., lxxxvi., p. 286, 1874. 
Chouppe, Boc. <U: Biol.,18 july,1874, Arch, de 

Physiol., 1-7."), j.. 101. 
David, G.,Gaz. mod., 1874, \>. 165. 



Apomorphia. 

Dujardin-Beaumetz, Bull. gen. de Therap., 

lxxxvii., Oct. 8, 1874, p. 345. 
Eichberg, Wurtemberg, Corr. Bl. S9, p. 1819- 

1873. 
Fronmiiller, Memorabil., xviii., 9, 1S73. 
jGanghofner, Bohn. Corrs. Blat., i., 3. p. 65, 

1873. 
Gee, St. Barth. Hosp. Reports, vol. v., p. 215, 

Trans. Clin. Soc, ii., p. 166, 1870. 
Gellhorn, Allgem. Ztschr. f. Psych, xxx., 46, 

1873. 
Greve, Berl. Klin. Wochens., xi., 28, 29, 1874. 
Harnack, Arch. f. exp. Path. u. Pharm., Bd. 

ii., p. 291, 1874. 
Huchard, H., Union med., Oct. 1874, p. 493. 
Juratsz's, Centralbl. f. d. med. Wiss., p. 499, 

1874. 
Lob, Berlin, Klin. Wochens, 1872. p. 400. 
Mattheissen, B. & C. B. A. Wright, Proceed- 
ings Boy. Soc, xvii., 455. 
Mayer, E. L., Berichte Deutsch. Chem. Ges., 

Berlin, 1871, iv., 121. 
Meyer, De, Bull, de la Soc. roy. de Pharm. de 

Bruxelles, 1872. 
Moller, Bull, de l'Acad. de Med. de Belgique, 

viii., 3, 1873, p. 749. 
Moerz, A. Prager Vierteljahr, 1872, Bd. cxv., 

p. 82. 
Oberlin, Bevue. Med. de l'Est, Aug., 1874, ii., 

p. 98. 
Onsum, Norsk. Mag., 3 B. iii., 155, 1S72. 
Quehl, Hallenser Diss., 1872. 
Pierce, British Medical Journ., 1870, vol i., p. 

204. 
Biegel u. Boehm, Deutsch. Arch. f. Klin. 

Medicin, Bd. ix.,211, 239, 1871. 
Bouty, These de Paris, 1874, No. 437. 
Siebert u. Boehm, Arch. d. Heilk., Bd. xii., 6. 

Heft, 1871, p. 522. 
Wertner, M., Wien. Med. Presse, 1876, 269. 
Ziolkowski, Apomorphin. Inaug. Diss. Greifs- 

wald, 1872. 

Araroba or Chrysaroba. 

Fayrer, Med. Times, ii., 1874, pp. 470, 547, 

1876 ; ii. p. 711. 
Thompson, I. Ashburton, British Med. Jour., 

May, p. 607, 1877. 



Arnica. 



p. SS5, Dec 



Balding, C. C, Lancet, vol. 

1870. 

Fayrer, Practitioner, xvi., p. 52. 
White, Boston Med. and Surg. Journ., Jan., 

1875, p. 61. 

Aromatic Compounds. 

Baumann u. Herter, Z. f. physiol. Chem., i., 

244, ii., 335. 
Brieger, A. f. Anat. u. Phys., 1S79, Physiol. 

Abth. Suppl. Bd. s.61 (Pyrocatechin,Hydro- 

chinon, Besorcin). 

Arsenic. 

Bin/, u. Sehulz, Arch. f.Exp. Path. u. Pharm., 

Bd. xi., p. 200. 
Bergeron and Lemaitro, Brit. & For. Med. 

Chir. Beview, vol. xlviii., j). 226, 1871. 
Blake, Edin. Med. and Surg. Jour., 1889. 
Boeck, Von, Zeitschr. f. Biol., Bd. vii.. p. us, 

u. xii., p. 512; u. Centralbl. d. Med. Wiss, 

1876, Ub. d. Zersetzung des Kiweisses, Miin- 
chen, ' ■. Bimmer, 1871, p. 11. 

Bohin u. Sch&fer, lib. den Einfluasdes Arson 
auf. Ungeform. Fermente,Wurtzbnrg Ver- 
nandlgen. N. F, Hd. iii., 1872. 

I'.rodie, Phil. Trans, 1811, 1812. 

[Jnterberger, Arch. f. exp. P. u. Pharm, Bd. 
xi, j). 89. 



BIBLIOGRAPHICAL INDEX. 



1019 



Arsenic. 

Cunze, Henle u. Pfeufer's Ztschr. f. rat. 

Med., 3,xxviii., p. 33, 1866, Schmidt's Jahrb., 

cxxxi., 19. 
Downie, K. M., Indian Medical Journ, 1872. 
D'Etiolles, Leroy, Gaz. Hebd., 1857, vol. iv. 
Fleck, Arch. f. Biologie, Bd. viii., p. 444. 
Flandin aDd Danger, Hausemann, Toxicolo- 



gic, p. 823. 
okl 



Fokker, Schmidt's Jahrb., clviii., 15. 
Fowler, Med. Rep. on Arsenic in Ague, etc., 

Lond. 1786. 
Gaethgens, Arch. f. exp. P. u. Pharm., Bd. v., 

p. 128 u. Centralbl. f. med. W., 1876. 
Gies, Arch. f. exp. Path. u. Pharm., Bd. viii., 

p. 175. 
Grohe, Fr. and Fr. Mosler, Virch. Arch., Bd. 

xxxiv., p. 213. 
Herapath, Philosophical Mag., 1851, p. 345. 
Heisch, Chas., Pharmaceutical Journ. and 

Trans., vol. i., 2d series, 1859, 1860, p. 556. 
Hoffman, Virch. Arch., Bd. 1. (50), p. 456. 
Imbert-Gourbeyre, Histoire des Eruptions 

arsenicales, Monit. des Hopit, 1857. 
Jager, Wirk. d. Arseniks auf Pflanzen, Stutt- 
gart, Schweizerbart, 1864, p. 113. 
Johanosohn, Arch. f. exp. P. u. Pharm., Bd. 

ii., p. 106. 
Jackson, .W. C, Amer. Journ. of the Med. 

Sciences, July, 1858, p. 57. 
Karajau, Tardieu, Sur l'empoisonnement, p. 

335. 
Kendall and Edwards, London Pharmaceuti- 
cal Journal, ix., 1850. 
Kohler, H., of Halle, Brit, and Foreign Med. 

Chir. Rev., 1870, vol. xlv., p. 538. 
Kossell and Gaethgens, Arch. exp. Path, et 

Pharm. Bd. v., 133, and Centralbl. Med. 

Wiss., 1875, 530, 1876, 833. 
Lachese, Ann. d'Hyg. et de Med. legale, 1837, 

le serie, tome xvii., page 334. 
Lesser, A., Virch. Arch., Bd. lxxiii., p. 398, 

and lxxiv., p. 125, 1878. 
Leube, Deutsch. Arch. f. klin. Medicin, Bd. 

v., 372, 1869. 
Mass, Verhandl. d. Leipziger Naturforsch. 

Vers. 1872. 
Mackenzie, Ind. Med. Gazette, 1872. 
Maclagan, C, Edin. Med. Journal, vol. x., 

1864, p. 203. 

Nunn, Emily A., Journ. of Physiology, i., 247. 
Pinkham, Boston Med. and Surg. Journ., 

1878, vol. xcix., 358. 
Renner, Wiirtzburger Diss., 1876. 
Ringer and Murrell, Journal of Physiol., i., 

p. 213. 
Saikovski, Virch. Arch., Bd. xxxiv., p. 77. 
Saikowsky, Mosler u. Grohe, Virch. Arch. 

1865, Sept. u. Oct., p. 208. 

Salomon, Alex., Wirk. kleiner Dosen Arsenik, 

Diss. Berl., 1873, p. 35. 
Sawitsch, Dorpater Dissert., 1854. 
Schmidt and Stiirzwage, Moleschott's Unters., 

vi. 3, 283, 1859. 
Schroff (senior), v. Zeitschr. d. Wiener Aerzte, 

N. F. ii., 44, Schmidt's Jahrb., 1860, cv., 176, 

1860. 
Schulz, Arch. f. exp. P. u. Pharm., Bd. xi., p. 

131. 
Sklarek, W., of Berlin, Reichert's Arch., 1866, 

p. 481, Schmidt's Jahrb., cxxxii., 290. 
Sturtzwage, Dorpater Dissert., 1859. 
Taylor, Guy's Hosp. Reports, vol. x., 3d 

series, 1864, p. 227. 
Unterberger, S., u. Bohm. Arch. f. exp. Path. 

u. Pharm., Bd. ii., p. 89, 99, 1874. 
Virchow, Virchow's Arch., Bd. xlvii., p. 524. 
Vogt, Lehrbuch d. Pharmacodynamik, 3te 

Aufl., Bd. i. 
Weir-Mitchell, New York Med. Journ., vol.i. 
Wyss, Arch. d. Heilkde., 1870, p. 15. 



Aspidospermin, vide Quebracho. 



Atropia. 

Anrep, Pfliiger's Arch., Bd.xxi., 1880 (chron. 

Atropinvergiftung.) 
Arlt, Arch. f. Ophthalmologic, 1869, p. 294. 
Bennett, Hughes, Brit. Med. Journ., 1874, 

vol. ii., 547, London Med. Record, 1877, p. 

341. 
Bernard, CI., Physiol, u. Path, du Systeme 

Nerveux, Parts, vol. ii., p. 212. 
Bezold, V., u. Blobaum, Unters, a. d. physiol. 

Labor, in Wiirtzburg, Bd. i., 1867. 
Boehm, Stodien iiber Herzgifte, Wiirtzburg, 

1871. 
Borelli, Ed. Med. Journ., Nov. 1871, vol. xvi., 

p. 480. 
Braun, Arch. f. Ophthalmologic, Band, v., 

Abth. ii., p. 112. 
Botkin, Virchow's Arch., Bd. xxiv., p. 83. 
Budge, Ueb. d. Bewegung der Iris, 1855. 
Chambers, Lancet, 1864, vol. i., p. 8. 
Da Costa, Amer. Journ. Med. Sciences, July, 

1865, p. 71; Pennsylvania Hosp. Rep., 1858; 

Philad. Med. Times, Feb. 15, 1871. 
Dogiel, J. Max Schultze's Arch. f. microscop. 

Anat., Bd. vi., Heft, i., 1870, p. 85. 
Donders, The Accommodation and Refrac- 
tion of the Eye, Syd. Soc. ed., p. 584, 588. 
Fraser, Transaction of the Royal Society of 

Edinburgh, May, 1869, vol. xxv., 450, Bd. 

xxvi., 1872, with complete resume of older 

literature. 
Fraser, T. R., Bartholow, Oglesby, Nunnely, 

The Practitioner, iv., 65, 27, and 217. 
Graefe, Von, Deutsches Klinik, 1851. 
Harley, The Old Veg. Neurotics, London, 

1869, p. 220. 
Hayden, Dublin Quarterly, Aug. 1863, p. 51. 
Heidenhain, Pfliig. Arch., Bd. v., p. 309. 
Hirschmann, L. Zur. Lehre v. d. durch Arz- 

neiin, etc., Reichert's Arch., 1863, p. 309. 
Iwanoff, Alex, and Alex. Rollett, Arch. f. 

Ophtham., vol. xv., p. 17. 
Jones, Wharton, Med. Times and Gazette, p. 

28, vol i., 1857. 
Ladenberg, Ber. d. deutsch. chem. Ges. Jg., 

xii., 1879, p. 941. 
Lemattre, Arch. Generates, Aug., 1865, p. 173. 
Lichteniels u. Frohlich, Denkschr. d. Wien. 

Acad. Math. Naturw CI., 1852, p. 113. 
Meuriot, De la Methode physiol. en Thera- 

peutique et de ses Applications a" l'Etude de 

la Belladonne, Paris, 1868, p. 73. 
Norris, Wm. F., Amer. Journ. of Med. Sci., 

Oct., 1862, p. 395. 
Putnam, Miss Mary, New York Med. Record, 

1873. 
Rossbach, Pharmakol, Unters, Bd. i., ii., iii., 

Wiirtzburg, 1873 (vide also Alkaloids). 
Rossbach, u. Frolich, Pharm. Unters. Wiirtz- 
burg, i., p. 6, N. F., v. 1874. 
Schroff, Zeitschr. d. Wien. Aerzte, 1852. 
Schmiedeberg, Arb. des Phys. Instit. z. Leip- 
zig, v., p. 41, 1870. 
Stellwag v. Carion, Der intraoculare Druck 

u. d. Innervations-Verhaltn. der Iris, Wien, 

1868. 
Valentin, Y. Versuch einer physiol. Path- 

ologie der Nerven, Leipzig, 1864, 2e Abth., 

p. 368. 
Weir-Mitchell, Injuries of Nerves, Philadel- 
phia, 1872, p. 258. 
Wood, Amer. Journ. Med. Sci., Ap., 1873, p. 

332 ; N. S., p. 128, Jan., 1871 ; Philadelphia 

Med. Times, vol. i., p. 290. 
Zeller, Virch's Arch., lxvi., p. 384. 

Barium. 

Bohm u. Mickwitz, Arch. f. exp. Path. u. 

Pharm., 1875, Bd. iii., p. 216. 
Brunton and Cash, Roy. Soc. Proa, No. 226, 

1883; Phil. Trans., 1884; Cent. d. Med. 

Wiss., 1884, p. 545. 
Hermann, Toxicologic, 1191. 
Onsum, Arch. F. path. Anat., Bd. xxviii., p. 

233. 



1020 



BIBLIOGRAPHICAL IXDEX. 



Bebeeru Bark. 

Albers, Yirch. Arch., Bd. xxiv., p. 304. 
Binz, Yirchow's Arch., Bd. xlvi., p. 130. 
Fliickiger, X. Jahrb. Pharm., 1S69. 
Gaingee and Maclagan, Edin. Rov. Soc. Trans., 

1S69, p. 567. 
Walz, N. Jahrb. Pharm., xii., 1861, p. 302. 

Benzoic Acid. 

Bird, Golding, Urinarv Deposits, Philad., 

1859, p. 160. 
Bucholtz, Arch. exp. Path. u. Pharm., Bd. 

iv., p. l. 
Brown, Zur Therapie der Diphtheritis, Arch. 

f. exp. Path. u. Pharm., Bd. viii., p. 140. 
Bryant, Lancet, ii., 1876, 747. 
Dougall, Med. Times and Gazette, i., p. 495, 

1S72. 
Delcours, Gaz. des Hop., Dec, 1844. 
Fleck, Benzoesaure, Carbolsaure, Zimmt- 

saure, Mitnehen, 8vo., Oldenburg, 1875. 
Garrod, Memoirs of the Chem. Soc, i., 1842; 

London Lancet, ii., p. 239, 1844. 
Griibe, W., Centralbl. f. Chim., 1876, pp. 777, 

778. 
Hallwachs u. Kiihne, Gotting, Nachr., 8, 1857. 
Saarsveld, A. f. exp. P. u. Pharm., x., 268. 
Jaffe, Ber. d. deutsch. chem. Ges., 1877, p. 

1925. 
Keller, Ann. der Chem. und Pharm. xliii., 

108 : Lancet, ii., Nov., 1844, p. 239. 
Lamaire, Phil. Med. Times, iv., 638. 
Meissener, u. Sbepard, Unters. lib. d. Enste- 

hen des Hippurs. im thier. Organismus, 

Hannover, S66. 
Morri, Trans. Phil. Coll. of Med., March, 7, 

1855. 
Rhode, Berl. klin. AVoch., 1871, 10. 
Salkowski, E.> Berl. klin. "Wochens., 1875, 

297. 
Seligshon, Chem. Centralbl., 1861. 
Shepard, U. C, Der Hippursaure im thier. 

Organismus, Hannover, 1866. 
Ure, Medico. Chir. Trans., xxiv., p. 30, 1841. 
Ure & Wood, Phil. Trans., March 7, 1856. 

Bexzol. 

Hoffmann, F. A., quoted by Bohm, Ziemssen's 

Cyclopaedia., vol. xvii., p. 513. 
Perrin, l'Union Med., 1861, No. 6, p. 92. 

Bichloride of Methylene. 

Richardson, B. W., Med. Times & Gaz., 1867, 
p. 470; Medical Times and Gazette, 1869, 
ii., 524; Brit. Med. Journ., vol. i., p. 332, 
1871; vol. ii., p. 249, 1872; London Lancet, 
1877, ii., 26. 

Bismuth. 

Beckf-r A: Jansen, Arch, der Pharm., Iv., 31. 

lxviii., 129, lxxvii., 231, lxxviii., 18. 
Bergeret & Mayenc, Journ. de l'Anatomie, 

1873, p. 2 12. 
Feder-Meyer, Wiirtzburg Diss., 1879. 

anowitsch-Lebedeff, Virch.'s u. Hirsch's 

Jahresb., 1869, p. 325. 
Wiggers, Canstatt'a Jahresb. Pharm., 1848, p. 

104, 1851, p. 105, 1-54, 109. 

Bitters. 

Buchheim u. Engel, in Buchheim's Beitr. z. 

Arzneimittellenre, Leipzig, 1849. 
Koehler, H., Tageblatt, d. 46 Naturforacher 

Versamml. zu Wiesbaden, 1873,8.70. 

liL.MTA Orientalis. 

I i nolotr, Lond. Record, 1877, p. 502. 

erger, Petersburg Med. Wochcnsch, 
1876. 



Blood Boot. 

Smith, R. M., Amer. Journ. Med. Sci., Oct., 
1876, p. 346. 

Borax. 

Binsvranger, Pharm. TVurdigung der Bor- 

saure des Borax, etc., 1846. 
Buchholz, Arch. exp. Path. u. Pharm., Bd. 

iv., p. 1. 
Copland, Diet, of Pr. Med. (Art., Abortion.) 
Dumas & Schnatzles, Pharmac Journ., Ap. 

1S74. 
Gmelin, App. Medicaminum, i., p. 104. 
Guibourt, Histoires des Drogues simples, i., 

p. 191. 
Homberg, Mem. de l'Acad. des Sci. de Paris, 

1702, 33. 
Richter, Ausfiihrl. Arzneiml., ill., p. 558. 
Yogt, Pharmakol., ii., 587. 
Wibmer, Wirk. d. Arzneim u. Gifte, v., 51. 

Brayera. 

Bedall, Sydenh. Year-Book, 1S68, p. 476; 

l'Union, 116, p. 596, 1S63. 
Leidesdorf, Wien. Med. ^Voch., xii., 26, 1871. 
Yiale, Journ. de. Chimie med., 5, ii., p. 207, 



Bromixe axd Bromide of Po- 
tassium. 

Anstie, Practitioner, xii., p. 19, 1874. 

Bartholow, The Bromides, 1871. 

Binz, Practitioner, xii., p. 6, Jan., 1874. 

Blake, Journ. of Ant., iv., 1, 1870. 

Clouston, Journ. Mental Sci., Oct., 1868, vol. 

xiv., p. 305. 
Clarke & Amory, Bromide of Potass., Boston, 

1872. 
Eulenburg u. Giittmann, Schmidt's Jahrb., 

exxxvii., p. 158, 1868. 
Hammond, Quart. Journ. of Psycholog.Med., 

vol. iii., p. 46, 1S69. 
Laborde, Paris, A. Delahaye, p. 30, 1870. 
Marchand, R., These de Paris, 1S68, p. 32. 
Xamias, Compt. Rendus, lxx.. 16, p. 882, 1S70. 
Ozanam, Gaz. des Hop., No. 66, 1856. 
Podcopaw, Virch. Arch., xxxiii., p. 505, 1S65. 
Paul, C, Gaz. des Hop., 91, 1866. 
Purser, J. M. Dub. Quart. Journ., xlii., 94, 

May, 1869. 
Ringer, Sidney Lancet, i., p. 392, 1869. 
Teissier, Gaz. med. de Lyon., p. 501, Nov. 15, 

1868. 
Williams, Obstet. Trans., xii., 249, 1871. 
Complete Literature, see Krosz, Arch. f. exp. 

P. u. Phaim., 1S76, Bd. vi., p. 46. 

Bromal Hydrate. 

McKendrick, J. G.., Ed. Med. Journ., July, 

1874, p. 1. 
Rabuteau, Gaz., Hebdoni., xliii., p. 6S1. 
Steinauer, E., Virch. Arch., 1870, Bd. 1. p. 235, 

lix., p. 65. 

Brominated Camphor. 

Besnier, < <az. des Hup., 35, 1865. 
Bourneville, Le Progrea Med., 1874 ; The Prac- 

titioner, Aug., 1874, \>. 119; Comptee Hend., 

A.ug., 1875. 
Cricbton-Brown, E<linb. Med. Journ., June, 

1865, i). 1085. 
Denefle, Presse M6d. Beige, 1871, p. 105. 
Hammond, Wm., N. V. .Med. journ., Dec, 

1871, p. 594. 
Hamilton, McLean, N. Y. Med. Journ., July, 

W_\ (). 72. 
Lawsou, Practitioner, vol. xiii., p. 324, 1874, 

vol. xiv., p. 262, 1875. 
Mussy, Guenau de Jnion M6d M B3 B6, 1866. 
Pathault, Bromure de Camphor, Paris, 1875. 



BIBLIOGRAPHICAL INDEX. 



1021 



Bromixated Camphor. 

Ricard, Union M§d., cxi., p. 417, 1869. 
Soulez, Amer. Joarn. Med. Sci., Julv, 1877, p. 
237 ; Lond. Med. Rec, 1877, p. 196. 

Broom. 

Fick, Arch. f. exp. Path. u. Therap., i. 397, 

1S73. 
Husernann, Die Pflanzenstoffe, p. 64. 

Cacodyl Compounds. 

Lebahn, Rostocker Inaug. Diss., 1868. 

Renz, Deutseh. Arch. f. klin. Med., 1865, i. 2, 

235. 
Schmidt u. Chomse, in Moleschott's Unters., 

vi. 122. 

Cadmium. 

Marine, Zeitschr. f. rat, Med., 1867, Bd. xxix., 
p. 113. 

Caffelx. 

Albers, Deutsches Klinik, 1S53, p. 370. 
AmoiT, Boston Med. Journ., Mar 28, 186S, p. 

261.' 
Aubert, Pfliiger's Arch., v., p. 589, 1S72. 
Bennett, Alex., Brit. Med. Journ., 1874, p. 510; 

Edin. Med. Journ., ccxx.p. 328, 1S73. 
Bennett, J. Hughes, Brit. Med. Journ., 1S74, 

vol. ii., p. 697. 
Binz, Arch. f. exp. Path. u. Ph., 1878, ix., p. 

31; Berl. Klin. Wochenschr., xlv., p. 545, 

1872. 
Bocker, Beitrage z. Heilk., Bd. i., 1849 ; Arch. 

d. Vereins f. Gerueins. Arb. zur Ford. d. 

Wiss. Heilkunde, Bd. i., p. 213. 
Brown-Sequard, Arch, de Phys. Norm, ct 

Path., 186S. 
Brill, Marburger Dissert., Elbert, 1862. 
Eggerth, Diss, de Coffea, Pesth, 1833, p. 31. 
Eisenmenger, Ueb. d. Einfluss v. Gifte a. d. 

Zuekungseurve, &c, Giessen. Pietsch, 1869. 

p. 49. 
Falck und Stuhlmann, Yirckow's Arch., Bd. 

xi., p. 325. 
Garrison, J. B., Phila. Med. and Surg. Re- 
porter, xxx., Feb. 6, p. i., 18-4. 
Gubler, Bull, ther., xciii., 523. 
Hoppe, F., 1'Echo Medical, 1858; Deutches 

Klinik, 1857, p. 181. 
Johannscn, O., Dorpater Diss., 1S69. 
Leven, Arcb. de Phys., 186S, vol. i., p. 178. 
Marvaud, Angel, Effets phvsiol. et therap. des 

Aliments d'Epargne, Paris, 1869-71, p. 118. 
Meihuizen, Pfliig. Arch., vii. 4-5, p. 201, 1873. 
Mitscherlich, Der Cacao und Chocolade, Berl., 

1859. 
Payen, Compt. Rend., xxii., p. 724, xxiii., pp. 

8 and 244, 1846. 
Roques, Schmidt's Jahrb., x., p. 18. 
Runge, Schweigg. Jour. Chem. Phvs., xxxi., 

1820. 
Schmiedeberg, Arch. f. exp. P. u. Ph., Bd. ii., 

p. 62, 1874. 
Smith, H. M., Journ. of Applied Sciences, 

Sept., 1874. 
Stuhlmann u. Falk. Yirch. Arch., Bd. xi., p. 

481. 
Thompson, Med.Times and Gaz., Feb. 12, p.lS5, 

1871. 
Uspenskv, Reichert's Arch., 1868, p. 522 ; Cen- 

tralbl., 1S68, p. 677. 
Voit, Ueber d. Wirk. d. Kochsalzes u. Kaffees 

auf d. Stoffwechsel, Miinchen, 1860, p. 135. 

Calabar Beax. 

Arnstein u. Sustschinsky, Wiirzb. Arbeit., 

iii„ 1867. 
Bezold, von, & E. Gotz, Centralbl. f. d. med. 

Wiss., 1867, 241. 



Calabar Be ax. 

Complete Literature bv Harnack, Arch. f. 

exp. Path. u. Pharra.," Bd. v. p. 401. 
Fraser, Ed. Med. Jour., ix., Aug. and Sep., pp. 

123 and 235, 1S63. Trans. Rov. Soc. Edin., 

xxiv., 73, 1867, xxvi., 1872. 
Fronmiiller, Deutseh. Klinik, 32, 35,1864. 
Grafe, A. von, Deut. Klinik, Xo. xxiv., 1863. 
Harlev, Jour, de l'Anat, et de la Phvs., 1864, 

p. 140-152. 
Hirschler, Wien. med. Woch., 13, xlii., 1S63. 
Horing, Wiirtemberg,Correspblatt.. xli.,1863. 
Kohler, H., Arch. f. exp. Path. u. Pharm., i., 

p. 277, 1S73. 
Laschkewitsch, Yirch. Arch., xxxv., p. 291, 

1866. 
Laurence, Ophthal. Hosp. Reports, iv.. 1, 129, 

1863. 
Leven & Laborde, Schmidt's Jahrb. ,Bd.cxlvi., 

p. 136. 
Ogle, Brit. Med. Jour., vol. i., p. 673, 1S63. 
Papi, Schmidt's, Jahrb., Bd. cxlii., p. 2S6. 
Rober, Berlin, Diss., 1868. 
Rossbach, Pharmak. Unters., Hefti., 1873. 
Schiff, Centralbl. f. d. med. Wiss., 1S73, p. 37. 
Yintschgau, Moletschott's Unters., ix., 800, 

1865. 
Watson, E., Ed. Med. Surg. Journ., xii., p. 11. 

Mav, 1S67. Centralbl. f. d. med . Wiss., 1868. 

p. 143. 
Weber, Klin., Monatsschr. f. Augenheilk.. 

Aug., 1863. 



Camphor. 

Baum, Centralbl. f. d. med. Wiss., 1S70, p. 467. 

Fliickiger, ]S eues Repertor. f. Pharm., xvii.. 
28, 186S. 

Gubler. Bull, de Therap., Dec. 30, 1871, p. 529. 

Grisar/Bonnar Diss., 1873, u. Centralbl. f. d. 
med. Wiss.. 1S74, p. 77. 

Harlev, Practitioner, ix., 210, 1872. 

Heubner, Arch. exp. Path. u. Pharm., v. p. 427. 

Hoffmann, Beitrag. z. Kenntn. d. Physiolog. 
W. d. Carbolsaure u. d. Camphors. Diss. 
Dorpat. 1866. 

Schmiedeberg u. Meyer, Z. f. phvs. Chem., 
ill, 422, 1S79. 

Wiedemann, Arch. f. exp. Path. u. Pharm., 

' Bd. vi. s., 216 (with complete list of Litera- 
ture). 



Cannabis Indica. 

Christison, Edin. Monthly Journ. of Med. Sci., 

July, 1851, p. 26. 
Fronmiiller, Klinische Studien lib. d. Schlaf- 

machende Wirkung. etc., Erlangen, bei 

Enke, 1869. 
Lawrie, Stille's Therap., vol. i., p. 772. 
O'Shaugnessv, on the Preparations of Indian 

Hemp, Calcutta, 1S39. 
Preobraschensky, Dragendorf s Jahrb., 1877, 

p. 98. 
Roemer, St. Louis Med. and Surg. Jour., p. 

363, 1873. 
Schroff, V., Zeitschrift d. Wien. Aerzte, 1857, 

u. Lehrbuch d. Pharmakologie, Aug. 3, 

1S68, p. 499. 
Wood, Proceed. Amer. Philos. Societv, 1869. 

vol. xi., p. 226. 



Cantharidix. 

Cautieri, Schmidt's Jahrb., Bd.cxlv., p. 237. 
Cornil, Practitioner, xxvii., p. 110. 
Galippe, Gaz. Hebdom., 1874, p. 439. 
Husernann, Handb. d. Toxicol., 1862, p. 264. 
Palle, Journ. de Pharm. et de Chimie, June, 

1871. 
Radecki, Dorpater Diss., 1S66. 
Schwakowa, Berner Diss., 1876. 
Stiiler, Deutsche Z. f. Chir., 1872, xii., 377. 



1022 



BIBLIOGRAPHICAL IXDEX. 



Carbazotic Acid. 

Binz. Yirch. Arch., Bd. xlvi., p. 130. 

Erb, W., Die Bikrinsiiure, Wurtzburg, 1865. 

Carbolated Camphor. 

Soulez, Amer. Journ. Med. Sci., July, 1877, p. 
237, and London Med. Becord, May, 1877. 

Carbolic Acid. 

Almen, Zeitse.hr. f. Anal. Chimie, Bd. x., p. 

125, Heft 7. 
Aufrecht, Centralbl. med. Wiss., 1S74, p. 129. 
Baumann, Pfliiger's Arch., Bd. xiii., p. 285 ; 

Zeits. f. PhTS. Chimie, v. Hoppe-Seyler, i., 

p. 244 : Dubois' Arch. Ptiysiol., Abth., 1879, 

iii., 24-5. 
Baumann u. Sonnenburg, Med. Times and 

Gaz., ii., 1S78. 
Bill, J. H., Amer. Journ. Med. Sci., Oct., 1870, 

p. 573. 
Brieger, Zeitschr. f. physiol. Chemie, iii., p. 

134. 
Buchholtz-Waldemar, Dorp. Diss., 1S66. 
Buchholtz-Einwick, a. Giihrungs Processe, 

Dorpat., 1866, p. 50. 
Buliginski, Hoppe-Seyler's Med. chem. Un- 

ters., Berlin, 1867, p. 234. 
Dougall, John, Lancet, 1870, vol. ii., p. 176. 
Eaines, J. H., Brit, Med. Journ., May, p. 490 

1S73. 
Erb, E., Schmidt's Jahrb., Bd. clxiv., p. 148. 
Hagen, Schmidt's Jahrb., Bd. clxiv., p. 147. 
Hoffmann, W., Dorpat, Diss., 1866. 
Hoppe-Seyler, Pfliiger's Arch., 1872, Bd. v., pp. 

470, 475, 476, 479. 
Hueter, C.,Deutsch. Zeits. f. Chir., iv., p. 508, 

1874; Schmidt's Jahrb., clxiv., p. 144. 
Husemann, Schmidt's Jahrb., Bd. civ., p. 274. 
Husemann u. Ummethum, Deutseh. Klinik, 

1S70 and 1871. 
Kempster, W., Amer. Journ. Med. Sci., July, 

186S, p. 31. 
Kunze, Centralbl. med. Wiss., 1874, p. 479. 
Labee. E. Arch. Gen. de Ser., t, xviii., p. 451, 

1871. 
Lemaire, J., De l'Acide phenique, 2e ed., 

Paris, 1865. 
Lister, J., Lancet, vol. ii., 1867, p. 353. 
Mader, Centralbl. f. Chir., 1*77, p. 376. 
Neumann, I., Arch. f. Dermat. u Svphil. 

Jahrg. i., 1869, p. 425. 
Oberst, Berl. klin. Woch., 1S78, p. 157, No. xii. 

Acute Poisoning.) 
Patrouillard, Journ de Pharm. et de Chimie, 

Dec, 1871, p. 459. 
Plugge, P. C, Pfliiger's Arch., 1S72, Bd. v., p. 

540. 
Bender, Journ. de Pharm., et de Chimie, p. 

456, Dec, 1871. 
Bosenbach, Ueb. d. Einfluss d. Carbolsaure, 

&C., (iottingen, 1873. 
Salskow>ki, Pfliiger's Arch., Bd. v., p. 210, 335, 

1872, Centralbl. med. Wiss. 1876, p. 818. 
Schafter, Journ. f. pract. Chimie, N. F. xviii., 

p. 282. 
Senator, Berl. kin. Wbchenschr., 1876, p. 69. 
Sonnenburg, Dent. Zeits. f. Chir., Bd. ix., p. 

BtSdeler, Ann. d. Chem. u. 1'harm., Bd. 

l.w.w ii.. p. 17. 
Stevenson, Brit. Med. Journ., vol. i., p. 142, 

1870: and Guy's Eosp. Rep., 1868, p. 407. 
Bchmidt, T., Centralbl. f. Chir., 1876, 552. 
Tauber, Z. r phys. Chem. ii. : 866. 
i rmmetnun, < idttingen I>i>s., 1873. 
Volkmann, Yolkmann's Samml. Klin. Vorr., 

1875, >'(>. xcvi., in Beit. /. Chir., p. 12. 
Waldenstrom, Zeitsclir. d. allgemeinen Apo- 

thek. Vereins, Jan. 10, 1872. 
Wilson, Erasmus, Journ. Cutaneous Med., 

June, 1870. 



Carbon. 



Liebermann, Sitzber. d. k. k. Acad. d. Wiss.. 
Wien, 1S77, p. 321. 

Stenhouse, Economical Applications of Char- 
coal, 3d ed., Lond., 1855. 



Carbonic Acid. 



Basch, von, u.'Dietl, Wien, m. Jahrb., 1870» 

xxvi., 3. 
Beddoes, on the Med. Effects of Factitious 

Airs, p. iv., p. 42. 
Bernard, CI., Subst. toxiques, etc, p. 135. 
Bert, Comptes Bend. T., Ixxxvii., p. 628. 
Buchheim, A. f. Exp. P. u. Ph., Bd. iv., p. 

137. 
Christison on Poisons, 3d ed., p. 745. 
Donder's, Pfliiger's Arch., Bd. v., p. 20. 
Friedlander u. Herter, Z. f. phvsiol. Chem., 

1S78, ii., y9, and 1879, iii., 19. 
Heidenhain u. L. Meyer, Stud. d. physiolog. 

Instit. zu Breslau, Bd. ii. 
Hickman, Seance de l'Acad. Boy., Sep. 24, 

1828. 
Humboldt, von, U. ub. d. gereizte Xerven u. 

Muskelfaser, ii., p. 321. 
Hermann, L. Exper. Toxicologic, 1S74, p. 

118. 
Liebig, G., Arch. f. Anat. u. Physiol., 1850, p. 

401. 
Pfluger, Pfliiger's Arch., Bd. i. 
Priestley, on Airs, vol. i., p. 302. 
Preyer, Wiener Acad. Sitzber. Math.-nat, CI. 

Bd. xlix. ; Pfliiger's Arch., Bd. i., p. 395. 
Quincke, A. f. exp. P. u. Ph., vii., p. 101, 1877. 
Setschenow, Wiener Acad. Sitzungber, Math.- 
nat, CI., Bd. xxxvi. ; Z. f. rat. Med., Bd. x., 

p. 101 ; Centralbl. t. d. med. Wiss., 1873, p. 

355, 1877, 625, u. 1879, p. 369. 
Zuntz, Centralbl. f. d. med. Wiss. Bonner 

Diss., I860, Berl. klin. AVcchenschr. 1S5, 

1870. 

Carbonic Oxide. 

Friedberg, Die Vergift. durch Kohlendunst> 

Berlin, 1866. 
Hoppe-Sevler, Virch. Arch., 1857, Bd. xii. 
Ktihne, Centralbl. f. d. med. Wiss., 1864, p. 

134. 
Lothar Meyer, Breslauer Diss., 1858. 
Poiikrowskv, Arch. f. Anat. u. Phvs., 1866 r 

p. 59. 
Senff, Dorpater Diss, 1862. 
Traube, Gesamnielte Beitriige, Berlin, 1878, iii. 

Chloral Hydrate. 

Adams, Lancet, i., pp. 212 and 567, 1870. 

Adrian, N. Y. Med. Journ., 1S70. 

Andrews & Da Costa, Amer. Journ. Med. Sci. > 

April, 1870, p. 359. 
Anstie & Andrews, Amer. Journ. of Insan.> 

July, 1871. 
Beck, Jos. B., St. Louis Med. and Surg. Journ., 

June, 1872. 
Bouchut, N. Y. Med. Gaz., Dec, 1870. 
Bradburv, J. B., Brit. Med. Journ., vol. 1, p. 

363, 1871. 
Brunton, Lauder, Journ. Anat., viii., p. 332, 

1874. 
Clarke, Lancet, May 2, 1874, p. 643. 
Clemens, Schmidt's Jahrb., Bd. cli., p. 105. 
Demarquay, Bull. Therap., t, lxxvii., p. 307. 
Dieulafoy & Krishaber, Amer. Journ. Med. 

Sci., Jan., 1870, p. 284. 
Djurberg, Schmidt's Jahrb., Bd. cli., p. 84. 
Dujardin-Beaumetz & Hirne, Bull. Therap., 

lxxxvi., p. 224, 1872. 
Elliott, G R, Lancet, 1873, i., 754. 
Fuller, H.W., Lancet, March, 403, 1871. 
( rascoyen, Brit. .Med. Journ., vol. i., p. 91, 1872. 
Giovanni & Bauzoli, Schmidt's Jahrb., lid. 

cli., p. 91. 
Hannnarsten, Deutsche Klinik, 1 

Schmidt's Jahrb., Bd. cli., p. 90. 



BIBLIOGKAPHICAL INDEX. 



1023 



Chloral Hydrate. 

Keen & Personne, Phila. Med. Times, vol.iv. 

p. 385. 
Keen, Schmidt's Jahrbiicher, clxxvii., p. 139; 

Ainer. Journ. Med. Sci., July, 1875, pp. 76 

and 150. 
Kirn, Ludwig, Allgem. Zeits. f. Pschychiatrie, 

xxix., 1872; Practitioner, vol. x., p. 361. 
Leavitt, Amer. Journ. Med. Sci., Ap., 1871, p. 

363. 
Levinstein, Lancet, i., p. 279, 1874. 
Lewisson, Reichert's Arb. f. Anat. u. Phys., 
. 1870, p. 348. 
Liebreicb, Chloralhydrat, ein neues Hypno- 

ticum, Berlin, 1869 ; Wiener Med. Wochens., 

Aug., 1869, p. 1087. 
Macnaniara, Pract., vol. ix., 257. 
Morgenstern, Wien. Med. Presse, Nov., 1871, 

p. 1212. 
Mosso, Schmidt's Jahrb., clxxvii., p. 138. 
Murchison, Lancet, ii., p. 596, 1870. 
Owsjannikow, Leipz. Acad. d. W., 1871. 
Pellogio, Schmidt's Jahrb., Bd. cli., p. 89. 
Personne, Journ. de Pharm. et de Chimie, 

1870, p. 1. 
Playfair, Lyon, Lancet, 1874, vol. i., p. 263. 
Rajewski, Centralb., f. d. med. Wiss., 1870, p. 

211; Schmidt's Jahrb., Bd. cli., p. 90. 
Rehn, Jahrb. f. Kinderkrankh., 1871, p. 430. 
Reynolds, Practitioner, 1870, iv., p. 188. 
Richardson, Med. Times and Gaz., vol. ii., p. 

374, 1870. 
Rigden, Practitioner, vol. v., p. 151, 1870. 
Russell, Glasgow Med. Journ., Feb., 1870, p. 

209. 
Schmidt's Jahrb., Bd. cli.; Kohler's Abstracts 

of papers. 
Schule, Allgem. Zeitschr. f. Psych., xxviii., 

p.l. 
Smith, N. R.,Bost. Med. and Surg. Journ., vol. 

viii., p. 33, 1871. 
Tomasczewitz, Pfl tiger's Arch., Bd. ix., p. 35. 
Watson, Med. and Surg. Reporter, Jan. 27, 

1871. 
Waterhouse, Practitioner, Dec, 1870, vol. v., 

p. 344. 
Widenhofer, Bost. Med. and Surg. Journ., 

1874. 

Chloride of Sodium. 

Becquerel & Rodier, Gaz. de Paris, xlviii., 

1844. 
Bert, P., Comp. Rend., lxxiii., p. 382. 
Berzelius, Lehrbuch, ix., p. 98. 
Guttmann, Klin. Woch., 1865, xxxiv.-xxxvi. 
Hoppe, Deutsche Klinik, xxxii., 1863. 
Klein u. Verson, Centralb. f. med. Wiss., 1867, 

p. 788. 
Lehmann, Physiol. Chem., i., p. 440, ii., 171, 

241, iii., 141, 255. 

Chlorate of Sodium. 

Nasse, H., R. Wagner's Handworterbuch, i., 

(Art, Blut.), p. 167. 
Panum, Virch. Arch., iv., 1852. 
Poggiale & Plouviez, Comp. Rend., xxv., p. 

110. 
Rabuteau, Bull, de Therap., lxxxi., 1871, p. 562. 
Voit, Unters. iib. d. Einfluss d. Kochsalzes, 

&c, Miinchen, 1860. 
Wiscknewsky, Canstatt's Chimie, p. 116,1867. 

Chloroform. 

Anstie, Stimulants and Narcotics, p. 321. 
Baudin, Le Progres Med., Sep., 1874. 
Bernard, CI., Lecons sur les Anesthesiques, 

Paris, 1875. 
Bernstein, Centralb. f. d. med. W., 1867, Bd. 

v., p. 38; Schmidt's Jahrb., Bd. clxii., p. 218. 
Bert, Comp. Rend., t. lxiv., 1867; Journ. of 

Anat. & Phys., May, 1870, p. 312. 
Bonwetsch, Dorpater Dissert., 1869. 



Chloroform. 

Bottcher, Virch. Arch., Bd. xxxii., p. 126. 
Bowditch, H. P., & C. S. Minot, Boston. Med. 

& Surg. Journ., May, 1874. 
Carter, Brit. Med. Journ., vol. i., p. 208, 1867. 
Chloroform Committee, Med. Chir. Trans., 

vol. xlvii., p. 326. 
Dogiel, Arch. f. Anat. u. Phys., 1866. 
English Chloroform Committee, Medico-Chir. 

Trans., 1864, vol. xlvii. 
Glover, Ed. Med. Journ., 1842, pp. 709 and 

1009. 
Gosselin, Arch. Gen., 1848, vol. xviii., p. 385. 
Harley, Phil. Trans., London, 1865. 
Hartmann, Giessener Dissert,, 1855. 
Hermann, Arch. f. Anat, u. Phys., 1866, p. 27. 
Holmes, E. L., Chicago Med. Examiner, Sep., 

1868. 
Husemann's Abstracts in Virchow-Hirsch's 

Jahresber; Schmidt's Jahrb., Bd. cli., p. 80. 
Knoll, Wien. Acad. Sitzber., 1874, 1876 u. 1877. 
Lallemand, Perrin, Duroy, du Role de 1' Al- 
cohol et des Anesthesiques, Paris, 1860. 
Leute, T. D., Psychol. & Med. Legal Journ., 

Feb., 1875. 
Noel, Lond. Med. Record, 1877, p. 457. 
Nothnagel, Berl., klin. Wochenschr., 1866, 

Bd. iii. 
Ranke, H, Centralb. f. med. W., 1867, p. 209 

u. 1877, No. 34, p. 608. 
Richardson, Med. Times & Gazette, 1866-1870. 
Sabarth, Das Chloroform, Wurzburg, 1866. 
Sansom, Chloroform, p. 55, Philadelphia, 1866. 
Scheinesson, Dorpater Diss., 1868, u. Arch. d. 

Heilk.,Bd. x., p. 36. 
Schenk, Sitzbericht d. Wien. Acad. M. N. CI., 

1868, Bd. lxviii. 
Schmidt's Jahrb., Bd. cxlii., cxlv., cli., H. 

Kohler's Abstracts. 
Schmidt, A., u. F. Schweiger-Seidel, Ber. d. 

Konig, Sachs. Gesell. d. Wiss. Math. Phys. 

Klin., 1867, p. 190. 
Schmiedeberg, Dorpater Diss., 1867. 
Simpson, Edin. Month. Journ. of Med. Sci., 

1847, p. 33, and 1848, p. 315. 
Simonin, Centralb. Chir., 1876, p. 234. 
Snow, On Chloroform and. other Anaesthetics, 

London, 1858. 
Westphal, Virch. Arch., Bd. xxvii., p. 409. 
Winslow, W. H., Phil. Med. Times, vi., p. 275. 

Chrysophanic Acid. 

Gehe's Handelsberichte, 1878 u.1879. 
Squire, Centralbl. f. d. med. Wiss., 1877, p. 
384, u. 1878, s. 699. 

ClMICIFUGA. 

Chapman, N., Elements of Therap., 6th ed., 

vol. i. 
Davies, N. S., Trans. Amer. Med. Assoc, 

1848, vol. i., p. 351. 

Young, Amer. Journ. Med. Sci., vol. ix., 1831, 
p. 310. 

Cocaln. 

Anrep, Pfliiger's Arch., Bd. xxi., 3, 38 (with 

complete list of literature). 
Bennett, A. Hughes, Edin. Med. Journ., Oct., 

1873. 
Koller, vide Cent. f. d. med. Wiss., 1884, p. 

870; Jessop, Practitioner, xxxiv., p. l. 

Codeia, vide Opium Alkaloids. 

Barbier, Gaz. Med. ii., p. 147, 1834. 
Barnay, De la Codeine, Paris, 1877. 
Baxt, W., Reichert's Arch., 1869, p. 125. 
Berthe, Compt, Rend., lix., p. 914, 1865. 
Cruni Brown and Fraser, Proceed. Roy Soc 

of Edin., xxv., Jan. 6, 1868. 
Des Brulais, Mon. des Hop., xcvi.,p. 767, 1856. 
Dumont, Mon. des Hop., xxviii., p. 221, 1858. 



1024 



BIBLIOGRAPHICAL INDEX. 



Codeia, vide Opium Alkaloids. 

Falck, Deutsches Klin., 1870. 
Guibert, Nouveaux Med., 397. 
Husemann. Pflanzenstoffe, p. 155. 
Harley, Old Veg. Neurotics, p. 179. 
Krebel, Med. Ztg. Russlands, 1856, p. 59. 
Kunkel, Journ. de Chimie Med.,xi., 223, 1S33. 
Mitcbell, "Weir, Ainer. Journ. Med. Sci., Jan., 

1S70, p. 26. 
Myrtle, Brit. Med. Journ., 1874, i., 478. 
Ott, Opium Alkaloids. 

Scbrotf, Yon, Pharmakologie, 3 Aufl., p. 483. 
Wacbs, L., Das Codein, Diss. Marburg, 1858. 

COLCHICUM. 

Albers, Deutscbe Klinik, 1856. 
Bacmeister, Arcb. d. Pbarmacie, 1857. 
Bird, Urinary Deposits, Pbila., 1859, p. 354. 
Garrod, A. B., Med. Cbir. Trans., 1858, xii., 

348. 
Geiger, Annal. Cbem. Pharm., vii, 274. 
Hammond, Proc. Pbila. Acad. Nat. Sci., Dec, 

1858. 
Hoppe u. Ascboff, Vierteljahrs. f. Prakt. 

Pbarm., vi. 
Krabmer, Journ. f. Pbarmacodynamik, ii., 

561. 
Lewins, P., Ed. Med. and Surg. Journ., 1841, 

vol. lvi., p. 200. 
Ludwig and Pfeiffer, Arcb.der Pbarm., cxi., 3. 
Maclagan, Ed. Monthly Journ. of Med. Sci., 

3d series, vol. xiv., p. 24. 
Major, G. W., Canada Med. Surg. Journ., 

Dec, 1873. 
Percy, S. B., Amer. Med. Times, Ap., 1862, p. 

173. 
Rossbacb, Pbarm. Unters., Bd. ii., 1876, s. 

1-58. 
Schroff, V., Zeitscbr. d. Ges. d. Aerzte, 1851, 

u. osster. Zeitscbr. f. prakt. Heilk., 1856. 
Scudamore, On Gout, London, 1835. 
Taylor, Med. Juris., 2d ed., vol. i. 
Wood, Geo. B., U. S. Dispensatory, 13tb ed., 

p. 1504. 

Colocynth, vide Purgatives. 

Bucbheim, Die scbarfen Stoffe, &c. 
Husemann, Handbucb d. Toxicol., p. 525. 
Marine, W., Zeits. f. rat. Mediz., xxvi., 61. 
Scbrott', Von, Pbarmacologie, 4 Aufl., p. 368, 
1873. 

CONDURANGO. 

Brunton, Lauder, Journ. of Phys., v., 17. 
Ernst, Yjhrschr. f. ger. Med., xvi., 2, p. 321, 

u.Scbmidt's Jahrb., clvii., p. 121. 
Friedreich, Berliner Klin. Wocbenschrift, 

1874, No. 1. 
Gianuzzi, Cent. f. d. med. Wiss., 1873, p. 824. 
Hulke, Centralb. f. d. Med. Wiss., 1872,p. 111. 
Obalinski, Centralbl. f. Cbir, 1874, No. 12, 

p. 177. 
Riegel, Berl. klin. Wochenschr., 1S74, No. 35, 

u. 36. 
Sanctis, De, Schmidt's Jahrb., clvii., p. 121. 
Sandahl, Hygiea, 1872, p. 14, and Schmidt's 

Jahrb., clviii., p. 121. 
BchrofF, un., Schmidt's Jahrb., clviii., p. 211. 

Copaiba. 

Bernatzik, Pr&ger. Vierteljahrs., lid. c, 1868, 

p. 289. 
Blanchard, Gaz. des Hop., xl.,i*52. 
Gubler, Comment. Therap. du Code, p. 88, 

Bull, de la Boo. dc Thfirapeut., l, series \ \ i. 
Mitseherlik, PreUss. Vereinsz., xix., 22, 1848. 
Bees, i ruy'a Hosp. Rep., vol. xvii. 
Schweizer, Poggeild. Ann., Bd. xvii., pp. 487 

and 1095. 
Valentine, Grundrias der Phya. 
Weikart ll , Arcb.d. Heilk., 1860,p. 170. 
\\iik-. Lancet, i., 12, Mar., j.. 410, 1878. 



Copper. 

Bailly, l'Union, 6, 1874; Schmidt's Jahrb., 

clxiii., 1874, iii., Bd., p. 61. 
Bergeret u. Mayengon, Journ. de l'Anat. et 

Phys., 1873. 
Blake, Frank's Magaz., ii , 405, 
Blasius, Zeitschr. f. rat. Med., 3 Beihe, Bd. 

xxvi., p. 240. 
Buchner, Toxikol., 2 Aufl., p. 525. 
Burq, Ducom, Schmidt's Jahrb., 1878, Bd. 

clxxviii., 14; Archde Phvs. Norm, et Path., 

1877, t. iv., 183. 
Clapton, Med. Times and Gaz., vol. i., p. 658, 

June, 1868. 
Clemens, Schmidt's Jahrb., exxxi., p. 82, 1866. 
Falck, Deutsches Klinik, xi., 1859. 
Faulk, Deutsch. Klin., x., 439. 
Galippe, Etude toxicol. sur la Cuivre, Paris, 

1875; Comptes Bendus, t. lxxxiv., pp.404 

and 718. 
Harnack, Arch. f. exp. P. u. Pbarm., Bd. iii., 

p. 46, u. Bd. ix., p. 162, 1874. 
HonerkopfF, Ueb. d. Anwend. d. schwefel- 

sauren Kupferoxydes gegen Croup. Leip- 
zig, 1852, p. 60. 
Lieberkiihn, PoggendorfT's An., 1852, Bd. 

lxxxvi. 
London Clinical Soc. Transactions, 1870, 

p. 13. 
Merat et de Lens, Diet. univ. de Mat. Med., 

ii., p. 67, 
Mitscherlich, Midler's Arch., 1837, p. 91. 
Neebe, Marburger Diss., 1857. 
Pierre, St. and Pecholier, Med. Centralbl., 

1854, p. 270. 
Wibmer, Wirk.der Arzneim. u. Gifte, ii.,260. 

1838. 

COTO. 

Albertoni. Arcb. f. Path. u. Pharm. xviii., 

291. 
Burkhart.Berl. klin. Wocb., 1877, p. 276. 
Jobst, Ber. d. deutsch. chem. Ges., 1876, No. 

17. 

Croton Oil, vide Purgatiyes. 

Adams, Husemann, Toxicol., Bd. ii., p. 443. 

Brunton, Lauder, Practitioner, xii., 346. 

Bucbheim, Virchow's Arch., xii., 1. 

Giacomini, Stille, Therapeutics, vol. ii., p. 451. 

Hertwig, Stille, Therapeutic-, 2d ed., vol. ii., 
p. 449. 

Joret, Bull, de Therap , lxi., p. 385, 1861. 

Badziejewsky, Casuistik der Vergiit. bei Huse- 
mann. Handbucb, p. 442, u. Pflauzen- 
storte, p. 111: 1 .. 

Wibmer, Wirkungen, cv.e., ii., 222. 

CUBEBAS. 

Adams, Edinb. Med. Surg. Journ., xv., 61. 
Bernatzik, Prag., Vierteljahrs., 1864, B.lxxxi., 

p. 9. 
Clarus, Arzneiml., p. 728. 
Crawford, Edin. JVIed. Surg. Journ., xiv., 32. 
Crane, Edin. Med. Surg. Journ., xxi., 802, 
Godecke, Preuss. Yereinsz., 34, 35, 1850. 



Curare. 

Bucbheim u. Loos, Ueber d. pharmakolog. 
Gruppe des Curarins, Giessener Dissert., 

1S70. 

Bernard, CI., Leeons sur les Substances i<>.\- 

ifjucs, Paris, 1857, ]>. 888. 
Bezold, Reichert's u. Bois Arch., 1859. 
Colasanii, PflUger's Arch., Bd. xvi., p. i"i7. ' 
EJckhardt, Beitr. z. An. u. Physiol., Bd. vi., p. 

19, GleS8en, 1871 (Historical). 
Funke, Ber.d. k. sflchs. Acad., 1869. 
Hermann, Pfliiger's Arch., Ba. xviii., p. 458, 

1S78. 
Ktflliker, Vlrch. Arch., Bd. x„ p. l. 



BIBLIOGRAPHICAL INDEX. 



1025 



Curare. 



Kiihne, Reichert's u. Du Bois' Arch,, 1860, p. 

477. 
Rohrig u. Zuntz, Pfliiger's Arch., Bd. iv., p. 

57, 1871. 
Steiner, J., Reichert's u. Du Bois' Arch., 1875, 

u. eigene Schrift. Leipzig, 1877. 
Zuntz, Pfliiger's Arch., Bd.xii., p. 522, 1876. 



Cyanogen, vide Prussic Acid. 
Daturia. 

Laurent, Ch., These, Paris, 1870, p. 22. 



Digitalis. 

Ackermann, Deutsch. Arch. f. Klin. Med., 

Bd. xi., 9, p. 135; Volkmann's samnil. Klin. 

Vortrage, No. 48, Leipzig, 1872. 
Bert, P., Gaz. Med. de Paris, xi., 1873. 
Boldt, Inaug. Diss., Schmidt's Jahrb., March, 

1872. 
Bohm, Pfliiger's Arch., Bd. v., 4 u. 5, p. 153, 

1872. 
Bordier, Bull. Therap., 1868, vol. lxxiv., p. 

110. 
Brunton, Lauder, on Digitalis, London, 1868. 
Brunton & Meyer, Journ. of Anat. and Phys., 

vii., 1872, p. 134. 
Coblentz, Z. E., Strasburg Thesis, 1862. 
Costa, Da, Amer. Journ. Med. Sci,, Jan., 1871, 

p.l. 
Dybkowsky, W., and E. Pelikan, Zeitschr. f. 

Wiss.Zool., Bd. xi., 1852. 
Dickinson, Med. Chir. Trans., vol. xxxix., 

p.l. 
Eulenberg u. Ehrenkaus, Med. central Z., 

xxviii., 777, 1859. 
Fagge and StevensoD, Proceed, of the Royal 

Soc. London, vol. xiv., p. 270. 
Fothergill, Digitalis, Lon., 1871 ; Brit. Med. 

Journ., pp. 5, 27, 57, 90, 115 and 146, 1871. 
Gortz, Schmidt's Jahrb., Bd. clviii., Unters. 

iib. Digitalis Praparationen,Dorpat, 1873. 
Gourvat,Gaz. Med. de Paris, 1871. 
Gaunot, Phila. Med. Times, iv., 30. 
Hammond, Proc. Biol. Dep. Acad. Nat. Sci., 

Phila., Dec, 1858 ; Am. Med. Journ., Jan., 

1859, p. 275. 
Homolle, Arch., Gener. de Med., July, 1861, 

p. 5 ; Journ. de Pharm. et de Chimie (3), 

vii., p. 57. 
Kohler, H., Arch., Exp. Path.u. Pharm., i., 2, 

p. 138, 1873. 
Kohnhorn, Lancet, 1876, i., p. 582. 
Koppe, Arch. f. Exp. Path. u. Pharm., Bd. iii., 

p. 274. 
Kosmann, Bull, de Therap., lix., July, p. 60, 

1860. 
Lorain, Paul, Journ. de l'Anat. et Phys., 1870, 

p. 128. 
Meihuizen, Arch. f. Phys., vii., p. 201, 1873. 
Meusnier, Aug., De PAction de la Digitale sur 

la Fonction glycogenique, Paris, Thesis, 

1868. 
Meyer, A. B., Arb. u. d. Phys. Inst, zu Zurich, 

Centralbl. f. med. Wiss., xvii.,p. 270, 1869. 
Onimus, Journ. de l'Anat. et Phys., ii., 337, 

July, 1865. 
Paul, C, Bull. Therap., 1868, lxxiv., p. 193. 
Perrier, Arch. f. Exp. Path. u. Pharm., Bd. 

iv., p. 191. 
Quevenne, Homolle et, Arch, de Phys. de 

Therap., etc., par Bouchard at, i., 1854. 
Ranvier, Comptes Rendus, 1869, vol. lxix., p. 

1327. 
Roucher, Practit.,ix., p. 304, 1872. 
Sanders, Edin. Med. Journ., iv., 369. 
Schmiedeberg, Arch. f. Exp. Path. u. Pharm., 

Bd. iii., p. 16. 
Schroff, v., Wien. W. S., xxiv., Wochenblatt 

d. k. k. G. der Aerzte z. Wien., xx., xxii., 



65 



Digitalis. 

Skoda, Wien. m. Presse, xiii., Jahrb., 142, p, 

21, 1864. 
Stadion, Prager Viertehahrs. f. d. prak. Heilk., 

1862, Bd. lxxiv., p. 97", 1872; Sydenham Soc. 

Year-Book, 1862, p. 451. 
Stannius, Arch. f. phys. Heilk., Bd. x., 1851, 

p. 177. 
Tardiau, Clinique, p. 685, Obs. viii., Paris, 

1867. 
Traube, Annalen. d. Charitekrankenh. in 

Berlin, 1851, Bd. ii., p. 1; Gesammelte Bei- 

trage. z. Path. u. Physiol., Bd. i., Berlin, 

1871; Med. Central. Z. xxx., 94, 1863; Berl. 

Klin. Woch., vii., 201, 213, 1870, xxxi., 

xxxiii., 1871. 
Vulpian, Comptes Rendus de la Soc. de Biol,, 

1855, p. 70. 
Weil, A., Reich. Arch. f. Anat., 1871, p. 252. 
Winkel, Phila. Med. Times, 1874, iv., p. 6, p. 

554, 1861. 
Winogradoff, Virch. Arch. f. Anat.,Bd. xxii., 

p. 457. 
Wood, Amer. Journ. Med? Sci., July, 1871. 
W underlich, Manual Med . Therm ., Sydenham 

Soc. Transl., p. 325. 

DUBOISIN. 

Mamie, Nachr. v. d. k. Ges. d. Wiss. u. d. G. 
A. Universit. zu Gottingen, 1878, No. xii., 
p. 413. 

Elaterium. 

Gibson, Brit, Med, Journ., Nov., 1861. 
Kohler, Virch. Arch.,Bd. xlix., p. 408, L. 2, p. 

273, 3, 375, 1870. 
Morries, Repertor. f. Pharm., xxxix,, p. 134. 
Schroff, Von, Pharmakologie, 4te Aufl., 371, 

1873. 
Stille, Therap., vol. ii., p. 459. 

Emetine. 

Ackermann, Rostocker Diss., 1856. 
Carriger, J. H., New York Med. Journ., 491, 

1878. 
Chouppe, Le Progres Med., 1874, p. 425; Bull, 

de Therap., June, 1874, 86, p. 481. 
D'Ornellas, Gaz. Med., 1873, p. 537. 
Duckworth, Dyce, Bartholomew Hosp. Rep., 

vol. v., p. 218, 1869, vol. vii., p. 91, 1871. 
Foulkrod, Phila. Med. Times, viii., p. 554. 
Harnack, E., Arch. f. Exp. Path. u. Pharm., 

Bd. ii., p. 299, iii., 44. 
Magendie u. Pelletier, Journ. d. Pharmacie, 

lix., p. 223, 1817. 
Orfila, Toxicol., i., 551. 
Pecholier, Comptes Rendus, Bd. Iv., 1862 ; p. 

771, Gaz. Med., 1862. 
Podwyssotski, A. f. Exp. Path. u. Pharm., Bd. 

xi., p. 231, 1879. 
Pollichronie, L'Ipecacuanha, Paris, 1874. 
Weylandt, Eckhardt's Beitrage z. Anat, u. 

Physiol., Giessen, 1869, v. i., u. Inaug. 

Dissert. 
Woodhull, A. A., Atlanta Med. and Surgical 

Journ., 1875. 

Ergot, vide Secale Cornutum. 

Bailly and See, Bull. Therap., t. lxxviii., p. 
435. 

Barlau-Fontayral, Journ. des Sci. med. pra- 
tiques de Montpellier, tomes vi., vii, 

Boldt, Schmidt's Jahrb., March, 1872. 

Bonjean, Traite de l'Ergot de Siegle, Paris, 
1845. 

Boreischa, Arbeit. Pharm. Lab. Moskaw, i., 55. 

Bodin, Journ. des Connaissances Med., 1842. 

Brown-Sequard, Arch, de Phys., 1870, t. iii., 
p. 434. 

Buchheim, Berl. Klin. Wochenschr., 1876, p. 
309, No. xxii. ; Arch. Exp, Path, u, Pharm., 
Bd. iii., p. 1. 



1026 



BIBLIOGKAPHICAL INDEX. 



Ergot, vide Secale Corntjtum. 

Clemens, Deutsches Klinik., 1865, 267. 
Christmann, Centralbl. f. d. rued. "Wiss., p. 

S00, Nov., 1869. 
Costa, Da,Amer. Med. Journ. Sci., Jan., p. 117, 

1S75. 
Diez, Stille, Therap., 2 ed., vol. ii., p. 585. 
Dragendorff u. Podwissotzkv, Arch. f. exp. 

Path. u. Pharmak., Bd. vi., p. 153, 192. 
Duboue, Becherches sur les Proprietes therap. 

du Seigle ergote, Paris, 1873. 
Eberty, Hallenser Diss., 1873; Schmidt's 

Jahrb., Bd. clvhi., p. 127. 
Goodall, Proceed. Med. Soc. Pennsylvania, 

1873. 
Hampel, Practitioner, vol. i., p. 263. 
Haudelin,Dorp. Diss., 1871; Schmidt's Jahrb., 

Bd. civ., p. 1-43. 
Hensinger, Journ. f. Pharmacodyn, Bd. i., p. 

405. 
Hermann, Biichner's Bepertor. f. Pharm., 

1871. 
Hildebrandt, Berl. Klin. Woch., p. 297, 1872. 
Holmes, Ch. L., Arch, de Physiol., t. iii., p. 

38-4, 1S70. 
Kersch, Betz's Memorabilien , vol. xviii. 
Kitchen, Amer. Journ. Insan., July, 1873. 
Kobert, Practitioner, xxxiii., 409. 
Kohler, H., Virch. Arch., Bd. lx., p. 384. 
Langenbeck, Berl. Klin. Woch., p. 117, 1869. 
Le Gendre, Bull. Therap., t. lxxvii., p. 282. 
Levi, Lo Sperimentale, Aug.. 1875. 
Luton, A., Gaz. Hebdom., Oct., 1871, p. 610. 
Meadows, Practitioner, vol. i., 166. 
Nicitin, Kossbach's Pharm. Unters., Bd. iii., 

1878. . 
Nicoll, P., and Mossop, Brit, and For. Med. 

Chir. Rev., vol. 1., 1872, p. 252. 
Oldwright, Canada Med. Journ., 1870,320, 321, 

404. 
Ostere, Stille, Therap., 2 ed., vol. ii. 
Povet & Commarmond, Annal. de la Soc. de 

Med. de St. Etienne et de la Loire, 1863. 
Bamsbotharn, Principles and Practice of Ob- 
stetric Med. and Surg., Phila., 1860, p. 31S. 
Rossbacb, Pbarm. Unters., Bd. i. 
Salkowski, Berl. Klin. Wochenschr., 1876, p. 

228. 
Schiiller, Berl. Klin. "Wochenschr., 1874, p. 

305. 
Tanret, Bull. Therap., xciii., p. 231. 
Tulasne, Ann. Sien. Natur. Botan., 3e serie, t. 

xx., 1853. 
Vogt, P., Berl. Klin. Wochenschr., 1869, No. 

xii., p. 117, March, 1872, p. 115. 
Wernieh, Yircb. Arch., Bd., hi., p. 505, 1872; 

u. Beitr. z. Geburtsh., Bd. iii., Berlin, 1874. 
Winckler, Amer. Journ. Pharm., May, 1864. 
Woakes, Practitioner, vol. i., p. 257. 
Wood, Phila. Med. Times, vol. iv. 
Wright, S. A.. Ed. Med. and Surg. Journ., 

Oct., 1839, vol. Iii., p. 293. 
Zweifel, Arch. f. exp. Path. u. Pharm., Bd. 

iv., p. 387. 

Erigeron. 

Starke, Lond. Med. Bee, 1876, p. 267. 

Etjier Oil. 

Binz, Arch. f. exp. Path. u. Pharm., Bd. v., p. 

109, Bd. nil, p. .",0. 
Bohm u. Kobert, ('., f. d. mod. Wiss., 1S79, p. 

689. 
Grisar, Bonner Dissertation, 1873. 
Hogyes, Centralblatt f. d. med. Wissen., 1879, 

p. 32. 
Kohler and liis pupils, Schmidt's Jahrb., Bd. 

clxxiv., p. 19, 80, 121. 

Eucalyptus Oil. 

Arou, Schmidt's Jahrb., Bd. clvii., p. 239. 
Binz, Brit. Med. Journ., i.. L874, p. 15. 

Bolin, Berl. Klin. Wocheus., p. 110, 1872. 



Eucalyptus Oil. 

Brudell, Bull. Therap., May, 1875, p. 108, vol. 

lxxxix. 
Cortau, Montpellier Med., Mav, 1872. 
Gimbert, Arch. Gen., 1873, xxi., p. 141. 
Haller, Wien. med. Wochens., xxvi. 
Keller, Wien. med. Wochens., xxii., p. 227, 

1872. 
Kohler, H., Arch. d. Pharm., 3 Eeihe, Bd. iii., 

Heft, 2. 
Lorrinser, Wien. med. Wochens., xix., xx. 
Martin, S., Bull. Therap., lxxxiii., p. 453. 
Mosler, Deutsch. Arch. Klin. Med., 1872, x., 

160. 
Pappillon, Gaz., Hebdom., 1872, p. 501. 
Babuteau, Bull. Therap , lxxxiii., 549. 
Schlager, Inaug. Diss. Gottingen, 1874. 
Seitz, Bayer. Arztl. Intell. Blatt, 1870, p. 310. 
Siegen, Bonner Diss., 1873. 
Tristany, Buchner's Bepertor., xix., 1870. 

Fat. 

Lassar, Berl. Klin. Wochenschr., 1879, No. 

xviii., p. 261. 
Munk, J., Verb. d. physiol. Ges. in Berlin, 

Jahrg., 1877-79, No. 13. 

Gelsemtum. 

Bartholow, Lond. Practitioner, v., p. 203. 
Centralbl. f. d. med. Wiss., 1S76, p. 128, 320, 

384, 608, 927; 1877, p. 783; lS78,p.652; 1880, 

s. 74. 
Court wright, Cincinnati Lancet and Obs., 

1876, p. 963. 
Ott, Phila. Med. Times, v., p. 691, vii., p. 289. 
Binger and Murrell, Lancet, ii., 1875, p. 908, 

1876, i., p. 83, 1876, vol. ii.. p. 78 and 569. 
Tweedy, J., Lond. Lancet, 1877, i., p. 833. 
Wormley, Amer. Journ. Pharm., 1870. 

Glycerine. 

Dujardin-Beaumetz and Audige, Bull.Thera., 

xci., p. 62. 
Eckhard, Centralbl. med. Wiss., 1876, p. 273. 
Luchsinger, Pfliig. Arch.,Bd. xi.,p. 502; Cen- 
tralbl. med. Wiss., 1877. 
Lewin, L., Z. f. Biologie., 1879, Bd. xv., p. 

243. 
Munk, J., Verh. d. physiol. Ges. zu Berlin, 13, 

Dec, 1878, u. Virch. Arch., Bd. lxxvi., Heft 

1, p. 119. 
Schultzen, Berliner klin. Wochenschr., 1872, 

No. xxxv., p. 417. 
Schwann, Lekhart's Beitrage z. Anat. u. 

Physiol, viii., p. 159. 
Ziemssen'sEncyclop., vol. xvi., for Literature. 

GUAIAC. 

Bell, Lond. Med. Gaz., Oct., 1840, p. 202. 
Bryden, Brit. Med. Journ., No. 47, 1857, p. 

967, No. 97, p. 927, 1858. 
Husemann, Die Ptianzenstoffe, p. 1106. 
Sandras, Bull, de Ther., v., 371. 
Walker, Brit. Med. Journ., vol. i., p. 528 and 

660, 1864. 
Wood, U. S. Dispensatory, p. 1233. 

Hellebore. 

Helm, Wiirzburger m. Z. S., ii. 5, 6, p. 448, 

1861. 
Marine, Z. f. rat. Med., 3 Reihe., Bd. xxvi., p. 

1098. 
Scattergood, EL, Journ. de Bruxelles, xxxix., 

p. 550, In) I. 
Sch rod", Von, Pra'ger. Vierteljahrss., lxii., 1859, 

p. 19, 95, 106, lxiii., p. 95. 

Hyoscya.mia. 

Earley, old Veg. Neurotics. 
Eellmann. Beitr. d. phys. W'irk.des Ilyoscya- 
inins, DiBS. Jena, 1873. 



BIBLIOGRAPHICAL INDEX. 



1027 



Hyoscyamia. 

Heikuann, Beitr. z. Kenntniss d, phys. Wirk. 

des Hyoscyaniins, Jen., 1873. 
Hohn, Arch. d. Pharm., 1868, p. 215. 
Laurent, De l'Hyoscyauiine et de la Daturine, 

p. 15, Paris, 1870. 
Lernattre, Arch. Gen., 1S65, vol. vi. 
Oulinont, Bull. Gen. de Therap., lxxxiii., p. 

481, 1872; Practitioner, vol. x., p. 1, 1S73. 
Schroff, V., Woch. d. Zeits. d. Gesellsch. d. 

Aerzte z. Wien, 1865. 

Iodine and Iodide of Potas- 
sium. 

Annuschat, A. f. exp. P. u. Pharm., x., 261 

(Action in Lead Poisoning). 
Bachrach, Berl. Diss., 1878. 
Balfour, Ed. Med. Journ., xiii., p. 775, xiv., p. 

33, xv., p. 47, xvi., p. 704; Brit. Med. Journ., 

1874, i., 112. 
Behier, Nerven Centralorg., Schmidt's Jahrh., 

cxxvi., 162, 1865. 
Bernard, CI., Arch. Gener., 1S53, Bd. i., p. 5. 
Benedikt, M., Wien. Jahrb., xviii., ii., 94, 1862. 
Binz, Virch. Arch., Bd. lxii., p. 124, u. Arch. 

f. exp. P. u. Ph., Bd. viii., s. 309. 
Bock, V., Z. f. Biol., 1869; Bd. iii., 126; Bd. v., 

393; Schmidt's Jahrb., Bd. cxlv., p. 142. 
Bbhm, u. Berg, A. f. exp. P. u. Ph., v., 337, 

1876. 
Branne, Diss. Leipzig, 1856. 
Buchheim, Arch. f. exp. Path. u. Pharm., Bd. 

iii., 104. 
Chuckerbutty, Brit. Med. Journ., vol. ii., pp. 

61 aud 85, 1862 (in Aneurysm). 
Cogswell, Edinburgh, 1837. 
Comdet, Froriep's Notizen, i., 55, 89, 1S22. 
Devergie Arch, gen. de Med., x., 2, p. 255, 

1826; Frank's Mag., iii., i., p. 201. 
Dorpater Diss. v. Arroneet, 1S52; Strauch, 

1852; Heubel, 1865; Sartisson, 1S66. 
Euleuburg, Berlin, Klin. W. S., xvi., 1870. 
Fournier, Centralb. f. d. med. W., 187S, p. 55. 
Issersohn, Berl. l^iss., 1877. 
Greeuhalgh, Brit. Med. Journ., vol. i., p. 52, 

1868. 
Handheld, Jones, Beale's Arch., i. 
Heubel, E., Dorpat. Diss., 1865, p. 70. 
Kammerer, Yirch. Arch., Bd. fix., p. 459; Bd. 

lx., p. 527. 
Keith, Edin. Med. Journ., xviii., p. 1077, 1873. 
Kochler, Deutsche Zeitschr. f. pract. Med., 

1877, No. xl. 
Melseus, Schmidt's Jahrb., Bd. cxxxiv., 19, 

1867 ; Memoire sur l'Emploi de l'foduie de 

Potassium pour combattre les Affections 

Saturnines mercurielles et les allid. con- 

secut. de la Syphilis, Bruxelles, 1868. 
Pellikan, V., Beitrage zur Pharm. u. Tox. 

Wiirzb., 1858, p. 118. 
Kabuteau, Gaz. Med. de Paris, xix., p. 190, 

xxii., p. 302, xxiii., p. 313, 1869. 
Rilliet, Bull, de l'Acad. Roy., xxv. 
Ringer, Practit., March, 1872, vol. viii., p. 129. 
Rose, Arch. f. path. Anat., 1866; Bd. xxxv. 
Rosier, Frank's Mag., ii., p. 120, 136. 
See, Lond. Med. Rec, i., p. 757, 777. 
Sharpe, T. S., Amer. Journ. Med. Sci., Jan., 

1876, p. 124. 
Taylor, R. W., Amer. Journ. Syphil. and 

Derma., April, 1873. 
Wallace, L, Liverpool Med. and Surg. Rep., 

1871. 

IODOFORM. 

Binz, Arch. f. exp. P. u. Ph., viii., 309. 
Elsberg, Phila. Med. Times, Oct. 4, 1873, vol. 

iv., p. 4. 
Fereol, Bull. Therap., t. Ixxiv., p. 400, Mav, 

1868. 
Hogyes, Arch. f. exp. P. u. Ph., x., 228. 
Izard, A. A., ISTew Treat, of Vener. Diseases, 

Boston, 1872. 



Iodoform. 

Kennedy, S., Med. and Surg. Rep., Jan., 1870, 

p. 50. 
Lazansky, Centralbl. Chir., 1876, 219. 
Moleschott, Wien, med. Wochenschr., 1S78 ; 

Lond. Med. Rec, Nov., 1878, pp. 350 and 

464. 
Oberlander, Centralbl. f. d. Med. W., 1879, 

s. 336. 
Pelletan, Phila. Med. Times, iv., 695. 
Volker, G., Bull. Therap., t. lxxiii., p. 493, 
* Dec, 1S67. 

Ipecacuanha, vide Emetia. 

Ackermann, Beobachtungen iib. physiol. 

Wirk. d. Emetica, Rostock, 1856, 4 Diss. 
Cunningham, Edin. Med. J., vii., p. 25, July, 

1871. 
Duekworth, Dyce, St. Barth. Hosp. Rep., v., 

p. 230, 1869, vii., p. 98, 1871. 
Higginbottom, Brit. Med. Journ., vol. i., p. 143, 

1869. 
Pecholier, Comp. Rend., vol. lvi., p. 718, 1863. 
Schuchard, Arzneim., p. 586. 
Wibmer, Wirk. d. Arzneim. u. Gifte, ii., 77. 

Irritants, vide Oil of Mustard. 
Iron. 

Bernard, CI., L'Union Med., 1854. 
Becquerel, Simon's Chemistry, vol, ii., p. 254. 
Blake, Journ. of Anat. and Phys., p. 280, Nov., 

1868. 
Cutler & Bradford, Amer. Journ. Med. S., f. 

1S7S, p. 78. 
Complete list of Literature (228 Nos.) by 

Scherpf, in Rossbach's pharmakolog. Un- 

ters., 1877, Bd. ii. ; later works, Hamburger 

Z. f. phys. Chein., v. 1; Hoppe-Seyler, ii., 

p. 191. 
Mialhe, Chim. Appliquee, Paris, 1856. 
Mitscherlich, C. g. Preuss. Vereins. Z., 1846, 

xxi. 
Nasse, Lond. Med. Rec, 1877, p, 498 ; Wag- 
ner's Handworterb., Bd. i. (Art. Blut.) 
Podrowskv, W., Yirch. Arch., Bd. xxii., 5 and 

6, p. 476, 1861. 
Quincke, Ueb. Siderosis, Festschr. z. Haller's 

Jubelf. Bern. Reichert u. Du Bois' Arch., 

vi., p. 757, 1868. 
Quevenne, Memoire sur l'Action phys. et 

therap. des Ferrugineux, Arch, de Phys., 

de Therap. et d'Hvgiene, Oct., 1854, p. 93. 
Sasse, A., Yierteljahrs. f. Prakt. Heilk., 1866, 

2Bd. 
Scherpf, Resorpt. u. Assim. d. Eisens, Wiirzb., 

1878. 
Simon, Animal Chem., Lond., 1845, Syd. 

Soc ed. 
Tiedemann u. Gmelin, Heidelberg, 1820. 

Jaborandi, vide Pilocarpin. 

Carville, Journ. de Therap., 1875, p. SI. 
Fereol, Journ. de Therap., Jan., 1875, p. 45. 
Galezowski, Med. Times and Gaz., 1877, ii., 

558. 
Greene, Phila. Med. Times, vi., p. 56. 
Hardy, Journ. d. Therap., 88, p. 469, 1875. 
Langlev, J. > ., Brit. Med. Journ., 1875, vol. i., 

p. 241 ; Journ. d. Phys., 1878, p. 339 ; Journ. 

Anat., x., 188, 194. 
Luchsinger, PfKiger's Arch., xv., 482. 
Pillicier, Med. Centralbl., 1876, p. 430. 
Purjesz. Deutsch. Arch. klin. Med., xvii.. 

p. 533. 
Ringer, Lancet, i., 1875, p. 159; Lond. Pract., 

xvii., p. 401. 
Schwann, Med. Centralbl., 1874, p. 440. 
Scotti, Berl. klin. Wochens., 1877, p. 141. 
Stumpf, Deutsch. Arch. f. klin. Med., xvi., 

p, 255. 
Tweedy, Lancet, i., 1875, p. 159. 
Weber, Med. Centralbl, 1874, p. 770. 



1028 



BIBLIOGRAPHICAL INDEX. 



Jalap, vide Purgatives. 
Lactic Acid. 

Auerbach, A., Deutsch. Zeitschr. f. pract. 

Medicin, 1877, No. xlvii. 
Erler. Centralbl. med. Wiss., 1876, p. 658. 
Fischer, Lond. Med. Eec, 1877, p. 193. 
Lothar, Meyer, Virch. Arch., Bd. lxvi., p. 120. 
Mendel, Deutsch. rued. Wochens., 1S76, No. 17. 
Preyer, Centralbl. med. Wiss., 1875, p. 577. 
Botticher, Berl-. klin. Wochens., 1877, p. 537. 

Lead. 

Annuschat, A. f. exp. Path u, Pharm., Bd. 

Tii., p. 45, und Bd. x., p. 261. 
Bardenhewer, E., Berl. klin. Wochens., 1877, 

126. 
Blake, Edin. Med. and Surg. Journ., lvi., 1, p. 

116, 1841. 
Chatin, Comptes Eendus Soc. Biolog., t. iy., 

1S62, p. 84. 
Cours, De, A., De l'Hemianaesthesia saturnine, 

Paris, 1S75. 
Debove et Renaut, Le Progres Med., 1876, 151. 
Eulenburg, A., Deutsch. Arch, fur klin. Med., 

Bd. iii., p. 506. 
Falck, Virch. Handbuch d. spec. Path, und 

Ther., ii., 1, 1855. 
Frank, A., Deutsch. Arch. klin. Med., xvi., 

423. 
Friedlander, Virch. Arch., Bd. lxxv., p. 24, 

1879. 
Gusserow, Arch. f. path. An., Bd. xxi. 
Harnack, A. f. exp. P. u. Pharm., Bd. iii., 54, 

1874, Bd. ix„ 152. 
Henle, Zeitschrift f. rat. Med., 3 E., Bd. iv., 

u. Handb. d, rat. Path., 1847, Bd. ii., 179. 
Hermann, Arch. f. Anat. u. Phys., 1867, 64. 
Heubel, Pathogen, u. Sympt. d. chron. Blei- 

Tergift,1871; Virch. u. Hirsch's Jahrbiicher, 

1871, vol. i., p. 316. 
Hitzig, Studien ii. Bleivergiftg., 1868. 
Kussmaul u. Merer, Arch. f. klin. Med., Bd. 

ix.,283. 
Lancereaux, E., Comptes Eendus de la Soc. 

Biol., liv., 3d ser., 1862, p. 84. 
Lewy, E„ Schmidfs Jahrb., Bd. clii., p. 250. 
Lewald, Enters, iib. d. Ausscheid. von Arz- 

neim., aus dem Organismus, Breslau, 1861. 
Malassez, Arch, de Phys., 1874, p. 50. 
Manouvriez, Arch. d. Phys. Normal et Pathol., 

1870, 411, 1876, 762; Recherches cliniques 

sur l'lntox. Saturnine locale et directe, 

Paris, 1874. 
Paul, C, Arch. Gen., 5th series, vol. xv., 1860, 

p. 513. 
Eemak, Arch. f. Psvchiatr. u. Nervenkr., Bd. 

ix., Heft 3, p. 510." 
Renaut, Gazette med., 1878, No. 32, u. Centralb., 

f. d. med. W., 1S79, p. 159. 
Rosenstein, Arch. f. path. Anat., Bd. xxxiv., 

1867, p. 4. 
Rosenstirn, Rossbach's pharmak. Enters. 

Wiirtzburg, 1874. 
Tanquerel des Planches, Die gesammten Blei- 

krankh., fibers v. Frankeuberg, 1842. 
Trousseau, Froriep's Notiz., xviii., No. 13, p. 

207, 1827. 
Wood, Geo. B., Therapeutics, vol. i., p. 158. 

Lithium, vide Alkalies. 

Gibb, Eeport of Brit. Assoc for Advancement 
of Science, 1864 

Mitchell, Weir, Anier. Journ. Medical Sci- 
ences, Oct., 1870, p. h:;. 

Lobelia. 

Ott, 1., Boet. Med. and Surg. Journ., 1875, vol. 
xcii., p. 121; Phila. Med. Times, vi., p. 121. 

Magnesium, vide Alkaline 
Earths. 



Manganese. 

Charvet, Bull. deTherap., lxxviii., p. 80, 1870, 
Lungengangran. 

Garrod, Med. Times and Gaz. 

Gmelin, U. S. Dispensatory. 

Laschkewitz, Journ. de B'ruxelles, Bd. xliv., 
p. 534, June, 1867. 

Leared, Glasgow Med. Journ., Jan., 1865, p. 
488. 

Petrequin, Nouvelles Recherches du Manga- 
nese, 2 ed., Paris, 1852; Bull. Therap., Mar., 
1852, p. 193. 

Williams, American Journ., N. S., cxvii., p. 74, 
Jan., 1870. 



Mercury. 

Baerensprung, Ann. d. Charite, 1856, Bd. vii., 

p. 2. 
Bamberger, Wien, med. Wochenschr., 1876, 

Nos. xi. u. xir. 
Boeck, V., Z. f. Biologie, v. 3, 1869; Schmidt's 

Jahrb., Bd. cxlv., p. 142. 
Foot, A. W., Dub. Journ. Med. Sci., 1873. 
Furbringer, Berl. klin. Wochenschr., 1878, 

No. xxiii., p. 332. 
Hassenstein, Konigsberger Diss., 1879. 
Heilborn, Arch. f. exp. Path. u. Pharm., Bd. 

viii., s. 361. 
Keves, E. L., Amer. Journal Med. Sci., Jan., 

1876, p. 17. 
Kolliker, Th., Verh. d. Wiirtzburger phys. 

med. Ges., N. F., Bd. x., 1877. ■ 
Eussmaul, Inters, iib. d. constit. Mercurial, 

1861, p. 17. 
Eewin, Charite-Ann., Bd. xiv. 
Mussy, N. G. de, Gaz. des Hopitaux, 1868. 
Oetlingen, V., Dorp. Diss., 1848. 
Overbeck, Mercur. u. Syphil., Berlin, 1861. 
Rmdfleisch, Arch. f. Dermatol., 1870. 
Saikowski, Virch. Arch., Bd. xxxvii., p. 346. 
Sigmond, Mercury, Blue Pill, and Calomel, 

Lond., 1840. 
Sigmund, Wien, med. Wochenschr., 1859. 
Stern, Berl. klin. Wochenschr., 1878, p. 59. 
Voit, Ueb. d. Aufnahme des. Q. u. seinerVerb., 

and Korper in his Phys. chem. Unters., 

1857. 
Wilbouchewitcz, Arch, de Physiol., Sep., 1874, 

p. 509. 



Morphia, vide Opium Alka- 
loids. 



Muscarin. 

Bauerlein, Zur Accommodat. des menschl. 
Auges Wiirtzburg, 1876. 

Bogolowski, Centralbl. f. d. med. Wiss., 1870, 
p. 97. 

Harnack, Arch. f. exp. Path. u. Pharm., Bd. 
iv., p. 168, 1875. 

Krenchel, Arch. f. Ophthalni., xx., ii., p. 134. 

Schmiedeberg u. Koppe, Das Muscarin, Leip- 
zig, 1869. 

Schmiedeberg u. Harnack, Arch. f. exp. Path, 
u. Pharm., Bd. vi., s. 101, 1876. 



Musk. 



Barbier, Mat. Med., ii., p. 217. 

Eilchne, Sitzungsber. der Erlanger phys. 

med. lies., 1876: a. Centralbl. f. d. med. 

Wiss., 1876. p. 880. 
JSrg. Materalien ■/.. e. ■/.. Arzneimittellehre, p. 

285, Leipzig, 1825. 
Tralles, Com.de rebus in Sc. Natur ct Med. 

golis, xxvi., p. 484. 

an & PidoUX, Traitr, etc., 8, ed. ii., p. 

187. 



BIBLIOGRAPHICAL INDEX. 



1029 



Narcia, vide Opium Compounds. 

Albers, Vireli. Arch., vol. xxvi., p. 225. 
Baxt, Eeichert's Arch., 1869, p. 112. 
Belner&Debout, Bull.Therap., t. lxvii., p. 145. 
Bernard CI., Arch., Generates, 1864, 6e ser., t. 

iv., p. 459. 
Eulenberg, Schmidt's Jahrb., Aug. and Oct., 

1866, cxxxi., p. 22. 
Fronmiiller, Schmidt's Jahrb., Bd. cxli., p. 15. 
Harley.The Old Veg. Narcotics, p. 143; Penn- 

syl. Hosp. Reports, 1868. 
Husemann, Pfanzenstoffe, p. 184. 
Kerseh, S., Schmidt's Jahrb., Bd. cxli., p. 15. 
Line, Journ. de Pharm., et de Chemie, 4e ser., 

t. iii., p. 386. 
Mitchell, Weir, Amer. Journ. Med. Sci., Jan., 

1870, p. 17. 
Oetlinger, Inaug. Diss., Tubingen, 1866. 

Narcotics, vide Opium Alka- 
loids. 

Rumpf, Centralb. med. Wiss., 18S4, p. 366. 

NlCOTIN. 

Albers, Deutsche Klinik, 1851, ISTo. 32. 
Anrep, V., Du Bois-Reym, A. f. An. u. Phys. ; 

Phys. Abth., Jg., 1S79 ; Suppl. Bd., p. 167 ; u. 

Jg., 1SS0, p. 209. 
Basch, V., u. Oser.,Wien. Med. Jahrb., 1872, p. 

367. 
Bernstein u. Dogiel, Yerhandl. des nat, Med. 

Vereins. zu Heidelberg, iv., 28. 
Benham, W.T., West Riding Lunatic Asylum 

Reports, vol. iv., p. 307, 1874. 
Bernard, CI., Substances Tox., p. 399, 410. 
Bibra, V., Die Narkot Genussmittel, 1855, p. 

297. 
Blatin, Recherches, phys. and clin. sur la 

Nicotine et le Tabac, Paris, 1870. 
Bohm, Herzgifte, Wurzburg, 1S71, p. 12. 
Bon, Le, Med.Centralzeit xli., 1, June, 1872. 
Bottger, Buchner's Neue Repert. der Pharm., 

xvi., 579. 
Brodie, Phil. Trans., 1811, p. 17S. 
Buchheim u. Loos, iib d. Griippe d. Curarius, 

Diss. Giessen, p. 48. 
Eulenberg u. Vohl, Vierteljahrsschr. f. Ge- 

richtl. Medicin, Bd. No. 6, p. 249, xiv. 
Griinhagen, Centralb. fiir med. Wiss., 1S63, p. 

577. 
Hammond, Amer. Jour. Med. Sci., p. 282, 1S57. 
Haushton, p. 55. 

Hirschmann, L. Reich. Arch., 1863, p. 309. 
Husemann, Handb. d. Toxicol., vol. ii., 483. 
Kolliker, Virch. Arch., x., p. 253, 1856. 
Krocker, Berl. Diss., 1855. 
Nasse, V., Beitr. z. Darrubewegung, Leipzig, 

1S66. 
Namias, Comp. Rend., lix., p. 90, 1864. 
Orfila, Memoire sur la Nicotine et sur la Coni- 

cine, Bruxelles, Youker, freres, 1851. 
Praag, L. v., Virch. Arch., Bd. viii., p. 56. 
Rogow, Zeitschr. f. rat. Med., xxix., p. 1. 
Reil, Journ. f. Pharmacodvn,Bd. ii., p. 203. 
Rosenthal, Centralb. f. d.med. Wiss., 1863, p. 

737. 
Schmiedeberg, Sitzber. d. E. Sachs. Acad., 

1870. 
See, Nouveau Diet. d. Med. V. art, Asthma, p. 

715, 1865; Journ. of Anat,, May, 1870, p. 315. 
Savory, The Lancet, 1863, vol. i., p. 549. 
Surminskv, Ztschr. f. rat. Med. (3), xxxvi., p. 

205. 
Tscheschichin, Reich, u. Dubois' Arch., 1866, p. 

151. 
Traube, Allgemeine Med. Central. Zeit., 1862. 
Truhart, Dorpater Diss.. 1869. 
Uspensky, Reich, u. Dubois' Arch., 1S68, p. 522. 
Yulpian, Comptes Rend, de la Soc. de Biol., 

1851, p. 151. 
Wertheim, Zeitschr. d. k. k. Gesellsch. d. 

Aerzte z. Wien. 1851, 8. 



Nitrite of Amyl. 

Aldridge, Ch., West Riding Lunatic Reports, 

vol. L, p. 71. 
Amez-Droz, Arch, de Phys. Norm. et. Path., 

Sept., 1S73, p. 467. 
Arb, a. d.physiol. Inst. z. Leipzig, 1869 ; Journ. 

of Anat. and Phys., vol. v., p. 93 ; Loud. 

Clin. Soc. Reports, vol. iii. 
Balard, Ann. de Chimie et de Phys., xii., 1844, 

p. 294. 
Berger, O., Allgem. Med. Central Zeit,, May, 

1871. 
Brunton, Lauder, Lancet, vol. ii., p. 97, 1867. 
Filehne, Pfl tiger's Arch., Bd. ix., p. 411 ; and 

Arch. f. Anat. u. Phvsiol., 1879, p. 385. 
Fothergill, Brit. Med. journ., 1874, i., p. 77. 
Gamgee, A., Philos. Trans., 1868, p. 589. 
Giacosa, Z. f. Physiol. Chimie, iii., p. 54. 
Grav, St. Clair, Glasg. Med. Journ., 1S71, p. 

188. 
Guthrie, Ann. d. Cheni. u. Pharm., Bd. iii. 
Hoffmann, F. A., Reichert's Arch., 1872, 747. 
Jacobi, Mary Putnam, New York Med. Rec, 

Jan., 1875, p. 11. 
Jolvet u. Regnard, Centralbl. f. d. med. 

Wis;., 1876, p. 860; Gaz. Med. de Paris, 

1876, No. 29. 
Ladendorf,Berl.klin.Wochens.,No. 43, 1S74, 

537. 
Mayer, S., A. f. exp. P. u. Pharm., v., 55, 63. 
Mitchell, -Weir, Phila. Med. Times, 1872, vol. 

v., p. 353. 
Pick, fiber d. Amylnitrit, 2 Aufl., bei Hirsch- 

wald, Berlin, 1877; mit ausfiihrlicher alterer 

Literaturangabe, Centralbl. Med. Wiss., No. 

55, p. 865, 1S73; Deutsch. Arch. Elin. med, 

xvii., 143. 
Richardson, B. W., Trans. Brit. Med. Assn. 

for Advance of Science, 1864-1872. 
Schuller, Berl. klin. Wochens., No. 25, 1874, 

294. 
Urbantschitsch, Wien. Med. Presse, 1877. 
Wood, Amer. Journ. Med. Sci., July, 1871, p. 39. 

NlTROBEXZOLE. 

Bahrdt, Arch. f. physiol. Heilk., 1871, p. 320. 
Filehne, A., f. exp., P. u. Ph., ix., p. 339. 
Guttmann. Arch. f. Anat. u. Phys., 1866. 
Helbis;, Deutsche mil.-arztl. Zeitschr., Bd.ii., 

1873. 
Letheby, Med. Chirurg. Review. 
Lewin, Virchow's Arch., lxxviii., p. 193, 1879. 
Poincare, Centralbl. f. d. med. Wiss., 1S79, p. 

937. 

Nitrogen. 

Chevreul, Nouv. bullet, d. 1. soc. philomet,, 

1816. 
Meyer, L. Zeitschr. f. r. Med. N. F., Bd. viii., 

p. 256. 
Regnault u. Reiset, Compt. Rend., Bd. xxvi. 

Nitroglycerin. 

Brunton, Lauder, andTait, St. Bartholomew's 

Hosp. Rep., 1S76, p. 140. 
Green, Practitioner, xxviil, 102. 
Murrell, Lancet, 1879, pp. 80, 113, 225. 
Pellikan, Beitriige. 

Nitric Oxide. 

Podolinsky, Arch. f. ges. Physiol., 1S72, Bd. 
vi., p. 553. 

Nitrous Oxide. 

Amory, N. Y. Med. Journ., Aug., 1870, p. 1. 
Bert, Gaz. d. Hop., 1S79, No. xxxvii. u. xli. 
Cotton, Phys. Action of Nitrous Oxide Gas, 

Pbila., 1871. 
Goltstein, Pfliiger's Arch., 1S78, Bd.xvii., 331. 
Hermann, L. Arch. f. Anat, u. Physiol., 1864, 

p. 521. 



1030 



BIBLIOGRAPHICAL INDEX. 



Nitrous Oxide. 

Jolvet and Blanche, Arch. d. Phys., July, 

1873, p. 364. 
Thomson, E., Phil. Med. Times, Nov. 15, 1873, 

p. 97, vol. iv. 
White, T.W., Dental Mat. Med., Phila., 1868. 
Zuntz, Pfluger's Arch., xvii., 135. 

Oil of Mustard. 

Heidenhain, Pfluger's Arch., Bd. iii., p. 504; 

Bd. v., p. 309; Bd. vi., s. 20. 
Kohler, Centralbl. f. d. med. W., 1878, p. 433 

u. 450. 
Naumanu,Prag.Vierteljahrsschr.,Bd.lxxvii., 

p. 1. 
Paalzow, Pfluger's Arch., 1871, vol. iv., p. 492. 

Opium Alkaloids. 

Albers, Arch. f. path. Anat., Bd. xxvi., p. 229. 
Baxt (Thebaia), Wien.Acad. Sitzber.,2 Abth., 

Bd. lvi., p. 189; u. Arch. f. Anat. u. Phys., 

1869, p. 128; Ludwig's Arbeiten. 
Bernard, CI. Lecons sur l'Anesth. et s. l'As- 

phyxie, Paris, 1875; Arch. Gen., p. 455, vol. 

iv., 6th ser., 1864. 
Bouchardat, Schmidt's Jahrb., Bd. cxx., p. 280. 
Boeck, V., Unters. iib. p. Zersetz d. Eiweiss. 

Miinchen, 1871. 
Buskirk, Washington Post, Jan. 23, 1878. 
Chalkius, Quart. Journ. Psychol. Med., 1868, 

vol. ii., 739. 
Charvet, Pereira's Mat. Med., vol. ii., p. 1035, 

Phila., 1854. 
Dain, Amer. Med. Journ., July, 1874. 
Dietl and Vintschgau, Pfliig. Arch., Bd. xvi., 

p. 316. 
Dragendorff, Pharm. Zeitschr. f. Russland, 

1866. 
Eckard, C. u. F. Eckard's Beitriige z. An. u. 

Phys., Bd.viii., s. 79, 138, 1878. 
Eulenberg (Narceinj, Deutsch. Arch. f. klin. 

Med., Bd. i., p. 55. 
Fiset, Morrison, N. Y. Med. Rec, July, 1874, 

p. 342. 
(rscheidlen (Morphin), Unters. a. d. physiol. 

Lab. in Wurtzburg, Bd. ii., 1869. 
Harley, Old. Veg. Neurotics, 107, London, 1869. 
Kauzmann, Dorpater Diss., 1868. 
Kolliker, Arch. f. path. Anat., Bd. x.; Virch. 

Arch., Bd. x., p., 248. 
Literature, complete, Arch. f. Path. u. Pharm., 

vii., 24. 
Loomis, A., New York Med. Rec, 1873. 
Meihuizen, Pfliiger's Arch., Bd. vii., 1873, p. 

201. 
Mitchell, Weir, Amer. Journ. Med. Sci., Jan., 

1869, p. 37, Jan., 1870, p. 17. 
Miiller (Thebaia), Marburger Dissert., 1868. 
Nasse, Beitr. z. Physiol, d. Darmbeu, Leip- 
zig 1866. 
Nothnagel, Handb. d. Arzneim., Berlin, 1870, 

p. 8. 
Oetinger (Narcein), Tubinger Diss., 1866. 
Paby, Med. Times & Gaz., June, 1869, p. 641, 
Reese, Amer. Journ. Med. Sci., Jan., 1871, pp. 

133 and 373. 
Balvioli, Ludwig's Arbeiten. 
Smith, EL Lancet, vol. i., p. 419, 1854. 
Wachs, iib. (Codeia), Marburger. Diss., 1868. 
Witkowski (Morphia), Arch, f.exp. Pathol, u. 

Pharm., Bd. vii., p. 247, Complete Literature. 
Wood, Boat. Med. Surg. Journ., vol. 1 i x . , p. 

268, 1868. 

Organic Acids, vide Acid.-. 
Oil of Turpentim:. 

Cruclfl, I/on, Dc la Trn'binthinc, Paris, The- 

L874. 
Fleischmann In Bossbach'B pharm. Unten., 
Bd. ii., Vgl, Sthezische Ocle. 



Oil of Turpentine. 

Hoppe, Journ. f. Pharmacodyn., Bd. i., p. 105. 
Robert, R, Centralbl. f. med. Wiss., 1877, p. 
129. 

Oxygen. 

Afanassiev, Ber. d. k. saohs Ges. d. Wiss., 1873. 
Assmuth, Dorp. Diss., 1864. 
Bert, Lecons sur la Respiration. 
Buchheim, Arch, f.exp. P . u. Ph., Bd. iv., p. 

137. 
Donders, Pfluger's Arch., Bd. v., p. 20. 
Dybkowski in Hoppe-Seyler's Med. Chem. 

Unters., Bd. i. 
Estor u. St. Pierre, Journ. de l'Anatomie et 

de la Phys., Bd. ii., 106. 
Fernet, Ann. d. Sciences nat, vi,, Bd. viii. 
Friedlimder u. Herter, Z. f. physiol. Chem., 

iii., 19. 
Gorup-Besanez, Annal. d. Chem. u. Pharm,, 

Bd. ex., u. exxv. 
Hacker, Dissert. Dorpat. Riga., 1863. 
Herter, Ueber d. Spannung desO. inarteriel- 

len Blut. Z. f. Physiol. Chem., iii., 98, 1879. 
Hoppe-Sevler, Med. Chem. Unters. Bd. i., in 

Arch. f. Physiol., Bd. vii., 9; Physiol. Chimie, 

i'., s. 7, u. 39. 
Hiifner, Zeits. f. phys. Chimie, i., p. 317, u. 

386, u. Centralbl., 1878, p. 710. 
Liebig, G., Aerzl. Intelligenzbl., 1879,No.xix. 
Magnus, Poggendorfs Ann., Bd. xl., p. 583, 

u. lxvi., p. 177. 
Manassein, Centralbl. f. m. Wiss., 1871, xliv., 

p. 688. 
Meyer, Lothar, Zeitsch. f. rat. Med., No. i., 

Bd. viii., p. 256. 
Muller, W., Wien. Acad. Sitzber., Bd. xxxiii., 

99. 
Pfliiger in Seinem Arch., Bd. 1., p. 274. 
Regnault u. Reiset, Compt. Rend., Bd. xxvi., 

pp. 3, 4, 17. 
Schmidt, Al., Ozom. im Blut. Dorpat. 1872 ; 

Hamatol. Studien Dorpat, 1865; Centralbl. 

f. d. Med. Wiss., 1867 ; Ber. d. k. sachs Ges. 

d. Wiss. M. phys. CI., Bd. xix.; Arch. f. 

path. Anat. u. Phvs., Bd. xlii. 
Schonbein, Roy. Soc. Proc, 1840. 

Pellitory. 

Browne, London Practitioner, xvii., p. 86. 

Peppermint. 

Marcusson, Hallenser Diss., 1877. 

Pepsin. 

Albertoni, Centralb. f. d. med. Wissen., 1878, 

p. 641. 
Beale, Arch. f. 1850, i., iv. 
Davidson, Practit,, March, 1872, vol. viii., p. 

131. 
Dowdeswcll, Pract., Papain, vol. xxx., p. 485. 
Ewald, Frerichs u. Leyden'sZ. f. klin. Med., 

i., 231. 
Gray, Jas., Edin. Med. Journ., Jan., 1853, p. 

31. 
Jovnes, L. S., Richm. and Louisville Med. 

journ., 1869. 
Leube, W. ()., Deutschcs Arch. f. klin. Med., 

ix., 532, x., 1,1872. 
.Manassein, Yinh. Arch., 1872, vol. Iv., p. 413. 
Roberts, W. 

Tuson, Med. Times and Gaz., vol. ii., 1882. 
Wayne, Amer. Journ. Pharm., 1868, 

Pepton. 

Penzoldt, Deut. med. Wochenschr., Bd. !▼., 

b. 418, 426. 
Schmidt-Muhlheim, Ludwig's Arh. 
Seegcn, Pfluger's Arch., vol. xxv., p. 165. 



BIBLIOGRAPHICAL INDEX. 



1031 



Peroxide of Hydrogen. 

Assmuth, Dorp. Diss., 1864. 

Guttraann, Virch., Arch., Bd. lxxiii., p. 23, u. 

lxxv., p. 255. 
Richardson, Lancet, vol. i., p. 383, 1862. 
Stohr, Arch. f. klin. Med., 1867, Bd. iii., p. 421. 

Petroleum. 

Lassar, Berl. klin. Wochenschr., 1879, No. 
xviii., s. 261. 

Phosphorus. 

Abstract of the Literature up to 1867, in 

Schmidt's Jahrb., Bd. cxxxvi., p. 209. 
. Andant, Journ. de Med. de Bruxelles, 1868-79. 
Anstie, Pract., 1873, vol. xi., 103. 
Aufrecht, Deut. Arch. f. klin. Med., xxiii., 

331. 
Bauer, Zeitschr. f. Biologie, Bd. vii. to xiv. 
Bollinger, Deutsch. Arch. klin. Med., Bd. v., 

p, 149, 1869 ; Bd. vi., p. 94, 1870. 
Demarbaix and Wilmart, Presse Med. beige, 

xxi., p. 197, xxv., 1869 ; Schmidt's Jahrb., 

b. cxliv., v., p. 152. 
Dybkowsky, Hoppe-Seyler's Med. Chem. 

Unters., Heft- i., p. 54. 
Eames, H., Dab. Journ., Med. Sci., Jan., 1872, 

p.l. 
Eulenberg and Guttman, Aertz Literatur- 

blatt, 1868, No. 12; Syd. Year-Book, 1868, p. 

450. 
Falk, jun., Arch. f. exp. Path. u. Pharm., Bd. 

vii., 1877. 
Freise, Berl. klin. Wochens., 1877, p. 437. 
Hartmann, Dorp. Diss., 1866. 
Hermann u. Brunner, Pfliiger's Arch., Bd. 

iii., p. 1 ; Deut, Arch. klin. Med., p. 198. 
Kohts, O. Pfl tig. Arch., vol. xiii., p. 84, Deutsch. 

Arch., f. klin. med., Bd. v., p. 168. 
Kohler, Berl. klin. Wochens., 1870. 
Lebert and Wyss, Arch. Gen., 1868. 
Mayer, Canstatt's Jahresb., Bd. v., 1862, p. 

123. 
Munk and Leyden, Die Acute Phosphorverg. 

Berl., 1865. 
Ossikowsky, Wein. Med. Presse, 1872. 
Percy, S. R., Prize Essay, Trans. Amer. Med. 

Assoc, 1872, p. 659. 
Poulet, Gaz. Med. de Paris, Aug., 1872. 
Schiff, Arch. Exp. Path. u. Pharm., Bd. ii., p. 

347. 
Schulzen u. Reiss, Ann. de Charite, Bd. xv. 
Schuchardt, Henle and Pfeufer's Arch , N. F., 

Bd. viii., p. 235. 
Sotnitschewsky, Z. f. physiol. Chimie, iii., p. 

391, 1879. 
Thompson, J. A., Lond. Pract., vol. xi., pp. 

13 and 27, July, 1873. 
Vetter, Virch. Arch., Bd. liii., p. 186, p. 21. 
Yigier, Bull. Therap., xc, Jan. 1876. 
Virchow, Sein. Arch., Bd. xxxi., p. 399, 1864. 
Wegner, Virch. Arch., Bd. lv., p. 11, June 22, 

1872; Wien. Med. Presse, Jan., 1872. 
Weyl, Arch. d. Heilk., 1878, p. 163. 

Physostigma. 

Amagat, Journ. de Therap., 1876. 

Arnstein, C, and Sustschinsky, Unters. Phys. 
Lab. Wiirzburg, 2 Th. p. 86. 

Edwards, J. B., Med. Times and Gaz., vol. ii., 
p. 212, 1864. 

Englehardt, Unters. a. d. Phys. Lab. Wurz- 
burg, 2 Th., 526. 

Fraser, Trans. Royal Society of Edin., vol. 
xxiv. 

Frolich, Pharm. Unters., i., 56. 

Grunhagen, Virch. Arch., Bd. xxv., p. 521. 

Harnack u. Witkowski, Arch. f. Exp. Path. 
u. Pharm., v., 142. 

Jones, W., Pract,, 1869, vol. iii., p. 163. 

Keyworth, Glasg. Med. Journ., N. S., 1869, i., 
p. 54. 



Physostigma. 

Kleinwachter. Revue Photogra. des Hopitaux, 

1870. 
Kohler, Arch. Exp. Path. u. Pharm., Bd. i., 

280. 
Laschkewitch, Virch. Arch., 1866, Bd. xxxv.. 

294. 
Leven and Laborde, Schmidt's Jahrb., Bd. 

cxlvi., p. 136. 
Lewisson, Reich. Arch., 1870, p. 346. 
Merson, Journ. of Mental Sci., Jan., 1875, vol. 

xx., p. 602. 
Papi, C, Schmidt's Jahrb., cxlii., 287 ; Gaz. 

Lomb., 1858. 
Robertson, Argyll, Edinb. Med. Journ., 1863. 
Roemer, St. Louis Med. and Surg. Journ., 

1873, 367. 
Rosenthal, Reich. Arch. 
Stubbotin, Arch. f. klin. Med., Bd. vi., 285, 

1869. 
Tachau, Arch. d. Heilk., 1865, p. 70. 
Vee and Leven, Comptes Rend, de la Soc. de 

Biol., 1865, p. 161. 
Westermann, Schmidt's Jahrb., Bd. cxxxviii., 

p. 290. 

PlLOCARPIN. 

Complete List of Literature (117 Authors), 
bei Lewin, Berl. Cnarite Annal., v. Jahrg., 
1878, p. 559. 



Prussic Acid. 

Bernard, CI., Lecons sur les Subst, toxiques, 

p. 193, Paris, 1857. 
Bischoff, Ueb. Vergift. Wein, 1844. 
Bohni, Arch. f. exp. P. u. Pharm., Bd. ii. 
Bohm u. Knie, Arch. f. exp. Path. u. Therap., 

Bd. ii., p. 135, 137. 
Bunge, A. f. exp. P. u. Pharm., xii., 1 (Gan- 

gas). 
Coze, Gaz. Med. de Paris, 1849; Comptes 

Rend., t. xxviii., 1849, p. 780. 
Fagge, Hilton, Guy's Hosp. Rep., 1868, p. 259. 
Funke, Ber. d. K. sachs Gesell. d. Wiss. z. 

Leipzig, Bd. xl , 1859, p. 28. 
Gahtgens in Hoppe-Sevler's Med. Chem. 

Unters. Berl., 1866, 324,"s. 346. 
Geinitz, E. Pfliiger's Arch., Bd. iii., 1870, p. 46. 
Harley, Lond. Phil. Trans., 1865, p. 706. 
Hiller, Centralbl. f. d. med. W., 1877, 577- 
Hiller and Wagner, Lancet, 1877, ii., 933. 
Hoppe-Seyler, Med. Chem. Unters. Berl., 1867, 

140; Virch. Arch., Bd. xxxviii., p. 475. 
Hiinefeld, Der Chemismus in d. thierischen. 

Organisation, Leipsic, 1840. 
Jones, J., N. Y. Med. Rec, vol. ii., p. 459. 
Keen, Proc , Phil. Acad. Nat. Sci., 1869. 
Kiedrowski, Virch. Jahresb., 1858, vol. i., p 

48. 
Kolliker, Virch. Arch., Bd. x., p. 272. 
Lankester, Ray, Pfliiger's Arch., vol. ii., 1869, 

p. 492. 
Laschkewitch, Reich. Arch., f. Anat., 1868, 

p. 653. 
Lecorche and Meuriot, Arch. Gen., t. xi., 6e 

serie, pp. 539, 543. 
Lewisson, Reich. Arch., 1870, p. 352. 
Preyer, Die Blausaure physiol. Unters., 2 Thle. 

Bown, 1868 u. 1870, contains a full resume 

of literature on the subject up to 1870. 
Preyer, Arch. f. exp. Path. u. Ph., Bd. iii., p. 

381. 
Rossbach u. Papilsky in Rossbach's pharm. 

Unters., Bd. iii., 1877. 
Schonbein, Schmidt's Jahrb., Bd. ex]., 1868, 

p. 161. 
Schubarth, Horn's Arch. f. med. Erf., Berl., 

1824. 
Sobernheim, J. F., Handb. d. Prakt. Toxicol., 

Berlin, 1838. 
Stannius, Arch. f. Anat,, 1858, p. 95. 
Vietz, F. B., Med. Jahrb. d. k. k. oesterreich. 

Staates, Bd. ii., 1814. 



1032 



BIBLIOGRAPHICAL INDEX. 



Prussic Acid. 

Wahl, De Vi et Effectu Acido Hydrocyanato, 

Bonn, 1865. 
Wallach, Ber. d. deutscli. chem. Gen., x., 2120. 



Purgatives. 

Asp, Ludwig's Arbeiten, 1868. 

Brieger, Arch. f. exp. Path., Bd. viii., p. 355. 

Brunton, Lauder, Med. Press and Circular, 

Dec. 31, 1S73, p. 590; Pract., vol. xii., pp. 

342 and 403. 
Buchheim, Arch. f. physiol. Heilk., Bd. xiii. 

u. xiv.; Virchow's Arch., Bd. xii., p. 1, 
Falck, Virchow's Arch., Bd. liv., p 173. 
Headland, Action of Medicines, London, 1867, 

p. 443. 
Hay, Matthew, Journ. of Anat. and Physiol., 

vol. xvi. 
Kohler, H., Virchow's Arch., Bd. xlix., p. 408. 
Moreau, F. A., Memoires de Physiologie, 

Paris, 1877; Comp. Ptend., t. lxvi., 1868; 

Arch Generates, 6e ser., t. xvi., p. 234. 
Hosier, Berl. klin. Wochens., No. xlv., 1873, 

p. 533. 
Nasse, N., Beitr. z. physiol. der Darmbewe- 

gung, Leipzig, 1866. 
Radziejewski, Eeichert's und Du Bois-Rey- 

mond, Arch., 1870, p. 37. 
Rohrig, A., Strieker's Med. Jahrb., 1873, p. 240 ; 

Exp. Unters. ii. d. Phys. d. Gallenabsonder- 

ung, Wien, 1873. 
Rutherford, British Med. Journ., vol. i., p. 

362, 1877; Schmidt's Jahib., 1878, Bd. 

clxxvii., p. 11, u. folgende. 
Schiff, II Morgagni, 1867. 
Simon, Gus., Arch. d. klin. Chir., xv., p. 99. 
Thiry, Sitzungsber. d. Wiener Acad. Math. 

Naturw. CI., 1864, Bd. i., p. 95; Gaz. Med., 

1871. 
Vulpian, Gaz. Med., 1873, p. 309. 
Wood, Amer. Journ. Med. Sci., vol. lix., p. 

395, 1870. 



QUININE. 

Albertoni & Giotto, Bull. Therap., xc, p. 403. 
Appert, Virch. Arch., Bd. lxxi., p. 364. 
Baldwin, W. O., Amer. Journ. Med. Sci., Ap., 

1847, p. 292. 
Bauer u. Kiinstle, Deutsch. Arch. f. klin. 

Med., Bd. xxiv., s. 53. 
Binz, Zur Salicylsaure u. Chininwirkung. 

Arch. f. exp. Path. u. Pharm., Bd. i., p. 18, 

1873, Bd. v., p. 39, Bd. vii., p. 275; Lond. 

Pract., p. 4, vol. v., 1870; Virch. Arch., Bd. 

xlvi., 1864, p. 138. 
Bochefontaine, Recherches exp. a laContrac- 

tilitg de la Kate, Paris, 1873; Arch, de 

Physiol, July, 1873. 
Boeck, Von, Unters. u. d. Zersetzung des 

Eiwcises im Thirkorper, Munich, 1871. 
Briquet, TraitC Therap. de Quinquina, Paris, 

1855. 
Brunton, Lauder, and Pardington, St. Barth- 
olomew's Hosp. Rep., 1876, p. 150. 
Hurt, Med. and Surg. Reporter, 1870. 
Chalvet, Schmidt's Jahrb., Bd. cxli., p. 152; 

( .az. Hehdom., 2d ser., t. v., 1868. 
Chaperon, Piliig. Arch. f. Phys., 1869, vol. ii., 

p. 295. 
Chiara, 1'Un. Med., Nor. 20, 1873, p. 795. 
Clapton, Med. Times and (iaz., vol. J., p. 462, 

1864. 
Complete Collection Of Literature up to 1875 ; 

(82 Nob.) In Binz., Das Chinin Berlin bei 

Hirsctrwald, 1875. 
Cutler, J. B.,Psyoh. and Med. Legal Journ., 

Dietl, Wien. Med. Wochens., 1852. 
Dupuis, [/Action I Mi vs. do Quinine, Paris, 
1877. 

En le n i H in', L, Reich. Arch. f. Anal. 1865, p. 

128. 
Qeltowsky, I. ond. Pract., vol. viii., p. 321. 



Quinine. 



Hallier, das Cholera-Contagium, Leipsic, 

1867. 
Hamilton, J. B., Tnd. Med. Gaz., 1873. 
Henbach, Arch. f. exp. Path. u. Pharm., Bd. 

v., p. 233; Centralbl. med. Wiss., 1874, p. 

673. 
Henke, Deutsch. Arch. f. klin. Med., Bd. xii., 

p. 630. 
Hesse, Ber. d. deutsch. Chem. Ges., x., 2152. 
Jacobowitch, Magnan, Revue des Sci. Med., 

1873. 
Jerusalimsky, ueb. d. phys. Wirk. d. Chinin. 

Berl. bei Hirschwald, 1875 ; Centralbl. med. 

Wiss., 1876, p. 476. 
Jones, Bence, Lectures on Path, and Therap., 

London, 1867. 
Kerner, Lond. Pract., vol. x., 169; Pfliig. 

Arch. f. Phys., 1870, p. 93. 
Kohler, Zeitschrift f. d. ges. Naturwiss, f. 

Sachsen,inThiiringen, Bd. xlix.,u. Sitzber. 

der Naturforscher Gesellsch. zu Halle, 

1876. 
Lauderer, Repertorium f. Pharm., Bd. xxv., 

1836, 1839, 1842. 
Liebermeister, Deutsch. Arch. f. klin. Med., 

Bd. iii., 1867. 
Magendie, Gaz. Med., 1847. 
Martin, A., Inaug. Dies. Giessen., 1868. 
Melier, Memoires de l'Acad., t. xii., p. 722, 

1843. 
Mosler, Path. d. Leukaemie,Berl., 1872 ? p. 451. 
Monteverdi, Ann. et Bull, de la Societe de 

Med. de Gand, May, 1871. 
Naunyn & Quincke, Reich. Arch. f. Anat., 

1869. 
Pages, Gaz. Med., 1846. 
Personne, Centralbl. f. d. med. Wiss., 1879, 

s. 110. 
Piorry, Arch. Gen. de Med., 1847. 
Pringle, Abs. on Diseases of the Army, 

Lond., 1765. 
Rabuteau, Bull. Therap., t. lxxv., p. 475. 
Raucillia, l'Union Med., 1873. 
Rapmund, Deutsch. klin., 1874. p. 51. 
Rausone, Inaug. Diss. Bonn., 1871. 
Renzi. D., Bull. Therap., xci., p. 45. 
Rhoads, E., & W. Pepper, jun., Pennsyl. 

Hos. Rep., vol. i., 1868. 
Rich, Charleston Med. Journ. and Review. 
Rossbach, Pharm. Unters , Bd. i., Heft iii. 
Sayre, Amer. Pract., 1871, p. 260. 
Seharrenbroich, Inaug. Diss. Bonn., 1867. 
Schloekow, De Child sulfurici Vi physi- 

nonnulla Exp. Vratisl., 1860. 
Schrofi; Strieker's Med. Jahrb., 1875, p. 175. 
Schulte, A., Centralbl. f. d. med. Wiss., p. 727, 

Nov. 1871. 
Walranen, Boston Med. and Surg. Journ., 

1873. 
West, Jos. J., Savannah Journ. Med., vol. i., 

p. 19, 1858. 
Wilson, J. S., South. Med. and Surg. Journ., 

p. 341, 1855, Sept., 1860. 
Zunst., Beit. z. Phys. des Blutes, Inaug. 

Diss. Bonn., 1868; Arch. f. Exp. Path., Bd. 

ii., p. 343. 



Rhubarb, vide Purgatives. 



Ricin, vide Purgatives. 



Rui:. 



Cahours et Gerhard, Annales de Chini. et de 

Physique, \\i\., p. 227, ser. iii.; Pharmaz. 

Jahreso. v. Wiggers, \ iii., 50. 
Cooper, <;. T., Med. Exam., N. S., Lx., 720. 
Gorup-Besanez, Neues Report, fiir Pharmaz., 

xix., 885. 
Helie, Bull de Therap., xv., 75; Schmidfa 

Jahrb., xxi., p. 275. 



BIBLIOGKAPHICAL INDEX. 



1033 



Salicylate and Salicylic Acid. 

Balz, Arch. d. Heilk., xviii., p. 60. 
Bochefontaine & Chabret. 
Bochefontaine, Le Progres Med., 1877, p. 630. 
Buchholtz, Arch. exp. Path. u. Pharm., Bd. 

iv.; Dorpat. Diss., 1(^66. 
Byasson, Centralbl. f. Chir., 1877, p. 809. 
Callender, Trans. Lond. Clin. Soc, ix., p. 9. 
Danewsky, Arbeit, in Pharm. Lab. Moskaw, 

i., p. 190. 
Drasche, Centralbl. f. Chir., 1876, p. 777. 
Farsky, Sitzber. d. k. Akad. d. Wiss., Bd. ii., 

lxxiv., p. 49. 
Jacoud, Le Progres Med., 1877, pp. 528, 745. 
Laborde, Bull, de Therap., xciii., p. 276. 
Marine, Gottinger Nachricht, 1878, No. vii., 

p. 229. 
Martenson, Petersb. Med. Zeits., 1875, p. 343. 
Meyer & Kolbe, Journ. f. prakt. Chem., Bd. 

xii., p. 9. 
Musey, Bull. Therap., xiii., p. 318. 
Riess, Berl. klin. Wochens., xii., 1875, pp. 674, 

675. 
Robin, Lond. Med. Rec., 1877, p. 151. 
Scheffer, Marburger Diss., 1860. 
Schroeder, Deutsch. Arch. f. klin. Med., xviii., 

516. 
See, Bull, de l'Acad. Med., 1877, p. 697. 
Senator, Berl. klin. Wochens., 1875, p. 461. 
Strieker, A. E., Berl. klin. Wochens., xiii., p. 

1, 1876. 
Weber, Bull, de Therap., xciii., p. 328. 
Wolffberg, Deutsch. Arch. klin. Med., xv., p. 

403. 
Wolfsohn, Konigsberg Diss., 1876 ; Centralb. 

f. med. Wiss., 1877, p. 30. 

Salicylic Acid. 

Bertagnini, Annal. d. Chemie u. Pharm., Heft 

xcvii., s. 248, 1856. 
Binz, Niederrh. Ges. f. Nat. u. Heilk. Sitz, v. 

6, Dec, 1875, u. 20 Marz., 1876; u. Berl. klin. 

Wochenschr., 1876, No. xxvii. 
Butt, Centralbl. i. d. med. Wiss., 1875, No. 

xviii., p 276; u. zur antipyret. Bedeutung 

d. Salicylsaure ii. d. salicyls. Natrons, 

Stuttgart, 1876. 
Ebstein, Berl. klin. Wochenschr., 1873, 1875, 

1876. 
Feser u. Friedberger, Arch. f. wiss. u. prac. 

Thierheilk., 1875, Heft ii., iii. u. vi., 1876, 

Heft ii. u. iii. 
Fleischer, Centralbl. f. d. med. Wiss., p. 628, 

1876, No. xxxvi.; u. Arch. f. klin. Med., 

1877, Bd. xix. 

Fleck, Benzoe'saure, Carbolsiiure, Salicylsaure, 

Zimmetsaure, Vergl. Versuche., Munchen, 

1875. 
Furbringer, Centralb. f. d. med. Wiss., p. 273 

1875, No. xviii. . 

Goltdammer, Berl. klin. Wochenschr., 1876, 

No. iv. 
Kohler, H., Centralb. f. d. med. Wiss., 1876, 

161, 195; Deutsch. Zeitschr. f. pract. Med. v. 

Kunze, 1877. 
Kolbe, Journ. f. pract. Chem., N. F., Bd. xii., 

1875, B. xi., p. 9. 

Moli, Berl. klin. Wochenschr., 1875, No. 

xxviii. 
Salkowski, Berl. klin. Wochenschr., 1875, No. 

xxii. 
Thiersch. Klin. Ergebnisse der Lister'schen 

Wundbehandl. in Volkmann'sSamml. klin. 

Vortrage, Nos. Ixxxiv. and lxxxv. 
Wolfsohn, Dissert. Konigsberg, 1876. 

Sanguinaria. 

Smith, R. M., Amer. Journ. Med. Sci., Oct., 

1876, p. 346. 

Santonin. 

Andaul, Brit. Med. Journ., vol. i., p. 186, 

1872. 
Berg, Wurttemberg Medic. Correspond., 1862. 



Santonin. 

Binz, Arch. f. exp. P. u. Ph., Bd. vi., p. 300. 
Brown, Dyce, Brit, and For. Med. Chir. Rev. 

April, 1871, p. 472. 
Falck, Deutsche Klinik, 1860. 
Guepin & Martin, Ann. de Therap., 1862. 
Krauss, Inaug. Diss. Tubingen, 1869. 
Manns, Marburger Diss., 1858. 
Rose, Virch. Arch., Bd. xvi.,p. 233, Bd. xviii., 

p. 15, Bd. xix., p. 522, Bd. xx., p. 245, Bd. 

xxviii., p. 30, Bd. xxx., p. 442. 
Walz, Jahresber. f. Pract. Phaim., Bd. xv. 

Saponin. 

Buchheim u. Eisenmenger, Eckhardt's Bei- 

tra'ge, v. 3, Giessen, 1869. 
Harnack, Arch. f. exp. Pharm., ii., 1874. 
Keppler, Berl. klin. Wochenschr., 1878, p. 

475. 
Kohler, H., Die totale Anasth. durch Saponin, 

Halle, 1873. 
Lautenbacb, Phila. Med. Times. 
Pellikan, Berl. klin. Wochenschr., xxxvi., 

1867, p. 375; u. Bulletin d. k. Acad, zu S. 

Petersburg, xii., 1867, p. 253. 

Savin. 

Letheby, Loudon Lancet, vol. i., p. 677,1845. 

Silver Nitrate, etc. 

Bogolowski, Arch. f. path. Anat., Bd. xlvi., p. 

413. 
Charcot and Ball, Gaz. Med., 1864. 
Curci, Lond. Med. Rec, 1877, p. 72. 
Eichmann, Husemann Toxicologie, 871. 
Fragstein, Berl. klin. Wochens., 1877, 294. 
Frommann, A r irch. Arch., Bd. xvii., p. 135. 
Jacobi u. Gissmann, A. f. exp. P. u. Pharm., 

Bd. viii., p. 217, 1878. 
Higgiubottom, Lond. Pract., vol. ii., p. 34, 

1869. 
Kramer, Das Silber als Arzneim, Halle, 1845. 
Neumann, Med. Jahrb., 1877, p. 369. 
Pepper, Trans. Phila. Coll. Phys., 1877. 
Riemer, Aich. f. Heilk., Bd. xvi., p. 296. 
Rosenstirn in Rossbach's pharmak. Unters. 

Bd. i. 
Rouget, Arch, de PAnatom. et de Physiol., 

Julv, 1873. p. 356, u. Jahresber. d. ges. Med., 

1870; Bd. i., p. 363. 
Roszahegzi, A. f. exp. P. u. Pharm. Bd. ix., p. 

289, 1878. 
Weichselbaum, Centralb. f. d. med. Wiss., 

1878, p. 954. 
Yandell, Amer. Pract., June, 1872. 

Soda, vide Alkalies. 

Barnard, Phys. Exp., t, ii., p. 393, Phila. Med. 

Times, vol. v. 
Bidder and Schmidt, Canstatt's Jahresb., 

1852. 
Grandeau, Robin's Journ. de l'Anat., 1864, p. 

378. 
Guttmann, Virch. Arch., Bd. xxxv., p. 450. 
Longet, Physiologie, Paris, 1861, t. i., p. 196. 
Munich, Arch. Ver^ins Gemeinsch. Aid.; Bd 

vi., p. 369, 1863. : 
Nothnagel, Virchow's Archiv. 
Plouviez, Com. Rend., t. xxv., 1847, p. 113. 
Podkaepow, Virch. Arch., Bd. xxxiii., p. 507. 
Rabuteau,L'Union Med., t. xii., p. 186, 1871. 
Roberts, Urinary and Renal Diseases, Am 

Ed., 1866, p. 240. 

Spigelia. 

Eberle, Materia Med. and Therap., vol. i. 
Spalsbury, Bost. Med. and Surg. Journ., vol 
iii., p. 72, 1855. 



1034 



BIBLIOGRAPHICAL INDEX. 



Squill. 



Dassen, Groninger Diss., 188J. 

Husemann, Arch. d. Pharmacie., Bd. vi., Heft 

iv., 1876 : Deutsch. Med. Wocherjs., xiii., p. 

149, 1875; Lond. Med. Eec, 1876, p. 120, 

Toxicologic, Bd. i., 413. 
Jarmersted, A. f. exp. P. u. Pharin., 1S79, Bd. 

ii., p. 22. 
Scliroff, Wien. Wochenschr., 1864, 43, p. 673. 
Wolfring, Bayer, arztl. Intelligenzbl., 1842. 

Strychnine. 

Ainagat, Journ. d. Therap., 1S75, p. 467. 

Ambrosoli, Gaz. Med., 1357, p. 525. 

Bennett, Brit. Med. Journ., vol. ii., p. 436, 

1874. 
Bernard, CI , Leeons sur les Substances Tox- 

iques, Paris. 
Bochefoutaine, Arch, de Phvs. norrn.etpath., 

1873, p. 664. 
Brown-iequard, Comptes Eendus, 1S49, 29, p. 

672. 
Buchheini u. Engel, Beitr. z. Arzneiml., 

Leipzig, 1849, i., p. 92. 
Cohn, Wien. Med. Wochens., Nos. xlii., xlvii., 

1873, 
Deen, Van, Phys. de la Moelle epiniere. 
Falck.F. A., jun., Yierteljahrsschr. f.gerichtl. 

Med., N. F.,Bd. xx., 2,193, xxi., 12, u. xxiii., 

1874. 
Falck, Senior, Virch, Arch., xlix.,1870,p. 458. 
Freusberg, Arch. f. exp. Path. u. Pharm., Bd. 

iii., p. 2u4, and 348, 1875. 
Harley, Lancet, July, 1856, p. 40. 
Heinernann, C., Virch. Arch., Bd. xxxiii., p. 

394. 
Hippel, V., Wirk. des Strvch. auf. Augen., 

Berlin, 1873, p. 77. 
Husemann, Arch. d. Pharrn., Bd. viii., Heft 

3, 1877. 
Jacond, Pathol. Interne., i., 441. 
Jochelsobn, Eossbach's pharm. Unters., Bd. i. 
Klapp, Journ. Mental Diseases, Oct., 1878. 
Kolliker, Virch. Arch., Bd. x., p. 239, 1856. 
Lange, F., Konigsberger Diss., 1S74. 
Leube, Arch. f. Anat. u. Phys., 1867, p. 629. 
Magendie, Paris Soc. Philom., N. Bull., i., 368, 

1808. 
Mager, S. Wiener, acad. Sitzungsber. Math. 

Nat. Wiss. CI. 3 Abth., 1871. 
Martin-MagronandBuisson,Brown-Sequard's 

Journ. de la Phys., 1860, t. iii., pp. 130, 342. 
Matteucci, Traite des Phenom. electro-phy- 

siol., Paris, 1884. 
Meschede, Berl. klin. W., 1878, No. xxiv. 
Moreau, Comptes. Bend. Soc. de Biol., 1855, 

p. 173. 
Nagel, Die Behandl. d. Amaurosen u. Ambly- 

opeen in. Strvch. Tubingen, 1871. 
Nasse, O., Ceutralbl. f. med. Wiss., 1S65, p. 

787. 
O'Farrell, L., Phila. Med. Times, vol. iii., p. 

311 
Orr, Gaz. Med., July 6, 1872. 
Pellikan, E., Beitr. z. ger. Med., p. 92, 1858. 
Eatike, Virch. Arch., lxxv , p. 1, 1878. 
Richter, Zeitschr. f. rat, Med., iii., Bd. xviii., 

]). 7t;. 
Rosenthal a. Leube, Arch.fiir. Anat. u.Phys., 

1867, p. 629. 
Rosenthal, Compt. Rend., lxiv., p. 1142. 

ich, Centralbl. f. med. Wi-s, p. 369, 

1873, xxiv. 
Rossbach u. Jochelsten, Wlirtzburg. Abhandl., 

1878, p. 92. 

. Lancet, May, 1863, Schmidt's Jahrb., 

cxix..p. 286, 1863. 
Bchiff, Schmidt's Jahrb., Bd. exit, p. 25. 
Schlesiuger, Wien. Med, Jahrb., 1874. 
Bchroff, v., juii., Wien. Med. Jahrb., L872, p. 

420. 
Schultzeu, Anli. f. Anai. u. I'll vs. (Dubois), 

p. 491, 1864 
Bpence, A.T., Edln. Med. Journ., July, 1866. 

.xii., i., p. 41. 



Strychnine. 

Tschepke, Deut. Klinik., xiii., 1861. 
Uspensky, Arch. f. Anat. u. Phys., 1868, iv., 

p. 522. 
Valentin, Path. der. Nerven, p. 327, pt, ii., 

Leipzig, 1864; Arch, de Physiol., Nov., 1870, 

p. 125, d. t, iii., p. 120. 
Wittich, Bericht Fortschritte Anat., 1857, p. 

434. 
Wundt, Unt. d. med. d. Nerven, Stuttgart, 

1871. 



Sugar. 

Mering u. Musculus, Hoppe-Seyler's Z. f. phys., 
Ch. i., p. 395, and ii., 177. 

Sulphide of Calcium. 

Einger, Sidney, Lancet, Feb., 1874, vol. i., p. 
264. 



Sulphur and Sulphuretted 
Hydrogen. 

Dorpater Diss. Krause, 1853, Trachtenberg, 

1861, Hoppener, 1863. 
Hermann, Toxicologic 
Hoppe-Seyler, Centralbl. f. d. med. Wiss., 

1863, p. 433; Med. chem. Unters., 1867, 

Bd. ii. 
Ivunkel, Pfliiger's Arch., Bd. xiv., p. 344. 
Poleck, Die chem. Natur der Minengase, 

etc. Berl., 1867. 
Eegensburger, Centralbl. med. Wiss., 1877, p. 

328. 
Eosenthal u. Kaufmann, Eeichert's Arch., 

1866, p. 647. 
Schmiedeberg, Arch. d. Heilk., 1867, Bd. viii., 

p. 422. 
Sertoli, Instituto fisiol. di. Pavia, 1869. 



Tannic Acid. 

Hennig, Arch. d. Pharm., Bd. exxxiii. 
Eoseustirn, Eossbach's pharmak. Unters., 

Bd. i. 
Sehroff, Die Pfianzenstoffe, Lehrb. d. Pharm., 

lte Aufiage. 



Tannin, vide Tannic Acid. 



Thuja. 

liohne, Gottingen Diss., 1883. 

Thymol. 

Husemann, Arch. f. exp. Path. u. Pharm., 

Bd. iv., 1875, p. 288. 
Lewin, Centralbl. f. d. med. Wiss., 1875, p. 324. 

Tobacco, vide Nicotine. 

Benham, W. T., West Eiding Luii. Eeports, 

vol. iv.,]>. 306, 1874. 
Bernard, (1., Substances Toxiques, p. 410. 
Copeland, Diet, of Pract. Med. art. Colic. 
Ilii-Mlniianii, Keich. Arch , 1868, |). 309. 
Huseinaiin, Ilaudb. d. Toxicol., vol. ii.,p.483. 
Nasse, Beitrfige /. Phvs. der Darmbcweguiig, 

Leipzig, 1866. 
Bell, Journ. f. Pharmacodyn, Bd.ii., p. 203. 
Rosenthal, Centralbl. f. med. Wiss., 1863, p. 

738. 
Traube. Allgem. Med. Central. Zelt., 1862. 
Uspensky. Reich. Arch., 1868, p. 525. 
Vuipian, I lomptes Eendus. de la Soc. de Biol., 

1859, )). 151. 



BIBLIOGKAPHICAL INDEX. 



1035 



Trimethylamine, or Propyla- 
mine 

Huseraann, Selige, Arch. f. exp. Path. u. 
Pharm., Bd. vi., p. 55. 



VALERIANATE OF AMYL. 

Wade, W. F., Brit. Med. Journ., i., 1874, p. 
741. 

Veratrine. 

Bezold, V., u. Hirst, Unters. a. d. Wiirtzburger- 

physiol. Laborator., Bd. i., 1869. (Contains 

the entire older Literature.) 
Brunton and Cash, Cent. f. d. med. Wiss., 

1883, p. 81; Journ. of Physiol., iv., 1. 
Claus., Journ. of Anat., viii., p. 228. 
Eisenmenger, Ueber d. Einnuss d. Gifte u. d. 

Zuckungscurve des Froschmuskels. Diss. 

Giessen., 1862, p. 40. 
Fick u. Bohm, Verhandl. d. phys. med. Ges. 

in Wiirtzburg, N. F. Bd. ill., p. 198, 229. 
Guttmann, Eeich. Arch. f. Anat., 1866, p. 498. 
Jones, Phila. Med. and Surg. Beporter, xvii., 

p. 361, 1872. 
Kolliker, Virch. Arch., Bd. x., p. 257, exp. ix. 
Ott, Toxicol. Studies, Phila., 1874. 
Pellikan, V., u. Kolliker, Wiirtzburg. Verb., 

ix., p. 106. 
Praag, L. von, Virch. Arch., vii., p. 252, 1854. 



Veratrine. 



Ringer, Arch, of Med., vii., Feb., 1882. 
Robin's Journ. de l'Anat., 1868; t. v., p. 206, 

Gaz. Med. de Paris, No. 5, p. 69, 8, p. 120, 10, 

p. 148, 11, p. 167, 1857. 
Rossbach, Clostermeyer u. Harteneck, in 

Bossbach's pharm. Unters. Bd. iii., and 

Pfliiger's Arch., Bd. xiii. u. xv. 
Bossbach u. Anrep, Pfliiger's Arch., Bd. xxi., 

240, 1880. 
Taylor, Med. Jurisp. 2d ed., London, 1873. 
Turnbull, Investigation of Extern. Applic. of 

Veratria, London, 1829 ; Schmidt's Jahrb., 

ii., 379. 
Weyland, vergleich. Unters. iib. Veratrin 

Sabadillin. Delphinin., &c, Giessen, 1869. 
Wood, H., Amer. Journ. Sci., Jan., 1870, p. 36. 



Whey. 



Mav, Bair. Arztl. Intelligenzbl., 1879, No. 
xii., s. 123. 



Zinc. 



Harnack, Arch. f. exp. Path. u. Pharm., Bd. 

iii., p. 44. 
Meihuizen, Arch. f. ges. Physiol., Bd. vii., p. 

212. 
Michaelis, Arch. f. phys. Heilk., 1851, p. 109. 
Schlokow, Deutsch. Med. Wochenschr., 1879, 

Nos. xvii. u. xviii., pp. 208 and 221. 



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Anatomy, Descriptive and Surgical. The Drawings by H. V. Carter, M. D., 
and Dr. Westmacott. The dissections jointly by the Author and Dr. Carter. "With 
an Introduction on General Anatomy and Development by T. Holmes, M. A., Surgeon to 
St. George's Hospital. Edited by T. Pickering Pick, F. R. C. S., Surgeon to and Lecturer 
on Anatomy at St. George's Hospital, London, Examiner in Anatomy, Royal College of 
Surgeons of England. A new American from the tenth enlarged and improved London 
edition. To which is added the second American from the latest English edition of 
Landmarks, Medical and Surgical, by Luther Holden, F.R. C. S., author of 
" Human Osteology," " A Manual of Dissections," etc. In one imperial octavo volume 
of 1023 pages, with 564 large and elaborate engravings on wood. Cloth, $6.00 ; leather, 
$7.00 ; very handsome half Russia, raised bands, $7.50. 

This work covers a more extended range of subjects than is customary in the ordinary 
text-books, giving not only the details necessary for the student, but also the application to 
those details to the practice of medicine and surgery. It thus forms both a guide for the 
learner and an admirable work of reference for the active practitioner. The engravings 
form a special feature in the work, many of them being the size of nature, nearly all 
original, and having the names of the various parts printed on the body of the cut, in 
place of figures of reference with descriptions at the foot. They thus form a complete and 
splendid series, which will greatly assist the student in forming a clear idea of Anatomy, 
and will also serve to refresh the memory of those who may find in the exigencies of 
practice the necessity of recalling the details of the dissecting-room. Combining, as it 
does, a complete Atlas of Anatomy with a thorough treatise on systematic, descriptive 
and applied Anatomy, the work will be found of great service to all physicians who receive 
students in their offices, relieving both preceptor and pupil of much labor in laying the 
groundwork of a thorough medical education. 

Landmarks, Medical and Surgical, by the distinguished Anatomist, Mr. Luther Holden, 
has been appended to the present edition as it was to the previous one. This work gives 
in a clear, condensed and systematic way all the information by which the practitioner can 
determine from the external surface of the body the position of internal parts. Thus 
complete, the work, it is believed, will furnish all the assistance that can be rendered by 
type and illustration in anatomical study. 



This well-known work comes to us as the latest 
American from the tenth English edition. As its 
title indicates, it has passed through many hands 
and has received many additions and revisions. 
The work is not susceptible of more improvement. 
Taking it all in all, its size, manner of make-up, 
its character and illustrations, its general accur- 
acy of description, its practical aim, and its per- 
spicuity of style, it is the Anatomy best adapted to 
the wants of the student and practitioner. — Medical 
Record, Sept. 15, 1883. 



There is probably no work used so universally 
by physicians and medical students as this one. 
It is deserving of the confidence that they repose 
in it. If the present edition is compared with that 
issued two years ago, one will readily see how 
much it has been improved in that time. Many 
pages have been added to the text, especially in 
those parts that treat of histology, and many new 
cuts have been introduced and old ones modified. 
— Journal of the American Medical Association, Sept. 
1, 1883. 



Also for sale separate — 
HOLDER, IUTHFM, F. M. C. S., 

Surgeon to St. Bartholomew' 1 s and the Foundling Hospitals, London. 

Landmarks, Medical and Surgical. Second American from the latest revised 
English edition, with additions by W. W. Keen, M. D., Professor of Artistic Anatomy in 
the Pennsylvania Academy of the Fine Arts, formerly Lecturer on Anatomy in the Phila- 
delphia School of Anatomy. In one handsome 12mo. volume of 148 pages. Cloth, $1.00. 



This little book is all that can be desired within 
its scope, and its contents will be found simply in- 
valuable to the young surgeon or physician, since 
they bring before him such data as he requires at 
every examination of a patient. It is written in 
language so clear and concise that one ought 



almost to learn it by heart. It teaches diagnoais by 
external examination, ocular and palpable, of the 
body, with such anatomical and physiological facts 
as directly bear on the subject. It is eminently 
the student's and young practitioner's book. — Phy- 
sician and Surgeon, Nov. 1881. 



WILSON, FHASMUS, F. M. 8. 

A System of Human Anatomy, General and Special. Edited by W. H. 
Gobrecht, M. D., Professor of General and Surgical Anatomy in the Medical College of 
Ohio. In one large and handsome octavo volume of 616 pages, with 397 illustrations. 
€loth, $4.00; leather, $5.00. 

SMITH, H. H, M. D., and HOMNFM, WM. M, M.D., 

Emeritus Prof, of Surgery in the Univ. of Penna., etc. Late Prof, of Anat. in the Univ. of Penna. 
An Anatomical Atlas, Illustrative of the Structure of the Human Body. In one 
large imperial octavo volume of 200 pages, with 634 beautiful figures. Cloth, $4.50. 

CLFLAND, JOHN, M. !>., F. M. $., 

Professor 6f Anatomy and Physiology in Queen's College, Oalway. 

A Directory for the Dissection of the Human Body. In one 12mo. 

volume of 178 pages. Cloth, $1.25. 



6 Lea Brothers & Co.'s Publications — Anatomy. 

ALLEN, HARRISON, M. D., 

Professor of Physiology in the University of Pennsylvania. 

A System of Human Anatomy, Including Its Medical and Surgical 
Relations. For the use of Practitioners and Students of Medicine. With an Intro- 
ductory Section on Histology. By E. O. Shakespeare, M. D., Ophthalmologist to 
the Philadelphia Hospital. Comprising 813 double-columned quarto pages, with 380 
illustrations on 109 full page lithographic plates, many of which are in colors, and 241 
engravings in the text. In six Sections, each in a portfolio. Section I. Histology. 
Section II. Bones and Joints. Section HI. Muscees and Fasciae. Section IY. 
Arteries, Veins and Lymphatics. Section V. Nervous System. Section VI. 
Organs op Sense, of Digestion and Genito-Urinary Organs, Embryology, 
Development, Teratology, Superficial Anatomy, Post-Mortem Examinations, 
and General and Clinical Indexes. Just ready. Price per Section, each in a handsome 
portfolio, $3.50; also bound in one volume, cloth $23.00; very handsome half Russia, 
raised bands and open back, $25.00. For sale by subscription only. Apply to the Publishers. 

Extract from Introduction. 

It is the design of this book to present the facts of human anatomy in the manner best 
suited to the requirements of the student and the practitioner of medicine. The author 
believes that such a book is needed, inasmuch as no treatise, as far as he knows, contains, in 
addition to the text descriptive of the subject, a systematic presentation of such anatomical 
facts as can be applied to practice. 

A. book which will be at once accurate in statement and concise in terms ; which will be 
an acceptable expression of the present state of the science of anatomy ; which will exclude 
nothing that can be made applicable to the medical art, and which will thus embrace all 
of surgical importance, while omitting nothing of value to clinical medicine, — would appear 
to have an excuse for existence in a country where most surgeons are general practitioners, 
and where there are few general practitioners who have no interest in surgery. 



It is to be considered a study of applied anatomy 
in its widest sense — a systematic presentation of 
such anatomical facts as can be applied to the 
practice of medicine as well as of surgery. Our 
author is concise, accurate and practical" in his 
statements, and succeeds admirably in infusing 
an interest into the study of what is generally con- 
sidered a dry subject. The department of Histol- 
ogy is treated in a masterly manner, and the 
ground is travelled over by one thoroughly famil- 
iar with it. The illustrations are made witn great 



care, and are simply superb. There is as much 
of practical application of anatomical points to 
the every-day wants of the medical clinician as 
to those of the operating surgeon. In fact, few 
general practitioners will read the work without a 
feeling of surprised gratification that so many 
points, concerning which they may never have 
thought before are so well presented for their con- 
sideration. It is a work which is destined to be 
the best of its kind in any language. — Medical 
Record, Nov. 25, 1882. 



CLARKE, W. B., F.R. C.S. & LOCKWOOD, C. B., F.R. C.S. 

Demonstrators of Anatomy at St. Bartholomew's Hospital Medical School. London. 
The Dissector's Manual. In one pocket-size 12mo. volume of 396 pages, with 
49 illustrations. Limp cloth, red edges, $1.50. Just ready. See Students' Series of 
Manuals, page 3. 



This is a very excellent manual for the use of the 
student who desires to learn anatomy. The meth- 
ods of demonstration seem to us very satisfactory. 
There are many woodcuts which, for the most 



part, are good and instructive. The book is neat* 
and convenient. We are glad to recommend it.— 
Boston Medical and Surgical Journal, Jan. 17, 1884. 



TREVES, FREDERICK, F. R. C. S>, 

Senior Demonstrator of Anatomy and Assistaiit Surgeon at the London Hospital. 
Surgical Applied Anatomy. In one pocket-size 12mo. volume of 540 pages, 
with 61 illustrations. Limp cloth, red edges, $2.00. Just ready. See Students' Series of 
Manuals, page 3. 

He has produced a work which will command a 
larger circle of readers than the class for which it 



was written. This union of a thorough, practical 
acquaintance with these fundamental branches, 



quickened by daily use as a teacher and practi- 
tioner, has enabled our author to prepare a work 
which it would be a most difficult task to excel.— 
The American Practitioner Feb. 1884. 



CTJRJSOW, JOHN, M. D., F. R. C F., 

Professor of Anatomy at King's College, Physician at King's College Hospital. 
Medical Applied Anatomy. In one pocket-size 12mo. volume. Preparing. 
See Students' Series of Manuals, page 3. 

BELLAMY, EDWARD, F. R. C. S.,- 

Senior Assistant-.- • : Charing- C¥o68 JIosj>ital, London. 

The Student's Guide to Surgical Anatomy : Being a Description of the 
most Important Surgical Regions of the Human Body, and intended as an Introduction to 
operative Surgery, in one 12mo. volume of 300 pages, with 50 illustrations. Cloth, $2.25. 

HARTSHORNE'S HANDBOOK OF ANATOMY HORNER'S SPECIAL ANATOMY AND HISTOL- 
AND PHYSIOLOGY. Second edition, revised. I OGY. Eighth edition, extensively revised and 
in one royal 12mo. volume of 310 pages, with 2'10 modified, in two octavo volumes of 1007 pages, 
woodcuts. Cloth, 81.75. witli 820 woodcuts. Cloth, $0.00. 



Lea Brothers & Co.'s Publications — Ana t., Physics, Physiol. 



I) ALTON, JOHN C, M. D-, 

Professor Emeritus of Physiology in the College of Physicians and Surgeons, New York. 

The Topographical Anatomy of the Brain. In three very handsome quarto 
volumes comprising 178 pages of descriptive text. Illustrated with 48 full page photo- 
graphic plates of Brain Sections, with a like number of explanatory plates, as well as many 
woodcuts through the text. Price for the complete work, $36. Just ready. For sale by 
subscription. As but few of the copies reserved for this country now remain unsold, 
gentlemen desiring the work will do well to apply to the publishers at an early date. 

precise and accurate, and the methods by which 
the sections were made and the specimens re- 
produced are given very plainly in an introductory 
chapter, which cannot fail to' be of the greatest 



This is one of the most magnificent works on 
anatomy that has appeared during the present 
generation, and will not only supersede all its 

Sredecessors on the topographical anatomy of the 
rain, but make any further work on the same 
lines unnecessary. It contains forty-eight ex- 
quisite illustrations of the brain en masse and in 
sections. Not only has perfect accuracy been 
secured, but one of the finest and most artistic 
works of recent times has been presented to the 
medical public. Its value as a work of reference 
is considerably increased by the very careful out- 
line sketches which accompany the plates and 
which enable them to be easily followed and 
understood. These sketches are very complete 
and accurate, and have been reproduced from 
tracings. The descriptions by the author are clear, 



value to any one desirous of making similar prep- 
arations. Criticism on such a work is super- 
fluous. We can only congratulate Dr. Dalton, his 
assistants, and the publishers on the energy they 
have shown in undertaking such a work, and the 
success with which they have overcome a task 
presenting so many mechanical difficulties. We 
envy our American confreres the authorship and 
execution of so beautiful and useful an addition 
to medical literature. Much light is thrown 
on some obscure relations of parts of the brain 
which have never before been seen in correct 
juxtaposition. — London Lancet, April 18, 1885. 



BY THE SAME AUTHOR. 
Doctrines of the Circulation of the Blood. A History of Physiological 
Opinion and Discovery in regard to the Circulation of the Blood. In one handsome 
12mo. volume of 293 pages. Cloth, $2. Just ready. 

In the progress of physiological study no fact 
was of greater moment, none more completely 
revolutionized the theories of teachers, than the 
discovery of the circulation of the blood. This 
explains the extraordinary interest it has to all 
medical historians. The volume before us is one 



of three or four which have been written within a 
few years by American physicians. It is in several 
respects the most complete. The volume, though 
small in size, is one of the most creditable con- 
tributions from an American pen to medical history 
that has appeared.— Med. & Surg. Rep., Dec. 6, 1884. 



ELLIS, GEOBGE VINEB, 

Emeritus Professor of Anatomy in University College, London. 

Demonstrations of Anatomy. Being a Guide to the Knowledge of the 
Human Body by Dissection. From the eighth and revised London edition. In one very 
handsome octavo volume of 716 pages, with 249 illustrations. Cloth, $4.25 • leather, $5.25. 

BOBEBTS, JOHN B., A. M., W. &., 

Prof, of Applied Anat. and Oper. Surg, in Phila. Polyclinic and Coll. for Graduates in Medicine. 
The Compend of Anatomy. For use in the dissecting-room and in preparing 
for examinations. In one 16mo. volume of 196 pages. Limp cloth, 75 cents. 

DBAFEB, JOHN C, M. D., LL. JD., 

Professor of Chemistry in the University of the City of New York. 

Medical Physics. A Text-book for Students and Practitioners of Medicine. In 
one octavo volume of 725 pages, with 376 woodcuts, mostly original. Cloth, $4. In a few days; 

From the Preface. 

The fact that a knowledge of Physics is indispensable to a thorough understanding of 
Medicine has not been as fully realized in this country as in Europe, where the admirable 
works of Desplats and Gariel, of Eobertson and of numerous German writers constitute a 
branch of educational literature to which we can show no parallel. A full appreciation 
of this the author trusts will be sufficient justification for placing in book form the sub- 
stance of his lectures on this department of science, delivered during many years at the 
University of the City of New York. 

Broadly speaking, this work aims to impart a knowledge of the relations existing 
between Physics and Medicine in their latest state of development, and to embody in the 
pursuit of this object whatever experience the author has gained during a long period of 
teaching this special branch of applied science. 

BOBEBTSON, J. McGBEGOB, M. A., M. B., 

Muirhead Demonstrator of Physiology, University of Glasgow. 
Physiological Physics. In one 12mo. volume of 537 pages, with 219 illustra- 
tions. Limp cloth, $2.00. Just ready. See Students' Series of Manuals, page 3. 

The title of this work sufficiently explains the 
nature of its contents. It is designed as a man- 
ual for the student of medicine, an auxiliary to 
his text-book in physiology, and it woul d be particu 



larly useful as a guide to his laboratory experi- 



ments. It will be found of great value to the 
practitioner. It is a carefully prepared book of 
reference, concise and accurate, and as such we 
heartily recommend it.— Journal of the American 
Medical Association, Dec. 6, 1884. 



BELL, F. JEFFBEY, 31. A., 

Professor of Comparative Anatomy at King's College, London. 

Comparative Physiology and Anatomy. Shortly. See Students' Series of 
Manuals, page 3. 



^^HHHH 



8 Lea Brothers & Co.'s Publications — Physiology, Chemistry, 



B ALTON, JOBHV C, M. JD., 

Professor of Physiology in the College of Physicians and Surgeons, New York, etc. 

A Treatise on Human Physiology. Designed for the use of Students and 
Practitioners of Medicine. Seventh edition, thoroughly revised and rewritten. In one 
very handsome octavo volume of 722 pages, with 252 beautiful engravings on wood. Cloth, 
$5.00 ; leather, $6.00 ; very handsome half Eussia, raised bands, $6.50. 

The merits of Professor Dalton's text-book, his 
smooth and pleasing style, the remarkable clear- 
ness of his descriptions, which leave not a chapter 
obscure, his cautious judgment and the general 
correctness of his facts, are perfectly known. They 
have made his text-book the one most familiar 



to American students.— Med. Record, March 4, 1882. 
Certainly no physiological work has ever issued 
from the press that presented its subject-matter in 
a clearer and more attractive light. Almost every 
page bears evidence of the exhaustive revision 
that has taken place. The material is placed in a 



more compact form, yet its delightful charm is re- 
tained, and no subject is thrown into obscurity. 
Altogether this edition is far in advance of any 
previous one, and will tend to keep the profession 
posted as to the most recent additions to our 
physiological knowledge. — Michigan Medical News, 
April, 1882. 

One can scarcely open a college catalogue that 
does not have mention of Dalton's Physiology as- 
the recommended text or consultation-book. ' For 
American students we would unreservedly recom- 
mend Dr. Dalton's work.- Va, Med. Monthly, July,'82. 



FOSTER, MICHAEL, M. JD., F. R. $., 

Professor of Physiology in Cambridge University, England. 
Text-Book of Physiology. Third American from the fourth English edition,. 
*ith notes and additions by E. T. Beichert, M. T>. In one handsome royal 12mo. volume 
*f over 1000 pages, with about 300 illustrations. Cloth, $3.25 ; leather, $3.75. In a few days. 
A notice of the previous edition is appended. 
A more compact and scientific work on physiol- 
ogy has never oeen published, and we believe our- 
selves not to be mistaken in asserting that it has 



now been introduced into every medical college 
in which the English language is spoken. This 
work conforms to the latest researches into zoology 
and comparative anatomy, and takes into consid- 



eration the late discoveries in physiological chem- 
istry and the experiments in localization of Ferrier 
and others. The arrangement followed is such as- 
to render the whole subject lucid and well con- 
nected in its various parts.— Chicago Medical Jour- 
nal and Examiner, August, 1882. 



POWER, HENRY, M. B., F. R. C. $., 

Examiner in Physiology, Royal College of Surgeons of England. 
Human Physiology. In one handsome pocket-size 12mo. volume of 396 pages, 
with 47 illustrations. Cloth, $1.50. See Students 7 Series of Manuals, page 3. 



The prominent character of this work is that of 
judicious condensation, in which an able and suc- 
cessful effort appears to have been made by its 
accomplished author to teach the greatest number 
of facts in the fewest possible words. The result 
is a specimen of concentrated intellectual pabu 



to every one of our readers. — The American Jour- 
nal of the Medical Sciences, October, 1884. 

This little work is deserving of the nighest 
praise, and we can hardly conceive how the main 
facts of this science could have been more clearly 
or concisely stated. The price of the work is such 



lum seldom surpassed, which ought to be care- | as to place it within the reach of all, while the ex- 
fully ingested and digested by every practitioner | cellence of its text will certainly secure for it most 
who desires to keep himself well informed upon | favorable commendation — Cincinnati Lancet and 
this most progressive of the medical sciences. Clinic, Feb. 16, 1884. 
The volume is one which we cordially recommend | 

CARPENTER, WM. B., 31. JD., F. R. S., F. G. 8., F. L. 8., 

Registrar to the University of London, etc. 

Principles of Human Physiology. Edited by Henry Power, M. B., Lond., 
F. K. C. S., Examiner in Natural Sciences, University of Oxford. A new American from the 
eighth revised and enlarged edition, with notes and additions by Francis G. Smith, M. D., 
late Professor of the Institutes of Medicine in the University of Pennsylvania. In one 
very large and handsome octavo volume of 1083 pages, with two plates and 373 illus- 
trations. Cloth, $5.50 ; leather, $6.50 ; half Eussia, $7. 



FOWNE8, GEORGE, Ph. JD. 

A Manual of Elementary Chemistry; Theoretical and Practical. Ke- 
vised by Henry Watts, B. A., F. R. S. New American edition. In one large royal 12mo. 
volume of over 1 000 pages, with 200 illustrations on wood and a colored plate. Cloth, 

$2.7-"); leather, $3.25. In press. 

A notice of the previous edition is appended. 



The book opens with a treatise on Chemical 
Physics, Including Heat, Light, Magnetism and 
Electricity. These subjects are treated clearly 
and briefly, but enough is given to enable the stu- 
dent to comprehend the facta ana laws of Chemis- 
try proper. It is the fashion of late years to omit 
these topics from works on chemistry, but their 
omission is not to becommended. As was required 
by the great advance in the science of Chemistry 



of late years, the chapter on the General Principles 
of Chemical Philosophy has been entirely rewrit- 
ten. The latest views on Equivalents, Quantiva- 
lence, etc., are clearly and fully set forth. This 
last edition is a great improvement upon its prede- 
cessors, which is saying not a little of a book that 
has reached its twelfth edition.— Ohio Medical Re- 
corder, Oct., 1878. 



Wohler's Outlines of Organic Chemistry. Edited by Fittig. Translated 
by Ira Rk.msent, M. I)., Ph. D. In one 12mo. volume of 550 pages. Cloth, $3. 



GALLOWAY'S QUALITATIVE ANALYSIS. New 
edition. 

LNN'S MANUAL OF CHEMICAL PHYS- 
IOLOGY, in one octavo volume <>f 827 pages, 
with 41 illustrations. Cloth, $2.26. 



CARPENTER'S PRIZE ESSAY ON THE USE AND 
>r AXOOHOLIC Liquors in Health and Dis- 
BASE. With explanations of scientific words. Small 
lL'mo. 178 pages. Cloth, GO cents. 



Lea Brothers & Co.'s Publications — Chemistry. 



9 



FBANKLAND, E., D. C.L., F. M.S., &JAFF, Ph. !>., F. I. C, 



Professor of Chemistry in the Normal School 
of Science, London. 



Assist. Prof, of Chemistry in the Normal 
School of Science, London. 



Inorganic Chemistry. In one handsome octavo volume of 600 pages, with 51 
woodcuts and 2 lithographic plates. Cloth, $3.75 ; leather, $4.75. In press. 

This work on elementary chemistry is based upon principles of classification, nomen- 
clature and notation which have been proved by nearly twenty years experience in teaching 
to impart most readily a sound and accurate knowledge of the science. 



ATTFIFLiy, JOHN, Fh. F., 

Professor of Practical Chemistry to the Pharmaceutical Society of Great Britain, etc. 

Chemistry, General, Medical and Pharmaceutical; Including the Chem- 
istry of the U. S. Pharmacopoeia. A Manual of the General Principles of the Science, 
and their Application to Medicine and Pharmacy. A new American, from the tenth 
English edition, specially revised by the Author. In one handsome royal 12mo. volume 
of 728 pages, with 87 illustrations. Cloth, $2.50 ; leather, $3.00. 

to put himself in the student's place and to appre- 
ciate his state of mind. — American Chemical Jour- 
nal, April, 1884. 



A text-book which passes through ten editions 
in sixteen years must have good qualities. This 
remark is certainly applicable to Attfield's Chem- 
istry, a book which is so well known that it is 
hardly necessary to do more than note the appear- 
ance of this new and improved edition. It seems, 
however, desirable to point out that feature of the 
book which, in all probability, has made it so 
popular. There can be little doubt that it is its 
thoroughly practical character, the expression 
being used in its best sense. The author under- 
stands what the student ought to learn, and is able 



It is a book on which too much praise cannot be 
bestowed. As a text-book for medical schools it 
is unsurpassable in the present state of chemical 
science, and having been prepared with a special 
view towards medicine and pharmacy, it is alike 
indispensable to all persons engaged in those de- 
partments of science. It includes the whole 
chemistry of the last Pharmacopoeia. — Pacific Medi- 
cal and Sugrical Journal, Jan, 1884. 



BLOXAM, CHARLES L., 

Professor of Chemistry in King's College, London. 

Chemistry, Inorganic and Organic. New American from the fifth Lon- 
don edition, thoroughly revised and much improved. In one very handsome octavo 
volume of 727 pages, with 292 illustrations. Cloth, $3.75 ; leather, $4.75. 



Comment from us on this standard work is al- 
most superfluous. It differs widely in scope and 
aim from that of Attfield, and in its way is equally 
beyond criticism. It adopts the most direct meth- 
ods in stating the principles, hypotheses and facts 
of the science. Its language is so terse and lucid, 
and its arrangement of matter so logical in se- 
quence that the student never has occasion to 
complain that chemistry is a hard study. Much 
attention is paid to experimental illustrations of 
chemical principles and phenomena, and the 
mode of conducting these experiments. The book 
maintains the position it has always held as one of 



the best manuals of general chemistry tn the Eng- 
lish language. — Detroit Lancet, Feb. 1884. 

The general plan of this work remains the 
same as in previous editions, the evident object 
being to give clear and concise descriptions of all 
known elements and of their most important 
compounds, with explanations of the chemical 
laws and principles involved. We gladly repeat 
now the opinion we expressed about a former 
edition, that we regard Bloxam's Chemistry as 
one ot the best treatises on general and applied 
chemistry. — American Jour, of Pharmacy, Dec. 1883. 



SIMON, W., Fh. &., M. &., 

Professor of Chemistry and Toxicology in the College of Physicians and Surgeons, Baltimore, and 

Professor of Chemistry in the Maryland College of Pharmacy. 
Manual of Chemistry. A Guide to Lectures and Laboratory work for Beginners 
in Chemistry. A Text-book, specially adapted for Students of Pharmacy and Medicine. 
In one 8vo. vol. of 410 pp., with 16 woodcuts and 7 plates, mostly of actual deposits, 
with colors illustrating 56 of the most important chemical reactions. Cloth, $3.00 ; also 
without plates, cloth, $2.50. Just ready. 



This book supplies a want long felt by students 
of medicine and pharmacy, and is a concise but 
thorough treatise on the subject. The long expe- 
rience of the author as a teacher in schools of 
medicine and pharmacy is conspicuous in the 
perfect adaptation of the work to the special needs 
of the student of these branches. The colored 



plates, beautifully executed, illustrating precipi- 
tates of various reactions, form a novel and valu- 
able feature of the book, and cannot fail to be ap- 
preciated by both student and teacher as a help 
over the hard places of the science.— Maryland 
Medical Journal, Nov. 22, 1884. 



MEMSEN, IMA, M. &., Fh. D. 9 

Professor of Chemistry in the Johns Hopkins University, Baltimore. 

Principles of Theoretical Chemistry, with special reference to the Constitu- 
tion of Chemical Compounds. Second and revised edition. In one handsome royal 12mo. 
volume of 240 pages. Cloth, $1.75. Just ready. 

of chemistry. The high reputation of the author 
assures its accuracy in all matters of fact, and its 
judicious conservatism in matters of theory, com- 
bined with the fulness with which, in a small 
compass, the present attitude of chemical science 
towards the constitution of compounds is con- 
sidered, gives it a value much beyond that accorded 
to the average text-books of the day,— American 
Journal of Science, March, 1884. 



The book is a valuable contribution to the chemi- 
cal literature of instruction. That in so few years 
a second edition has been called for indicates that 
many chemical teachers have been found ready 
to endorse its plan and to adopt its methods. In 
this edition a considerable proportion of the book 
has been rewritten, much new matter has been 
added and the whole has been brought up to date. 
We earnestly commend this book to every student 



10 



Lea Brothers & Co.'s Publications — Chemistry, 



CMARLE8, T. CRAN8TOVN, M. D., F. C. 8., 31. 8., 

Formerly Asst. Prof, and Demonst. of Chemistry and Chemical Physics, Queen's College, Belfast. 

The Elements of Physiological and Pathological Chemistry. A 

Handbook for Medical Students and Practitioners. Containing a general account of 
Nutrition, Foods and Digestion, and the Chemistry of the Tissues, Organs, Secretions and 
Excretions of the Body in Health and in Disease. Together with the methods for pre- 
paring or separating their chief constituents, as also for their examination in detail, and 
an outline syllabus of a practical course of instruction for students. In one handsome octavo 
volume of 463 pages, with 38 woodcuts and 1 colored plate. Cloth, $3.50. 

Dr. Charles' manual admirably fulfils its inten- 



The work is thoroughly trustworthy, and in- 
formed throughout by a genuine scientific spirit. 
The author deals with the chemistry of the diges- 
tive secretions in a systematic manner, which 
leaves nothing to be desired, and in reality sup- 
plies a want in English literature. The book ap- 
pears to us to be at once full and systematic, and 
to show a just appreciation of the relative import- 
ance of the various subjects dealt with. — British 
Medical Journal, November 29, 1884. 



tion of giving his readers on the one hand a sum- 
mary, comprehensive but remarkably compact, of 
the mass of facts in the sciences which have be- 
come indispensable to the physician ; and, on the 
other hand, of a system of practical directions so 
minute that analyses often considered formidable 
may be pursued by any intelligent person. — 
Archives of Medicine, Dec. 1884. 



HOFFMAJYJST, F, A.M.,Fh.L>., & FOWER F.B., Fh.D., 

Public Analyst to the State of Nexo York. Prof, of Anal. Chem. in the Phil. Coll. of Pharmacy. 

A Manual of Chemical Analysis, as applied to the Examination of Medicinal 
Chemicals and their Preparations. Being a Guide for the Determination of their Identity 
and Quality, and for the Detection of Impurities and Adulterations. For the use of 
Pharmacists, Physicians, Druggists and Manufacturing Chemists, and Pharmaceutical and 
Medical Students. Third edition, entirely rewritten and much enlarged. In one very 
handsome octavo volume of 621 pages, with 179 illustrations. Cloth, $4.25. 



"We congratulate the author on the appearance 
of the third edition of this work, published for the 
first ^me in this country also. It is admirable and 
the information it undertakes to supply is both 
extensive and trustworthy. The selection of pro- 
cesses for determining the purity of the substan- 
ces of which it treats is excellent and the descrip- 



tion of them singularly explicit. Moreover, it is 
exceptionally free from typographical(errors. "We 
have no hesitation in recommending it to those 
who are engaged either in the manufacture or the 
testing of medicinal chemicals. — London Pharma- 
ceutical Journal and Transactions, 1883. 



CLOWE8, FRAJSE1, Z>. 8c, London, 

Senior Science- Master at the High School, Newcastle-under-Lyme, etc. 

An Elementary Treatise on Practical Chemistry and Qualitative 
Inorganic Analysis. Specially adapted for use in the Laboratories of Schools and 
Colleges and by Beginners. Third American from the fourth and revised English edition. 
In one very handsome royal 12mo. volume of about 400 pages, with about 50 illustrations. 
Cloth, $2.50. In a few days. 

The d emand for four editions of this work proves the success of Professor Clowes' effort 
to provide a simple, concise and trustworthy guide to qualitative analysis. The use and 
preparation of apparatus, and the directions for working have been so fully and clearly 
detailed that the book is admirably adapted not only to relieve the teacher of unnecessary 
labor, but also to answer all the requirements of self-instruction. 

RALFE, CHARLES JET., M. D., F. R. C. F., 

Assistant Physician at the London Hospital. 

Clinical Chemistry. In one pocket-size J12mo. volume of 314 pages, with 16 

illustrations. Limp cloth, red edges, $1.50. 

This is one of the most instructive little works 

that we have met with in a long time. The author 

is a physician and physiologist, as well as a chem- 



ist, consequently the book is unqualifiedly prac- 
tical, telling the physician just what he ougnt to 
know, of the applications of chemistry in medi- 



See Students 1 Series of Manuals, page 3. 
cine. Dr. Ralfe is thoroughly acquainted with the 
latest contributions to his science, and it is quite 
refreshing to find the subject dealt with so clearly 
and simply, yet in such evident harmony with the 
modern scientific methods and spirit.— Medical 
Record, February 2, 1884. 



CLA88EJST, ALEXANDER, 

Professor in the Royal Polytechnic School, Aix-la-Chapelle. 

Elementary Quantitative Analysis. Translated, with notes and additions, by 
Edgar F. Smith. Ph. D., Assistant Professor of Chemistry in the Towne Scientific School, 
University of Penna. In one 12mo. volume of 324 pages, with 3G illust. Cloth, $2.00. 

It is probably the best manual of an elementary 
nature extant insomuch as its methods are the 



best. It teaches by examples, commencing with 
single determinations, followed by separations, 



and then advancing to the analysis of minerals and 
such products as are met with in applied chemis- 
try. It is an indispensable book for students in 
chemistry.— Boston Journal of Chemistry, Oct. 1878. 



GREENE, WILLIAM H., M. D., 

Demonstrator of Chemistry in the Medical Department of the University of Pennsylvania. 

A Manual of Medical Chemistry. For the use of Students. Based upon Bow- 
man's Medical Chemistry. In one 12mo. volume of 310 pages, with 74 illus. Cloth, $1.75. 
It is a concise, manual of three hundred pages, the recognition of compounds due to pathological 
giving mi excellent BUtnmary of fche besl methods conditions. The detection of poisons is treated 
of analyzing the liquids and solids of the body, both with sufficient fulness for the purpose of thestu- 
forthe estimation of their normal constituents and dent or practitioner. — Boston Jl. of Chem., June, '80. 



Lea Brothers & Co.'s Publications — Pliarm., Mat. Med., Therap. 11 



PARRISH, En WARD, 

Late Professor of the Theory and Practice of Pharmacy in the Philadelphia College of Pharmacy. 
A Treatise on Pharmacy : designed as a Text-book for the Student, and as a 
Guide for the Physician and Pharmaceutist. With many Formulae and Prescriptions. 
Fifth edition, thoroughly revised, by Thomas S. Wiegajstd, Ph. G. In one handsome 
octavo volume of 1093 pages, with 256 illustrations. Cloth, $5 ; leather, $6. 



No thoroughgoing pharmacist will fail to possess 
himself of so useful a guide to practice, and no 
physician who properly estimates the value of an 
accurate knowledge of the remedial agents em- 
ployed by him in daily practice, so far as their 
miscibility, compatibility and most effective meth- 
ods of combination are concerned, can afford to 
leave this work out of the list of their works of 
reference. The country practitioner, who must 
always be in a measure his own pharmacist, will 
find it indispensable. — Louisville Medical News, 
March 29, 1884. 

This well-known work presents itself now based 
upon the recently revised new Pharmacopoeia. 



Each page bears evidence of the care bestowed 
upon it, and conveys valuable information from 
the rich store of the editor's experience. In fact, 
all that relates to practical pharmacy — apparatus, 
processes and dispensing— has been arranged and 
described with clearness in its various aspects, so 
as to afford aid and advice alike to the student and 
to the practical pharmacist. The work is judi- 
ciously illustrated with good woodcuts — American 
Journal of Pharmacy, January, 1884. 

There is nothing to equal Parrish's Pharmacy 
in this or any other language.— London Pharma- 
ceutical Journal. 



BRTJNTOW, T. LAUDER, M. I)., 

Lecturer on Materia Medica and Therapeutics at St. Bartholomew's Hospital, London, etc. 

A Text-book of Pharmacology, Materia Medica and Therapeutics. 

In one handsome octavo volume of about 1000 pages, with over 200 illustrations. Cloth, 
$5.50 ; leather, $6.50. In press. 

It is with peculiar pleasure that the early appearance of this long expected work is 
announced by the publishers. Written by the foremost authority on its subject in Eng- 
land, it forms a compendious treatise on materia medica, pharmacology, pharmacy, and 
the practical use of medicines in the treatment of disease. Space has been devoted to the 
fundamental sciences of chemistry, physiology and pathology, wherever it seemed necessary 
to elucidate the proper subject-matter of the book. A general index, an index of diseases 
and remedies, and an index of bibliography close a volume which will undoubtedly be of 
the highest value to the student, practitioner and pharmacist. • 

HERMAJSJST, Dr. L~, 

Professor of Physiology in the University of Zurich. 

Experimental Pharmacology. A Handbook of Methods for Determining the 
Physiological Actions of Drugs. Translated, with the Author's permission, and with 
extensive additions, by Robert Meade Smith, M. D., Demonstrator of Physiology in the 
University of Pennsylvania. In one handsome 12mo. volume of 199 pages, with 32 
illustrations. Cloth, $1.50. 



Prof. Hermann's handbook, which Dr. Smith has 
translated and enriched with many valuable addi- 
tions, will be gladly welcomed by those engaged in 
this department of physiology. It is an excellent 
little book, full of concise information, and it 
should find a place in every laboratory. It ex- 



plains the various methods and instruments used, 
and points out what lines of investigation are to 
be pursued for studying different phenomena, 
and also how and what particularly to observe.— 
American Journal of the Medical Sciences, Jan. 1884, 



MAIS CS, JOHJSTM., Fhar. D., 

Professor of Materia Medica and Botany in the Philadelphia College of Pharmacy. 

A Manual of Organic Materia Medica; Being a Guide to Materia Medica of 
the Vegetable and Animal Kingdoms. For the use of Students, Druggists, Pharmacists 
and Physicians. New (second) edition. In one handsome royal 12mo. volume of 550 
pages, with 242 illustrations. Cloth, $3.00. Just ready. 

This work contains the substance, — the practical excellent, being very true to nature, and are alone 
"kernel of the nut" picked out, so that the stu- worth the price of the book to the student. To the 
dent has no superfluous labor. He can confidently practical physician and pharmacist it is a valuable 



accept what this work places before him, without 
any fear that the gist of the matter is not in it. 
Another merit is that the drugs are placed before 
him in such a manner as to simplify very much 
the study of them, enabling the mind to grasp 
them more readily. The illustrations are most 



work for handy reference and for keeping fresh 
in the memory the knowledge of materia medica 
and botany already acquired. We can and do 
heartily recommend it.— Medical and Surgical Re- 
porter, Feb. 14, 1885. 



BRUCE, J. MITCHELL, M. I)., F. It. C. P., 

Physician and Lecturer on Materia Medica and Therapeutics at Charing Cross Hospital, London. 

Materia Medica and Therapeutics. An Introduction to Eational Treat- 
ment. In one pocket-size 12mo. volume of 555 pages. Limp cloth, $1.50. Just ready. 
See Students' Series of Manuals, page 3. 

One of the very latest works upon Materia 
Medica and Therapeutics, replete with informa- 
tion abreast of the times, we unhesitatingly 



recommend it as one of the very best for either 
medical student or practitioner of medicine. — 
Cincinnati Medical News, August, 1884. 



GRIFFITH, ROBERT EGLESFIELD, M. D. 

A Universal Formulary, containing the Methods of Preparing and Adminis- 
tering Officinal and other Medicines. The whole adapted to Physicians and Pharmaceut- 
ists. Third edition, thoroughly revised, with numerous additions, by John M. Maisch, 
Phar. D., Professor of Materia Medica and Botany in the Philadelphia College of Pharmacy. 
In one octavo volume of 775 pages, with 38 illustrations. Cloth, $4.50 ; leather $5.50. 



12 Lea Brothers & Co.'s Publications — Mat. Med., Therap. 
STILLE, A., M.n.,LL.I>., & MAISCH, J. M.,I>har.n., 

Professor Emeritus of the Theory and Prac- Prof, of Mat. Med. and Botany in Phila. 

tice of Medicine and of Clinical Medicine College of Pharmacy, Sec 'y to the Ameri- 

in the University of Pennsylvania. can Pharmaceutical Association. 

The National Dispensatory : Containing the Natural History, Chemistry, Phar- 
macy, Actions and Uses of Medicines, including those recognized in the Pharmacopoeias of 
the United States, Great Britain and Germany, with numerous references to the French 
Codex. Third edition, thoroughly revised and greatly enlarged. In one magnificent 
imperial octavo volume of 1767 pages, with 311 fine engravings. Cloth, $7.25; 
leather, $8.00; half Russia, open back, $9.00. With Denison's "Beady Reference Index" 
$1.00 in addition to price in any of above styles of binding. Just ready. 

In the present revision the authors have labored incessantly with the view of making 
the third edition of The National Dispensatory an even more complete represen- 
tative of the pharmaceutical and therapeutic science of 1884 than its first edition was of 
that of 1879. For this, ample material has been afforded not only by the new United 
States Pharmacopoeia, but by those of Germany and France, which have recently appeared 
and have been incorporated in the Dispensatory, together with a large number of new non- 
officinal remedies. It is thus rendered the representative of the most advanced state of 
American, English, French and German pharmacology and therapeutics. The vast amount 
of new and important material thus introduced may be gathered from the fact that the 
additions to this edition amount in themselves to the matter of an ordinary full-sized octavo 
volume, rendering the work larger by twenty-five per cent, than the last edition. The 
Therapeutic Index (a feature peculiar to this work), so suggestive and convenient to the 
practitioner, contains 1600 more references than the last edition — the General Index 
3700 more, making the total number of references 22,390, while the list of illustrations 
has been increased by 80. Every effort has been made to prevent undue enlargement of 
the volume by having in it nothing that could be regarded as superfluous, yet care has 
been taken that nothing should be omitted which a pharmacist or physician could expect 
to find* in it. 

The appearance of the work has been delayed by nearly a year in consequence of the 
determination of the authors that it should attain as near an approach to absolute ac- 
curacy as is humanly possible. With this view an elaborate and laborious series of 
examinations and tests have been made to verify or correct the statements of the Pharma- 
copoeia, and very numerous corrections have been found necessary. It has thus been ren- 
dered indispensable to all who consult the Pharmacopoeia. 

The work is therefore presented in the full expectation that it will maintain the 
position universally accorded to it as the standard authority in all matters pertaining to 
its subject, as registering the furthest advance of the science of the day, and as embody- 
ing in a shape for convenient reference the recorded results of human experience in the 
laboratory, in the dispensing room, and at the bed-side. 



Comprehensive in scope, vast in design and 
splendid in execu-tion, The National Dispensatory 
may be justly regarded as the most important work 
of its kind extant. — Louisville Medical News, Dec. 
6, 1884. 

We have much pleasure in recording the appear- 
ance of a third edition of this excellent work of 
reference. It is an admirable abstract of all that 
relates to chemistry, pharmacy, materia medica, 
pharmacology and therapeutics. It may be re- 
garded as embodying the Pharmacopoeias of the 
civilized nations of the world, all being brought 



up to date. The work has been very well done, a 
large number of extra-pharmacopceial remedies 
having been added to those mentioned in previous 
editions. — London Lancet, Nov. 22, 1884. 

Its completeness as to subjects, the comprehen- 
siveness of its descriptive language, the thorough- 
ness of the treatment of the topics, its brevity not 
sacrificing the desirable features of information 
for which such a work is needed, make this vol- 
ume a marvel of excellence. — Pharmaceutical Re- 
cord, Aug. 15, 1884. 



FARQUHARSOJT, ROBERT, M. D., 

Lecturer on Materia Medica at St. Mary's Hospital Medical School. 

A Guide to Therapeutics and Materia Medica. Third American edition, 
specially revised by the Author. Enlarged and adapted to the U. S. Pharmacopoeia by 
Frank Woodbury, M. D. In one handsome 12mo. volume of 524 pages. Cloth, f 2.25. 

Dr. Farquharson's Therapeutics is constructed 

upon a plan which brings before the reader all the 

essential points with reference to the properties of 

drugs. It impresses these upon him in such away 

.able him to take a clear view of the actions 



of medicines and the disordered conditions in 
Which they must prove useful. The double-col- 



umned pages — one side containing the recognized 
physiological action of the medicine, and the other 
the disease in which observers (who are nearly al- 
ways mentioned) have obtained from it good re- 
sults — make a very good arrangement. The early 
chapter containing rules for prescribing is excel- 
lent. — Canada Med. and Surg. Journal, Dec. 1882. 



STILLE, ALFRED, M. L>., LL. D., 

Professor of Theory and Practice of Med. and of Clinical Med. in the Univ. of Penna. 

Therapeutics and Materia Medica. A Systematic Treatise on the Action and 
Uses of MedidnaJ Agents, including their Description and History. Fourth edition, 
revised and enlarged. In two large and handsome octavo volumes, containing 1936 pages. 
Cloth, $10.00; leather, $12.00; very handsome half Russia, raised bands, $13.00. 

We can hardly admit that it has a rival in the in pharmacodynamics, but as by far the most com- 
multitnde of its citations and the fulness of its plete treatise upon the clinical and practical side 
research into clinical histories, and we must assign of the question. — Boston Medical andSurgical Jour- 
it a place in the physician's library; not, indeed, nal, Nov. 5, 1874. 
as fully representin g the present state of knowledge 



Lea Brothers & Co.'s Publications — Pathol., Histol. 



13 



COATS, JOSEPH, M. D., F. F. JP. S., 

Pathologist to the Glasgow Western Infirmary. 

A Treatise on Pathology. In one very handsome octavo volume of 829 pages, 
with 339 beautiful illustrations. Cloth, $5.50 • leather, $6.50. 

condition effected in structures by disease, and 
points out the characteristics of various morbid 
agencies, so that they can be easily recognized. But, 
not limited to morbid anatomy.it explains fully how 



The work before us treats the subject of Path- 
ology more extensively than it is usually treated 
in similar works. Medical students as well as 
physicians, who desire a work for study or refer- 
ence, that treats the subjects in the various de- 
partments in a very thorough manner, but without 
prolixity, will certainly give this one the prefer- 
ence to any with which we are acquainted. It sets 
forth the most recent discoveries, exhibits, in an 
interesting manner, the changes from a normal 



the functions of organs are disturbed by abnormal 
conditions. There is nothing belonging to its de- 
partment of medicine that is not as fully elucidated 
as our present knowledge will admit.— 'Cincinnati 
Medical News, Oct. 1883. 



GBFFW, T. MBJSTBY, M. D., 

Lecturer on Pathology and Morbid Anatomy at Charing-Cross Hospital Medical School, London. 

Pathology and Morbid Anatomy. Fifth American from the sixth revised 
and enlarged English edition. In one very handsome octavo volume of 482 pages, with 
150 tine engravings. Cloth, $2.50. Just ready. 



The fact that this well-known treatise has so 
rapidly reached its sixth edition is a strong evi- 
dence of its popularity. The author is to be con- 
fratulated upon the thoroughness with which he 
as prepared this work. It is thoroughly abreast 
with all the most recent advances in pathology. 



No work in the English language is so admirably 
adapted to the wants of the student and practi- 
tioner as this, and we would recommend it most 
earnestly to every one. — Nashville Journal of Medi- 
cine and Surgery, Nov. 1884. 



WOODMFAI), G. SIMS, M. D., F. B. €. JP. F., 

Demonstrator of Pathology in the University of Edinburgh. 

Practical Pathology. A Manual for Students and Practitioners. In one beau- 
tiful octavo volume of 497 pages, with 136 exquisitely colored illustrations. Cloth, $6.00. 

The author merits all praise for having produced 
a valuable work. — Medical Record, May 31, 1884. 

It is manifestly the product of one who has him- 
self travelled over the whole field and who is skilled 
not merely in the art of histology, but in the obser- 
vation and interpretation of morbid changes. The 
work is sure to command a wide circulation. It 



It forms a real guide for the student and practi- 
tioner who is thoroughly in earnest in his en- 
deavor to see for himself and do for himself. To 
the laboratory student it will be a helpful com- 
panion, and all those who may wish to familiarize 
themselves with modern methods of examining 
morbid tissues are strongly urged to provide 
themselves with this manual. The numerous 
drawings are not fancied pictures, or merely 
schematic diagrams, but they represent faithfully 
the actual images seen under the microscope. 



should do much to encourage the pursuit of path- 
ology, since such advantages in histological study 
have never before been offered.— The Lancet, Jan. 
5, 1884. 



SCMAFBB, FDWABJO A., F. M. S., 

Assistant Professor of Physiology in University College, London. 

The Essentials of Histology. In one octavo volume of about 300 pages, 
with about 325 illustrations. In press. 

COBWIL, V., and BAJSTIFB, L., 

Prof, in the Faculty of Med. of Paris. Prof, in the College of France. 

A Manual of Pathological Histology. Translated, with notes and additions, 
by E. O. Shakespeare, M. D., Pathologist and Ophthalmic Surgeon to Philadelphia 
Hospital, and by J. Henry C. Simes, M. D., Demonstrator of Pathological Histology in 
the University of Pennsylvania. In one very handsome octavo volume of 800 pages, with 
360 illustrations. Cloth, $5.50 ; leather, $6.50 ; half Kussia, raised bands, $7. 

KLEIN, F., M. J)., F. B. S., 

Joint Lecturer on General Anat. and Phys. in the Med. School of St. Bartholomew's Hosp. t London. 

Elements of Histology. In one pocket-size 12mo. volume of 360 pages, with 181 
illus. Limp cloth, red edges, $1.50. See Students' Series of Manuals, page 3. 

Although an elementary work, it is by no means The illustrations are numerous and excellent. We 
superficial or incomplete, for the author presents commend Dr. Klein's Elements most heartily to 
in concise language nearly all the fundamental facts the student.— Medical Record, Dec. 1, 1883. 
regarding the microscopic structure of tissues. 



BEPBEB, A. J., M.B., M. S., F. B. C. S., 

Surgeon and Lecturer at St. Mary's Hospital, London. 

Surgical Pathology. In one pocket-size 12mo. volume of 511 pages, with 81 
illustrations. Limp cloth, red edges, $2.00. See Students' Series of Manuals, page 3. 



It is not pretentious, but it will serve exceed 
ingly well as a book of reference. It embodies a 

treat deal of matter, extending over the whole 
eld of surgical pathology. Its form is practical, 
its language is clear, and the information set 
forth is well-arranged, well-indexed and well- 



illustrated. The student will find in it nothing 
that is unnecessary. The list of subjects covers 
the whole range of surgery. The book supplies a 
very manifest want and should meet with suc- 
cess. — New York Medical Journal, May 31, 1884. 



SCHAFER'S PRACTICAL HISTOLOGY. In one 
handsome royal 12mo. volume of 308 pages, with 
40 illustrations. 

©LUGE'S ATLAS OF PATHOLOGICAL HISTOL- 



OGY.- Translated by Joseph Leidt, M. D. In one 
volume, very large imperial quarto, with 320 
copper-plate figures, plain and colored and des- 
criptive letter-press. Cloth, $4.00„ 



14 



LeA Brothers & Co.'s Publications — Practice of Med. 



FLINT, AUSTIN, 31. D., 

Prof, of the Principles and Practice of Med. and of Clin. Med. in Bellevue Hospital Medical College, N. T. 

A Treatise on the Principles and Practice of Medicine. Designed for 
the use of Students and Practitioners of Medicine. With an Appendix on the Researches 
of Koch, and their bearing on the Etiology, Pathology, Diagnosis and Treatment of 
Phthisis. Fifth edition, revised and largely rewritten In one large and closely-printed 
octavo volume of 1160 pages. Cloth, $5.50 ; leather, §6.50 ; half Russia, $7. 

Koch's discovery of the bacillus of tubercle gives promise of being the greatest 
boon ever conferred by science on humanity, surpassing even vaccination in its benefits to 
mankind. In the appendix to his work, Professor Flint deals with the subject from a 
practical standpoint, discussing its bearings on the etiology, pathology, diagnosis, prog- 
nosis and treatment of pulmonary phthisis. Thus enlarged and completed, this standard 
work will be more than ever a necessity to the physician who duly appreciates the re- 
sponsibility of his calling. 



A well-known writer and lecturer on medicine 
recently expressed an opinion, in the highest de- 
gree complimentary of the admirable treatise of 
Dr. Flint, and in eulogizing it, he described it ac- 
curately as " readable and reliable." No text-book 
is more calculated to enchain the interest of the 
student, and none better classifies the multitudi- 
nous subjects included in it. It has already so far 
won its way in England, that no inconsiderable 
number of men use it alone in the study of pure 
medicine; and we can say of it that it is in every 
way adapted to serve, not only as a complete guide, 
but also as an ample instructor in the science and 
practice of medicine. The style of Dr. Flint is 
always polished and engaging. The work abounds 
in perspicuous explanation, and is a most valuable 
text-book of medicine. — London Medical News. 



This work is so widely known and accepted as 
the best American text-book of the practice of 
medicine that it would seem hardly worth while to 
give this, the fifth edition, anything more than a 
passing notice. But even the most cursory exami- 
nation shows that it is, practically, much more 
than a revised edition ; it is, in fact, rather a new 
work throughout. This treatise will undoubtedly 
continue to hold the first place in the estimation 
of American physicians and students. No cna of 
our medical writers approaches Professor Flint in 
clearness of diction, breadth of view, and, what we 
regard of transcendent importance, rational esti- 
mate of the value of remedial agents. It is thor- 
oughly practical, therefore pre-eminently the book 
for American readers.— S£. Louis Clin. Bee, Mar. '81. 



HAKTSHORNE, HENMY, M. JD., II. D., 

Lately Professor of Hygiene in the University of Pennsylvania. 

Essentials of the Principles and Practice of Medicine. A Handbook 
for Students and Practitioners. Fifth edition, thoroughly revised and rewritten. In one 
royal 12mo. volume of 669 pages, with 144 illustrations. Cloth, $2.75 ; half bound, $3.00. 



"Within the compass of 600 pages it treats of the 
history of medicine, general pathology, general 
symptomatology, and physical diagnosis (including 
laryngoscope, ophthalmoscope, etc.), general ther- 
apeutics, nosology, and special pathology and prac- 
tice. There is a wonderful amount of information 
contained in this work, and it is one of the best 
of its kind that we have seen. — Glasgow Medical 
Journal, Nov. 1882. 

An indispensable book. No work ever exhibited 
a better average of actual practical treatment than 



this one ; and probably not one writer in our day 
had a better opportunity than Dr. Hartshorne for 
condensing all the views of eminent practitioners 
into a 12mo. The numerous illustrations will be 
very useful to students especially. These essen- 
tials, as the name suggests, are not intended to 
supersede the text-books of Flint and Bartholow, 
but they are the most valuable in affording the 
means to see at a glance the whole literature of any 
disease, and the most valuable treatment.— -Chicago 
Medical Journal and Examiner, April, 1882. 



BBISTOWE, JOHN STEM, M. !>., F. B. C. P., 

Physician and Joint Lecturer on Medicine at St. Thomas' 1 Hospital. 

A Treatise on the Practice of Medicine. Second American edition, revised 
by the Author. Edited, with additions, by James H. Hutchinson, M.D., physician to the 
Pennsylvania Hospital. In one handsome octavo volume of 1085 pages, with illustrations. 
Cloth, $5.00 ; leather, $6.00 ; very handsome half Russia, raised bands, $6.50. 



The reader will find every conceivable subject 
connected with the practice of medicine ably pre- 
sented, in a style at once clear, interesting and 
concise. The additions made by Dr. Hutchinson 



are appropriate and practical, and greatly add to 
its usefulness to American readers. — Buffalo Med- 
ical and Surgical Journal, March, 1880. 



WATSON, SIR THOMAS, M. !>., 

Late Physician in Ordinary to the Queen. 

Lectures on the Principles and Practice of Physic. A new American 
from the fifth English edition. Edited, with additions, and 190 illustrations, by Henry 
Hartshorne, A. M., M. D., late Professor of Hygiene in the University of Pennsylvania. 
In two large octavo volumes of 1840 pages. Cloth, $9.00 ; leather, $11.00. 



LECTURES ON THE STUDY OF FEVER. By 
A. Hudson, M. D., M. R. I. A. In one octavo 
volume of 308 pages. Cloth, 82.50. 

3TOKES' LECTURES ON FEVER. Edited by 
John William Moore, M. D., F. K. Q. C. P. In 
one octavo volume of 280 pages. Cloth, $2.( 



.nil. 



A TREATISE ON FEVER. By Robert D. Lyons, 
K. C. C. In one 8vo. vol. of 354 pp. Cloth, 82.26. 

LA ROCHE ON YELLOW FEVER, considered in 
its Historical, Pathological, Etiological and 
Therapeutical Relations. In two large and hand- 
some octavo volumes of 1468 pp. Cloth, 87.00. 



A CENTURY OF AMERICAN MEDICINE, 1776—1876. By Drs. E. H. Clarke, H. J. 
Biorxow, S. D. Gross, T. Gk Thomar. and .1. 8. Hu-linos. In one 12mo. volume of 370 pages. Cloth, 82.25. 



Lea Brothers & Co.'s Publications — Systems of Med. 15 

For Sale by Subscription Only, 



A System of Practicai Medicine. 

B Y AMERICAN A TJTHORS. 
Edited by WILLIAM PEPPER, M. D., LL. D., 

PROVOST AND PROFESSOR OF THE THEORY AND PRACTICE OF MEDICINE AND OF 
CLINICAL MEDICINE IN THE UNIVERSITY OF PENNSYLVANIA, 

Assisted by Louis Starr, M. D., Clinical Professor of the Diseases of Children in the 
Hospital of the University of Pennsylvania. 

In five imperial octavo volumes, containing about 1100 -pages each, with illustrations. Price per 
volume, cloth, $5 ; leather, $6 ; half Russia, raised bands and open bach, $7. Volume I. 
(General Pathology, Sanitary Science and General Diseases) contains 1094 pages, 
with 24 illustrations and is just ready. Volume II. (General Diseases [con- 
tinued] and Diseases of the Digestive System) will be ready June 1st, 
and the subsequent volumes at intervals of four months thereafter. 

The publishers feel pardonable pride in announcing^ this magnificent work. For 
three years it has been in active preparation, and it is now in a sufficient state of forward- 
ness to justify them in calling the attention of the profession to it as the work in which 
for the first time American medicine is thoroughly represented by its worthiest 
teachers, and presented in the full development of the practical utility which is its 
preeminent characteristic. The most able men — from the East and the West, from the 
North and the South, from all the prominent centres of education, and from all the 
hospitals which afford special opportunities of study and practice — have united in 
generous rivalry to bring together this vast aggregate of specialized experience. 

The distinguished editor has so apportioned the work that each author has had 
assigned to him the subject which he is peculiarly fitted to discuss, and in which his views 
will be accepted as the latest expression of scientific and practical knowledge. The 
practitioner will therefore find these volumes a complete, authoritative and unfailing work 
of reference, to which he may at all times turn with full certainty of finding what he needs 
in its most recent aspect, whether he seeks information on the general principles of medi- 
cine, or minute guidance in the treatment of special disease. So wide is the scope of the 
work that, with the exception of midwifery and matters strictly surgical, it embraces the 
whole domain of medicine, including the departments for which the physician is accustomed 
to rely on special treatises, such as diseases of women and children, of the genito-urinary 
organs, of the skin, of the nerves, hygiene and sanitary science, and medical ophthalmology 
and otology. Moreover, authors have inserted the formulas which they have found most 
efficient in the treatment of the various affections. It may thus be truly regarded as a 
Complete Library of Practical Medicine, and the general practitioner possessing it 
may feel secure that he will require little else in the daily round of professional duties. 

In spite of every effort to condense the vast amount of practical information fur- 
nished, it has been impossible to present it in less than 5 large octavo volumes, containing 
about 5500 beautifully printed pages, and embodying the matter of about 15 ordinary 
octavos. Illustrations are introduced wherever they serve to elucidate the text. 

As material for the work is substantially complete in the hands of 'the editor, the pro- 
fession may confidently await the appearance of the remaining volumes upon the dates 
above specified. A detailed prospectus of the work will be sent to any address on appli- 
cation to the publishers. 



It is a large undertaking, but quite justifiable in 
the case of a progressive nation like the United 
States. At any rate, if we may judge of future 
volumes from the first, it will be justified by the 
result. We have nothing but praise to bestow 
upon the work. The articles are the work of 
writers, many of whom are already recognized in 



this country as authorities on the particular topics 
on which they deal, whilst the others show by the 
way they have handled their subjects that they 
are fully equal to the task they had undertaken. 
* * * A work which we cannot doubt will make 
a lasting reputation for itself. — London Medical 
Times and Gazette, May 9, 1885. 



MEYJVOLDS, J. MVSSBLL, M. JD., 

Professor of the Principles and Practice of Medicine in University College, London. 

A System of Medicine. With notes and additions by Henry Hartshorne, 
A. M., M. D., late Professor of Hygiene in the University of Pennsylvania. In three large 
and handsome octavo volumes, containing 3056 double-columned pages, with 317 illustra- 
tions. Price per volume, cloth, $5.00 ; sheep, $6.00 ; very handsome half Kussia, raised bands, 
$6.50. Per set, cloth, $15 ; leather, $18 ; half Russia, $19.50. Sold only by subscription. 



There is no medical work which we have in 
times past more frequently and fully consulted 
when perplexed by doubts' as to treatment, or by 
having unusual or apparently inexplicable symp- 
toms presented to us, than "Reynolds' System of 
Medicine." It contains just that kind of informa- 
tion which the busy practitioner frequently finds 



himself in need of. In order that any deficiencies 
may be supplied, the publishers nave committed 
the preparation of the book for the press to Dr. 
Henry Hartshorne, whose judicious notes distrib- 
uted throughout the volume afford abundant evi- 
dence of the thoroughness of the revision.— A-m er- 
ica n Journal of the Medical Sciences, Jan. 1&80. 



16 Lea Brothers & Co.'s Publications — Clinical Med., etc, 

STILLE, ALFRED, M. L>., LL. JD., 

Professor Emeritus of the Theory and Practice of Med. and of Clinical Med. in the Univ. of Penna. 

Cholera: Its Origin, History, Causation, Symptoms, Prevention and Treatment. 
In one handsome 12mo. volume of about 175 pages, with a chart. Cloth, $1.25. Shortly. 

The threatened importation of cholera into the country renders peculiarly timely 
this work of an authority so eminent as Professor Stille. The history of previous epi- 
demics, their modes of propagation, the vast recent additions to our knowledge of the 
causation, prevention and treatment of the disease, all have been handled so skilfully as 
to present with brevity the information which every practitioner should possess in ad- 
vance of a visitation. 



FLINT, AUSTLW, 31. JD. 

Clinical Medicine. A Systematic Treatise on the Diagnosis and Treatment of 
Diseases. Designed for Students and Practitioners of Medicine. In one large and hand- 
some octavo volume of 799 pages. Cloth, $4.50 ; leather, $5.50 ; half Eussia, $6.00. 

sistently with brevity and clearness, the different 
subjects and their several parts receiving the 
attention which, relatively to their importance, 
medical opinion claims for them, is still more diffi- 
cult. This task, we feel bound to say, has been 
executed with more than partial success by Dr. 
Flint, whose name is already familiar to students 
of advanced medicine in this country as that of 
the author of two works of great merit on special 
subjects, and of numerous papers exhibiting much 
originality and extensive research.— The Dublin 
Journal. Dec. 1879. 



It is here that the skill and learning of the great 
clinician are displayed. He has given us a store- 
house of medical knowledge, excellent for the stu- 
dent, convenient for the practitioner, the result of 
a long life of the most faithful clinical work, col- 
lected by an energy as vigilant and systematic as 
untiring, and weighed by a judgment no less clear 
than his observation is close. — Archives of Medicine, 
Dec. 1879. 

To give an adequate and useful conspectus of the 
extensive field of modern clinical medicine is a task 
of no ordinary difficulty; but to accomplish this con- 



By the Same Author. 

Essays on Conservative Medicine and Kindred Topics. In one very hand- 
some royal 12mo. volume of 210 pages. Cloth, $1.38. 

BBOAEBENT, W. EC., M. JD., F. B. C. B., 

Physician to and Lecturer on Medicine at St. Mary's Hospital. 
The Pulse. In one 12mo. volume. See Series of Clinical Manuals, page 3. 

SCEEBEJTBEB, JDB. JOSEBJBE. 

A Manual of Treatment by Massage and Methodical Muscle Ex- 
ercise. Translated by Walter Mendelson, M. D., of Few York. In one handsome 
octavo volume of about 300 pages, with about 125 fine engravings. Preparing. 

FIJSLAYSOir, JAMES, M. J)., Editor, 

Physician and Lecturer on Clinical Medicine in the Glasgow Western Infirmary, etc. 
Clinical Diagnosis. A Handbook for Students and Practitioners of Medicine. 
With Chapters by Prof. Gairdner on the Physiognomy of Disease ; Prof. Stephens on 
Diseases of the Female Organs; Dr. Eobertson on Insanity; Dr. Gem m ell on Physical 
Diagnosis ; Dr. Coats on Laryngoscopy and Post-Mortem Examinations, and by the Editor 
on Case-taking, Family History and Symptoms of Disorder in the Various Systems. In 
one handsome 12mo. volume of 546 pages, with 85 illustrations. Cloth, $2.63. 



This is one of the really useful books. It is at- 
tractive from preface to the final page, and ought 
to be given a place on every office table, because it 
contains in a condensed form all that is valuable 
in semeiology and diagnostics to be found in 



bulkier volumes; and because of its arrangement 
and complete index it is unusually convenient for 
quick reference in any emergency that may come 
upon the busy practitioner.— N. C. Med. Journ. t 
Jan. 1879. 



FENWICK, SAMUEL, M. JD., 

Assistant Physician to the London Hospital. 

The Student's Guide to Medical Diagnosis. From the third revised and 
enlarged English edition. In one very handsome royal 12mo. volume of 328 pages, with 
87 illustrations on wood. Cloth, $2.25. 

TAJSTNEB, THOMAS SAWKES, M. JD. 

A Manual of Clinical Medicine and Physical Diagnosis. Third American 
from the second London edition. Revised and enlarged by Tilbury Fox, M. D., Phy- 
sician to the Skin Department in University College Hospital, London, etc. In one small 
12mo. volume of 362 pages, with illustrations. Cloth, $1.50. 

FOTHEBGILL, J. M., M. JD., Edin., M. B. C. B., Lond., 

Physician to the City of London Hospital for Diseases of the Chest. 

The Practitioner's Handbook of Treatment ; Or, The Principles of Thera- 
peutics. New edition. In one octavo volume. Preparing. 

STURGES' INTRODUCTION TO THE STUDY 
OF CLINICAL MEDICINE. BeingaGuide to 
the investigation of Disease. In one handsome 
12mo. volume of 127 pages. Cloth, 81.25. 



DAVIS' CLINICAL LECTURES ON VARIOUS 
IMPORTANT DISEASES. By N. S. Davis, 
M. D. Edited by Frank H. Davis, M. D. Second 
edition. 12mo. 287 pages. Cloth, 81.75. 



Lea Brothers & Co.'s Publications — Hygiene, Electr., Pract. 



17 



MICHAHDSON, B. W., M.A., M.I)., LL. D., F.B.S., F.S.A. 

Fellow of the Royal College of Physicians, London. 
Preventive Medicine. In one octavo volume of 729 pages. Cloth, $4; leather, 
$5 ; very handsome half Russia, raised bands, $5.50. 



Dr. Richardson has succeeded in producing a 
work which is elevated in conception, comprehen- 
sive in scope, scientific in character, systematic in 
arrangement, and which is written in a clear, con- 
cise and pleasant manner. He evinces the happy 
faculty of extracting the pith of what is known on 
the subject, and of presenting it in a most simple, 
intelligent and practical form. There is perhaps 
no similar work written for the general public 
thatcontains such a complete, reliable and instruc- 
tive collection of data upon the diseases common 
to the race, their origins, causes, and the measures 
for their prevention. The descriptions of diseases 
are clear, chaste and scholarly; the discussion of 



the question of disease is comprehensive, masterly 
and fully abreast with the latest and best knowl- 
edge on the subject, and the preventive measures 
advised are accurate, explicit and reliable. — The 
American Journal of the Medical Sciences, April, 1884. 

This is a book that will surely find a place on the 
table of every progressive physician. To the 
medical profession, whose duty is quite as much to 
prevent as to cure disease, the book will be a boon. 
— Boston Medical and Surgical Journal, Mar. 6, 1884. 

The treatise contains a vast amount of solid, valu- 
able hygienic information. — Medical and Surgical 
Reporter, Feb. 23, 1884. 



BABTHOLOW, MOBEKTS, A. M., M. !>., LL. L>., 

Prof, of Materia Medica and General Therapeutics in the Jefferson Med. Coll. of Phila., etc. 
Medical Electricity. A Practical Treatise on the Applications of Electricity 



to Medicine- and Surgery. Second edition, 
pages, with 109 illustrations. Cloth, $2.50. 

The second edition of this work following so 
soon upon the first would in itself appear to be a 
sufficient announcement; nevertheless, the text 
has been so considerably revised and condensed, 
and so much enlarged by the addition of new mat- 
ter, that we cannot fail to recognize a vast improve- 
ment upon the former work. The author has pre- 
pared his work for students and practitioners — for 
those who have never acquainted themselves with 
the subject, or, having done so, find that after a 
time their knowledge needs refreshing. We think 
he has accomplished this object. The book is not 
too voluminous, but is thoroughly practical, sim- 
ple, complete and comprehensible. It is, more- 
over, replete with numerous illustrations of instru- 
ments, appliances, etc. — Medical Record, November 
15, 1882. 



In one very handsome octavo volume of 292 



A most excellent work, addressed by a practi- 
tioner to his fellow-practitioners, and therefore 
thoroughly practical. The work now before us 
has the exceptional merit of clearly pointing out 
where the benefits to be derived from electricity 
must come. It contains all and everything that 
the practitioner needs in order to understand in- 
telligently the nature and laws of the agent he is 
making use of, and for its proper application in 
practice. In a condensed, practical form, it pre- 
sents to the physician all that he would wish to 
remember after perusing a whole library on medical 
electricity, including the results of the latest in- 
vestigations. It is the book for the practitioner, 
and the necessity for a second edition proves that 
it has been appreciated by the profession. — Physi- 
cian and Surgeon, Dec. 1882. 



TELE YEAB-BOOK OF TREATMENT. 

A Comprehensive and Critical Review for Practitioners of Medi- 
cine. In one 12mo. volume of 320 pages, bound in limp cloth, with red edges, $1.25. 

This work presents to the practitioner not only a complete classified account of all 
the more important advances made in the treatment of Disease during the year ending 
Sept. 30, 1884, but also a critical estimate of the same by a competent authority. Each 
department of practice has been fully and concisely treated, and into the consideration of 
each subject enter such allusions to recent pathological and clinical work as bear directly 
upon treatment. As the medical literature of all countries has been placed under contri- 
bution, the references given throughout the work, together with the separate indexes of 
subjects and authors, will serve as a guide for those who desire to investigate any thera- 
peutical topic at greater length. 

The contributions are from the pens of the following well-known gentlemen: — J. 
Mitchell Bruce, M.D. ; T. Lauder Brunton, M.D., F.B.S. ; Thomas Bryant, F.E. 
C.S. ; F. H. Champneys, M.B. ; Alfred Cooper, F.E.C.S. ; Sidney Coupland, M.D. ; 
Dyce Duckworth, M.D. ; George P. Field, M.B.C.S. ; Beginald Harrison, F.B. 
C.S. ; J. Warrington Haward, F.E.C.S. ; F. A. Mahomed, M.B. ; Malcolm Morris, 
F.E.C.S., Ed. ; Edmund Owen, F.E.C.S. ; E. Douglas Powell, M.D. ; Henry Power, 
M.B., F.E.C.S.; C. H. Ealfe, M.D. ; A. E. Sansom, M.D.; Felix Semon, M.D.; 
Walter G. Smith, M.D. ; J. Knowsley Thornton, M.B. ; Frederick Treves, 
F.E.C.S. ; A. de Watteville, M.D. ; John Williams, M.D. 



BEABEBSBLOlSr, S. O., M. !>., 

Senior Physician to and late Lect. on Principles and Practice of Med. at Guy's Hospital, London. 

On the Diseases of the Abdomen ; Comprising those of the Stomach, and 
other parts of the Alimentary Canal, (Esophagus, Caecum, Intestines and Peritoneum. Second 
American from third enlarged and revised English edition. In one handsome octavo 
volume of 554 pages, with illustrations. Cloth, $3.50. 



PAVY'S TREATISE ON THE FUNCTION OF DI- 
GESTION; its Disorders and their Treatment. 
From the second London edition. In one octavo 
volume of 238 pages. Cloth, $2.00. 

CHAMBERS' MANUAL OF DIET AND REGIMEN 
IN HEALTH AND SICKNESS. In one hand- 
. some octavo volume of 302 pp. Cloth, $2.75. 



BARLOW'S MANUAL OF THE PRACTICE OF 
MEDICINE. With additions by D. F. Condie, 
M. D. 1 vol. 8vo., pp. 603. Cloth, $2.50. 

TODD'S CLINICAL LECTURES ON CERTAIN 
ACUTE DISEASES. In one octavo volume of 
320 pages. Cloth, $2.50. 

HOLLAND'S MEDICAL NOTES AND REFLEC- 
TIONS. 1 vol. Svo., pp. 493. Cloth, $3.50. 



■■■■ 



18 Lea Brothers & Co.'s Publications — Throat, Lungs, Heart. 



COHEN, J. SOLIS, M. D., 

Lecturer on Laryngoscopy and Diseases of the Throat and Chest in the Jefferson Medical College. 

Diseases of the Throat and Nasal Passages. A Guide to the Diagnosis and 
Treatment of Affections of the Pharynx, (Esophagus, Trachea, Larynx and Nares. Third 
edition, thoroughly revised and rewritten, with a large number of new illustrations. In 
one very handsome octavo volume. Preparing. 



SEILEM, CAML, M. D., 

Lecturer on Laryngoscopy in the University of Pennsylvania. 

A Handbook of Diagnosis and Treatment of Diseases of the Throat, 
Nose and Naso-Pharynx. Second edition. In one handsome royal 12mo. volume 
of 294 pages, with 77 illustrations. Cloth, $1.75. 



It is one of the best of the practical text-books 
on this subject with which we are acquainted. The 
present edition has been increased in size, but its 
eminently practical character has been main- 
tained. Many new illustrations have also been 
introduced, a case-record sheet has been added, 
and there are a valuable bibliography and a good 
index of the whole. For any one who wishes to 
make himself familiar with the practical manage- 
ment of cases of throat and nose disease, the book 
will be found of great value. — New York Medical 
Journal, June 9, 1883. 

The work before as is a concise handbook upon 



the essentials of diagnosis and treatment in dis- 
eases of the throat and nose. The art of laryngos- 
copy, the anatomy of the throat and nose and the 
pathology of the mucous membrane are discussed 
with conciseness and ability. The work is pro- 
fusely illustrated, excels in many essential feat- 
ures, and deserves a place in the office of the 
practitioner who would inform himself as to the 
nature, diagnosis and treatment of a class of dis- 
eases almost inseparable from general medical 
practice. With advanced students the book must 
be very popular on account of its condensed style. 
— Louisville Medical News, June 26, 1883. 



BKOWNE, LENNOX, F. M. C. S., Edin., 

Senior Surgeon to the Central London Throat and Ear Hospital, etc. 
The Throat and its Diseases. Second American from the second English edi- 
tion, thoroughly revised. With 100 typical illustrations in colors and 50 wood engravings, 
designed and executed by the Author. In one very handsome imperial octavo volume of 
about 350 pages. Preparing. 

FLINT, AUSTIN, M. D., 

Professor of the Principles and Practice of Medicine in Bellevue Hospital Medical College, N. T. 

A Manual of Auscultation and Percussion ; Of the Physical Diagnosis of 
Diseases of the Lungs and Heart, and of Thoracic Aneurism. Third edition. In one hand- 
some royal 12mo. volume of 240 pages. Cloth, $1.63. 



It is safe to say that there is 'not in the English 
language, or any other, the equal amount of clear, 
exact and comprehensible information touching 
the physical exploration of the chest, in an equal 
number of words. Professor Flint's language is 
precise and simple, conveying without dubiety 



the results of his careful study and ample ex- 
perience in such wise that the young will find it the 
best source of instruction, and the old the most 
pleasant means of reviving and complementing 
their knowledge. — American Practitioner, June, 
1883. 



BY THE SAME AUTHOR. 



Physical Exploration of the Lungs by Means of Auscultation and 
Percussion. Three lectures delivered before the Philadelphia County Medical Society, 
1882-83. In one handsome small 12mo. volume of 83 pages. Cloth, $1.00. 

A Practical Treatise on the Physical Exploration of the Chest and 
the Diagnosis of Diseases Affecting the Respiratory Organs. Second and 
revised edition. In one handsome octavo volume of 591 pages. Cloth, $4.50. 

Phthisis: Its Morbid Anatomy, Etiology, Symptomatic Events and 
Complications, Fatality and Prognosis, Treatment and Physical Diag- 
nosis ; In a series of Clinical Studies. In one handsome octavo volume of 442 pages. 
Cloth, $3.50. 

A Practical Treatise on the Diagnosis, Pathology and Treatment of 
Diseases of the Heart. Second revised and enlarged edition. In one octavo volume 
of 550 pages, with a plate. Cloth, $4. 



GKOSS, S. !>., M.I)., LL.D., D.C.L. Oxon., LL.JD. Cantab. 

A Practical Treatise on Foreign Bodies in the Air-passages. In one 

octavo volume of 452 pages, with 59 illustrations. Cloth, $2.75. 



FULLER ON DISEASES OF THE LUNGS AND 
AIBrPASSAGES. Their Pathology, Physical Di- 
agnosis, Symptoms and Treatment. Prom the 
second and revised English edition. In one 
octavo volume of 475 pages. Cloth, $3.r>(). 

8LADE ON DIPHTHERIA; its Nature and Treat- 
ment, with an account of the History of its Pre- 
valence in various Countries. Second and revised 
edition. In one 12mo. vol., pp. 158. Cloth, $1.25. 

WALSHE ON THE DISEASES OP THE HEART 
AND GREAT VESSELS. Third American edi- 
tion. In 1 vol. 8vo., 410 pp. Cloth, $3.00. 



SMITH ON CONSUMPTION; its Early and Reme- 
diable Stages. 1 vol. 8vo., pp. 253. Cloth, $2.25. 

LA ROCHE ON PNEUMONIA. 1 vol. 8vo. of 490 
pages. Cloth, $3.00. 

WILLIAMS ON PULMONARY CONSUMPTION; 
its Nature, Varieties and Treatment. With an 
analysis of one thousand cases to exemplify its 
duration. In one 8vo. vol. of 303 pp. Cloth, $2.50. 

JONES' CLINICAL OBSERVATIONS ON FUNC- 
TIONAL NERVOUS DISORDERS. Second Am- 
erican edition. In one handsome octavo volume 
of 340 pages. Cloth, $3.25. 



Lea Brothers & Co.'s Publications — Nerv.andMent. Dis.,°etc. 19 



MITCHELL, 8. WEIM, M. D., 

Physician to Orthopcedic Hospital and the Infirmary for Diseases of the Nervous System, Phila., etc. 

Lectures on Diseases of the Nervous System; Especially in Women. 
Second edition. In one 12mo. volume of 288 pages. Cloth, $1.75. Just ready. 

So great have been the achievements of the system perfected by the author for the treat- 
ment of hysterical and nervous diseases that the profession will welcome the second and 
enlarged edition of a work which gives in detail the methods of enforced rest, massage and 
systematic feeding on which this mode of treatment is based. Many of these lectures are 
original studies of well-known diseases, and others deal with subjects which have been 
hitherto slighted in medical literature or which are almost unknown to it. 



The interest lies in the keen insight into the 
nature of the subject and in the suggestions which 
the author manages to throw into his accounts. 
The lectures must command the thoughtful 



attention and careful study of all who desire to 
read what is best in medical science. — The London 
Lancet, May 16, 1885. 



HAMILTON, ALLAN McLANE, Mo JD., 

Attending Physician at the Hospital for Epileptics and Paralytics, BlackwelVs Island, N. T. 
^ Nervous Diseases ; Their Description and Treatment. Second edition, thoroughly 
revised and rewritten. In one octavo volume of 598 pages, with 72 illustrations. Cloth, $4. 

When the first edition of this good book appeared 
we gave it our emphatic endorsement, and the 

E resent edition enhances our appreciation of the 
ook and its author as a safe guide to students of 
clinical neurology. One of the best and most 
critical of English neurological ournals, Brain, has 



characterized this book as the best of its kind in 
any language, which is a handsome endorsement 
from an exalted source. The improvements in the 
new edition, and the additions to it, will justify its 
purchase even by those who possess the old. — 
Alienist and Neurologist, April, 1882. 



TUHE, DANIEL HACK, M. D., 

Joint Author of The Manual of Psychological Medicine, etc. 

Illustrations of the Influence of the Mind upon the Body in Health 
and Disease. Designed to elucidate the Action of the Imagination. New edition. 
Thoroughly revised and rewritten. In one handsome octavo volume of 467 pages, with 
two colored plates. Cloth, $3.00. 



It is impossible to peruse these interesting chap- 
ters without being convinced of the author's per- 
fect sincerity, impartiality, and thorough mental 
grasp. Dr. Tuke has exhibited the requisite 
amount of scientific address on all occasions, and 
the more intricate the phenomena the more firmly 
has he adhered to a physiological and rational 



method of interpretation. Guided by an enlight- 
ened deduction, the author has reclaimed for 
science a most interesting domain in psychology, 
previously abandoned to charlatans and empirics. 
This book, well conceived and well written, must 
commend itself to every thoughtful understand- 
ing. — New York Medical Journal, September 6, 1884. 



CLOUSTOJST, THOMAS 8., M. H, F. H. C. F., L. H. C. 8., 

Lecturer on Mental Diseases in the University of Edinburgh. 

Clinical Lectures on Mental Diseases. With an Appendix, containing an 
Abstract of the Statutes of the United States and of the Several States and Territories re- 
lating to the Custody of the Insane. By Charles F. Foxsom, M. D., Assistant Professor 
of Mental Diseases, Medical Department of Harvard University. In one handsome 
octavo volume of 541 pages, illustrated with eight lithographic plates, four of which- 
are beautifully colored. Cloth, $4. 



The practitioner as well as the student will ac- 
cept the plain, practical teaching of the author as a 
forward step in the literature of insanity. It is 
refreshing to find a physician of Dr. Clouston's 
experience and high reputation giving the bed- 
side notes upon which his experience has been 
founded and his mature judgment established. 
Such clinical observations cannot but be useful to 



the general practitioner in guiding him to a diag- 
nosis and indicating the treatment, especially in 
many obscure and doubtful cases of mental dis- 
ease. To the American reader Dr. Folsom's Ap- 
pendix adds greatly to the value of the work, and 
will make it a desirable addition to every library. 
— American Psychological Journal, July, 1884. 

'Dr. Folsom's Abstract may also be obtained separately in one octavo volume of 
108 pages. Cloth, $1.50. 

SAVAGE, GEOMGE H., M. D., 

Lecturer on Mental Diseases at Guy's Hospital, London. 

Insanity and Allied Neuroses, Practical and Clinical. In one 12mo. vol- 
ume of 551 pages, with 18 typical illustrations. Cloth, $2.00. Just ready. See Series oj 
Clinical Manuals, page 3. 



As a handbook, a guide to practitioners and stu- 
dents, the book fulfils an admirable purpose. The 
many forms of insanity are described with char- 
acteristic clearness, the illustrative cases are care- 
fully selected, and as regards treatment, sound 



common sense is everywhere apparent. We re- 
peat that Dr. Savage has written an excellent 
manual for the practitioner and student. — Am- 
erican Journal of Insanity, April, 1885. 



FLATFAIM, W. S., M. D., F. M. C. P., 

The Systematic Treatment of Nerve Prostration and Hysteria. 

one handsome small 12mo. volume of 97 pages. Cloth, $1.00. 



In 



Blandford on Insanity and its Treatment : Lectures on the Treatment, 

Medical and Legal, of Insane Patients. In one very handsome octavo volume. 



20 



Lea Brothers & Co.'s Publications — Surgery. 



GBOSS, S. D., M. D., LL. JO., L>. C. L. Oxon., LL. D. 

Cantab, , 

Emeritus Professor of Surgery in the Jefferson Medical College of Philadelphia. 
A System of Surgery : Pathological, Diagnostic, Therapeutic .and Operative. 
Sixth edition, thoroughly revised and greatly improved. In two large and beautifully- 
printed imperial octavo volumes containing 2382 pages, illustrated by 1623 engravings. 
Strongly bound in leather, raised bands, $15; half Eussia, raised bands, $16. 

Dr. Gross' System of Suraery has long been the 
standard work on that subject for students and 
practitioners.— London Lancet, May 10, 1884, 



The work as a whole needs no commendation. 
Many years ago it earned for itself the enviable rep- 
utation of the leading American work on surgery, 
and it is still capable of maintaining that standard. 
The reason for this need only be mentioned to be 
appreciated. The author has always been calm 
and judicious in his statements, has based his con- 
clusions on much study and personal experience, 
has been able to grasp his subject in its entirety, 
and, above all, has conscientiously adhered to 
truth and fact, weighing the evidence, pro and 
con, accordingly. A considerable amount of new 



material has been introduced, and altogether the 
distinguished author has reason to be satisfied 
that he has placed the work fully abreast of the 
state of our knowledge.— Med. Record, Nov. 18, 1882. 
His System of Surgery, which, since its first edi- 
tion in 1859, has been a standard work in this 
country as well as in America, in "the whole 
domain of surgery," tells how earnest and labori- 
ous and wise a surgeon he was, how thoroughly 
he appreciated the work done by men in other 
countries, and how much he contributed to pro- 
mote the science and practice of surgery in his 
own. There has been no man to whom America 
is so much indebted in this respect as the Nestor 
of surgery.— British Medical Journal, May 10, 1884. 



ASMHJJBST, JOHN, Jr., M. L>., 

Professor of Clinical Surgery, Univ. of Penna., Surgeon to the Episcopal Hospital, Philadelphia. 

The Principles and Practice of Surgery. Fourth edition, enlarged and 
revised. In one large and handsome octavo volume of about 1100 pages, with about 575 
illustrations. In press. 

GOULD, A. JPEABCE, M. S., M. B., F. B. C. S„ 

Assistant Surgeon to Middlesex Hospital. 

Elements of Surgical Diagnosis. In one pocket-size 12mo. volume of 589* 
pages. Cloth, $2.00. Just ready. See Students' Series of Manuals, page 3. 



The student and practitioner will find the 
principles of surgical diagnosis very satisfactorily 
set forth with all unnecessary verbiage elimi- 
nated. Every medical student attending lectures 
should have a copy to study during the intervals, 



and if practitioners would devote a portion of their 
leisure to the study of it, they would receive 
immense benefit in the way of refreshing their 
knowledge and bringing it up to the present state 
of progress. — Cincinnati Medical News, Jan., 1885. 



GIBJVEY, V. P., M. J>., 

Surgeon to the Orthopaedic Hospital, New York, etc. 
Orthopaedic Surgery. For the use of Practitioners and Students, 
some octavo volume, profusely illustrated. Preparing. 



In one hand- 



BOBEBTS, JOHN B., A. M., M. &., 

Lecturer on Anatomy and on Operative Surgery at the Philadelphia School of Anatomy. 

The Principles and Practice of Surgery. For the use of Students and 
Practitioners of Medicine and Surgery. In one very handsome octavo volume of about 500 
pages, with many illustrations. Preparing. 



BELLAMY, EJDWABJD, F. B. 

Surgeon and Lecturer on Surgery at Charing 
College of Surgeons, London. 



a s., 

Cross Hospital, Examiner in Anatomy Royal 



Operative Surgery. Shortly. See Students' Series of Manuals, page 3. 



STIMSOJST, LEWIS A., B. A., M. JD., 

Prof, of Pathol. Anat. at the Univ. of the City of New York, Surgeon and Curator to Bellevue Ho&p* 

A Manual of Operative Surgery. In one very handsome royal 12mo. volume 
of 477 pages, with 332 illustrations. Cloth, $2.50. 

every student should possess one. This work 



This volume is devoted entirely to operative sur- 
gery, and is intended to familiarize the student 
with the details of operations and the different 
modes of performing them. The work is hand- 
somely Illustrated, and the descriptions are clear 
and well-drawn. It is a clever and useful volume ; 



does away with the necessity of pondering over 
larger works on surgery for descriptions of opera- 
tions, as it presents in a nutshell what is wanted 
by the surgeon without an elaborate search to 
find it.— Maryland Medical Journal, August, 1878. 



SARGENT ON HAN PAGING and OTHER OPERA- 
TIONS OF MINOR SURGERY. New edition, 
with a Chapter on military surgery. Onel2mo. 
volume of 888 pages, with 187 cuts. Cloth, $1.75. 

MILLER'S PRINCIPLES OP SURGERY. Fourth 
American from the third Edinburgh edition. In 
one 8vo. vol. of 688 pages, with :M0 illustrations. 
Cloth, 83.75. 

MILLER'S PRACTICE OP SURGERY. Fourth 
and revised American from the last Edinburgh 
edition. In one large 8vo. vol. of 082 pages, with 
3C4 illustrations. Cloth, 83.75. 



PIRRIE'S PRINCIPLES AND PRACTICE OF 
SURGERY. Edited by John Neill, M. D. In 
one 8vo. vol. of 784 pp. with 316 illus. Cloth, $3.75. 

COOPER'S LECTURES ON THE PRINCIPLES 
AND PRACTICE OF SURGERY. In one 8vo.vol. 
of 707 pages. Cloth, 82.00. 

SKEY'S OPERATIVE SURGERY. In one vol. 8vo- 
of 661 pages, with 81 woodcuts. Cloth, 83.25. 

GIBSON'S INSTITUTES AND PRACTICE OF 
SURGERY. Eighth edition. In two octavo vols- 
of 965 pages, with 34 plates. Leather 86.50. 



Lea Brothers & Co.'s Publications — Surgery. 



21 



FBLCJK8FJST, JOHJT JE., F. B. 8., F. B. C. 8., 

Professor of Surgery in University College, London, etc. 

The Science and Art of Surgery ; Being a Treatise on Surgical Injuries, Dis- 
eases and Operations. From the eighth and enlarged English edition. In two large and 
beautiful octavo volumes of 2316 pages, illustrated with 984 engravings on wood. 
Cloth, $9; leather, raised bands, $11 ; half Eussia, raised bands, $12. Just ready. 

After the profession has placed its approval upon 
a work to the extent of purchasing seven editions, 
it does not need to be introduced. Simultaneous 
with the appearance of this edition a translation 
is being made into Italian and Spanish. Thus 



this favorite text-book on surgery holds its own in 
spite of numerous rivals at the end of thirty years. 
It is a grand book, worthy of the art in the interest 
of which it is written. — Detroit Lancet, Jan. 10, 1885. 
After being before the profession for thirty 
years and maintaining during that period a re- 
putation as a leading work on surgery, there is not 



much to be said in the way of comment or criti- 
cism. That it still holds its own goes without say- 
ing. The author infuses into it his large experi- 
ence and ripe judgment. Wedded to no school, 
committed to no theory, biassed by no hobby, he 
imparts an honest personality in his observations, 
and his teachings are the rulings of an impartial 
judge. Such men are always safe guides, and their 
works stand the tests of time and experience. 
Such an author is Erichsen, and such a work is his 
Surgery.— Medical Record, Feb. 21, 1885. 



BBYANT, THOMA8, F. B. C. 8., 

Surgeon and Lecturer on Surgery at Guy's Hospital, London. 
The Practice Of Surgery. Fourth American from the fourth and revised Eng- 
lish edition. In one large and very handsome imperial octavo volume of 1040 pages, with 
727 illustrations. Cloth, $6.50; leather, $7.50; half Eussia, $8.00. Just ready. 

This most magnificent work upon surgery has 



The treatise takes in the whole field of surgery, 
that of the eye, the ear, the female organs, ortho- 
paedics, venereal diseases, and military surgery, 
as well as more common and general topics. All 
of these are treated with clearness and with 
sufficient fulness to suit all practical purposes. 
The illustrations are numerous and well printed. 
We do not doubt that this new edition will con- 
tinue to maintain the popularity of this standard 
work. — Medical and Surgical Reporter, Feb. 14, '85. 



reached a fourth edition in this country, showing 
the high appreciation in which it is held by the 
American profession. It comes fresh from the 
pen of the author. That it is the very best work 
on surgery for medical students we think 
there can be no doubt. The author seems to have 
understood just what a student needs, and has 
prepared the work accordingly. — Cincinnati Medical 
News, January, 1885. 



By the same Author. 
Diseases of the Breast. In one 12mo. volume. Preparing. See Series of Clinical 
Manuals, page 3. 

F8MABCH, Dr. FBIFDBICH, 

Professor of Surgery at the University of Kiel, etc. 
Early Aid in Injuries and Accidents. Five Ambulance Lectures. Trans- 
lated by H. E. H. Princess Christian. In one handsome small 12mo. volume of 109 
pages, with 24 illustrations. Cloth, 75 cents. 

The course of instruction is divided into five 
sections or lectures. The first, or introductory 
lecture, gives a brief account of the structure and 
organization of the human body, illustrated by 
clear, suitable diagrams. The second teaches how 
to give judicious help in ordinary injuries — contu- 
sions, wounds, haemorrhage and poisoned wounds. 
The third treats of first aid in cases of fracture 
and of dislocations, in sprains and in burns. Next, 



the methods of affording first treatment in cases 
of frost-bite, of drowning, of suffocation, of loss of 
consciousness and of poisoning are described ; 
and the fifth lecture teaches how injured persons 
may be most safely and easily transported to their 
homes, to a medical man, or to a hospital. The 
illustrations in the book are clear and good. — Medi- 
cal Times and Gazette, Nov. 4, 1882. 



TBFVE8, FBEDFBICK, F. B. C. 8., 

Assistant Surgeon to and Lecturer on Surgery at the London Hospital. 

Intestinal Obstruction. In one pocket-size 12mo. volume of 522 pages, with 60 



illustrations. Limp cloth, blue edges, $2.00 
page 3. 

A standard work on a subject that has not been 
so comprehensively treated by any contemporary 
English writer. Its completeness renders a full 
review difficult, since every chapter deserves mi- 
nute attention, and it is impossible to do thorough 



Just ready. See Series of Clinical Manuals, 

justice to the author in a few paragraphs. InteS' 
tinal Obstruction is a work that will prove of 
equal value to the practitioner, the student, the 
pathologist, the physician and the operating sur- 
geon. — British Medical Journal, Jan. 31, 1885. 



BALL, CMABLF8 B., M. Ch., Dub., F. B. C. 8. M. 9 

Surgeon and Teacher at Sir P. Dun's Hospital, Dublin. 

Diseases of the Rectum and Anus. In one 12mo. volume of 550 pages. 
Preparing. See Series of Clinical Manuals, page 3. 



See Series of Clinical 



BTJTLIN, JELFWBT T., F. B. C. 8., 

Assistant Surgeon to St. Bartholomew's Hospital, London. 

Diseases of the Tongue. In one 12mo. volume. 
Manuals, page 3. Shortly. 

DBTJITT, BOBFBT, M. B. C. 8., etc. 

The Principles and Practice of Modern Surgery. From the eighth 
London edition. In one 8vo. volume of 687 pages, with 432 illus. Cloth, $4 ; leather, $5. 



22 Lea Brothers & Co.'s Publications — Surgery. 



HOL3IES, TI3IOTHY, 31. A., 

Surgeon and Lecturer on Surgery at St. George's Hospital, London. 

A System of Surgery ; Theoretical and Practical. IN TREATISES BY 
VARIOUS AUTHORS. American edition, thoroughly revised and re-edited 
by John H. Packard, M. D., Surgeon to the Episcopal and St. Joseph's Hospitals, 
Philadelphia, assisted by a corps of thirty-three of the most eminent American surgeons. 
In three large and very handsome imperial octavo volumes containing 3137 double- 
columned pages, -with 979 illustrations on wood and 13 lithographic plates, beautifully 
colored. Price per volume, cloth, $6.00 ; leather, $7.00 ; half Russia, $7.50. Per set, cloth, 
$18.00 ; leather, $21.00 ; half Russia, $22.50. Sold only by subscription. 

Volume I. contains General Pathology, Morbid Processes, Injuries in Gen- 
eral, Complications of Injuries and Injuries op Regions. 

Volume II. contains Diseases of Organs of Special Sense, Circulatory Sys- 
tem, Digestive Tract and Genito-Urinary Organs. 

Volume HI. contains Diseases of the Respiratory Organs, Bones, Joints and 
Muscles, Dlseases of the Nervous System, Gunshot Wounds, Operative and 
Mlnor Surgery, and Miscellaneous Subjects (including an essay on Hospitals). 

This great work, issued some years since in England, has won such universal confi- 
dence wherever the language is spoken that its republication here, in a form more 
thoroughly adapted to the wants of the American practitioner, has seemed to be a duty 
owing to the profession. To accomplish this, each article has been placed in the hands of 
a gentleman specially competent to treat its subject, and no labor has been spared to bring 
each one up to the foremost level of the times, and to adapt it thoroughly to the practice 
of the country. In certain cases this has rendered necessary the substitution of an entirely 
new essay for the original, as in the case of the articles on Skin Diseases, on Diseases of 
the Absorbent System, and on Anaesthetics, in the use of which American practice differs 
from that of England. The same careful and conscientious revision has been pursued 
throughout, leading to an increase of nearly one-fourth in matter, while the series of 
illustrations has been nearly trebled, and the whole is presented as a complete exponent 
of British and American Surgery, adapted to the daily needs of the working practitioner. 

In order to bring it within the reach of every member of the profession, the five vol- 
umes of the original have been compressed into three by employing a double-columned 
royal octavo page, and in this improved form it is offered at less than one-half the price of the 
original. It is printed and bound to match in every detail with Reynolds' System of Medi- 
cine. The work will be sold by subscription only, and in due time every member of the 
profession will be called upon and offered an opportunity to subscribe. 

The authors of the original English edition are 
men of the front rank in England, and Dr. Packard 
has been fortunate in securing as his American 
coadjutors such men as Bartholow, Hyde, Hunt, 
Conner, Stimson, Morton, Hodgen, Jewell and 
their colleagues. As a whole, the work will be 
solid and substantial, and a valuable addition to 



the library of any medical man. It is more wieldly 
and more useful than the English edition, and with 
its companion work — " Reynolds' System of Medi- 
cine " — will well represent the present state of our 
science. One who is familiar with those two works 
will be fairly well furnished head-wise and hand- 



•iy 

Mi 



wise.— The Medical News, Jan. 7, 1882. 



STIMSOW, LEWIS A., B. A., M. D., 

Professor of Pathological Anatomy at the University of the City of New York, Surgeon and Curator 
to Bellevue Hospital, Surgeon to the Presbyterian Hospital, New York, etc. 

A Practical Treatise on Fractures. In one very handsome octavo volume of 
598 pages, with 360 beautiful illustrations. Cloth, $4.75 ; leather, $5.75. 



The author has given to the medical profession 
in this treatise on fractures what is likely to be- 
come a standard work on the subject. It is certainly 
not surpassed by any work written in the English, 
or, for that matter, any other language. The au- 
thor tells us in a short, concise and comprehensive 
manner, all that is known about his subject. There 
is nothing scanty or superficial about it, as in most 
other treatises ; on the contrary, everything is thor- 
ough. The chapters on repair of fractures and their 
treatment show him not only to be a profound stu- 
dent, but likewise a practical surgeon and patholo- 
gist. His mode of treatment of the different fract- 
ures is eminently sound and practical. We consider 
this work- one of the best on fractures; and it will 
be welcomed not only as a text-book, but also by 



the surgeon in full practice. — N. O. Medical and 
Surgical Journal, March, 1883. 

The author gives in clear language all that the 
practical surgeon need know of the science of 
fractures, their etiology, symptoms, processes of 
union, and treatment, according to the latest de- 
velopments. On the basis of mechanical analysis 
the author accurately and clearly explains the 
clinical features of fractures, and by the same 
method arrives at the proper diagnosis snd rational 
treatment. A thorough explanation of the patho- 
logical anatomy and a careful description of the 
various methods of procedure make the book full 
of value for every practitioner. — Centralblatt fur 
Chirurgie, May 19, 1883. 



3IAJIS1I, HOWARD, F. B. C. S., 

Senior Assistant Surgeon to and Lecturer on Anatomy at St. Bartholomew's Hospital, London. 
Diseases of the Joints. In one 12mo. volume. Preparing. See Series of Clinical 
Manuals, page 3. 

PICK, I. PICKERING, F. It. C. S., 

Surgeon to and Lecturer on Surgery at St. George's Hospital, London. 

Fractures and Dislocations. In one 12mo. volume. Preparing. See Series 
of Clinical Manuals, page 3. 



Lea Brothers & Co.'s Publications — Frac, Disloc, Ophtkal. 23 



HAMILTON, FMANKJBC., M. D., LL. D., 

Surgeon to Bellevue Hospital, New York. 

A Practical Treatise on Fractures and Dislocations. Seventh edition, 
thoroughly revised and much improved. In one very handsome octavo volume of 998 



pages, with 379 illustrations. Cloth, $5.50 
open back, $7.00. Just ready. 

Hamilton's great experience and wide acquaint- 
ance with the literature of the subject have enabled 
him to complete the labors of Malgaigne and to 
place the reader in possession of the advances 
made during thirty years. The editions have fol- 
lowed each other rapidly, and they introduce us 
to the methods of practice, often so wise, of his 
American colleagues. More practical than Mal- 
gaigne's work, it will serve as a valuable guide to 
the practitioner in the numerous and embarrass- 
ing cases which come under his observation. — 
Archives Generates de Medecine, Paris, Nov. 1884. 

This work, which, since its first appearance 
twenty-five years ago, has gone through many 
editions, and been much enlarged, may now be 
fairly regarded as the authoritative book of refer- 
ence on the subjects of fractures and dislocations. 
Each successive edition has been rendered of 
greater value through the addition of more re- 



leather, $6.50 ; very handsome half Eussia, 

cent work, and especially of the recorded re- 
searches and improvements made by the author 
himself and his countrymen. — British Medical 
Journal, May 9, 1885. 

With its first appearance in 1859, this work took 
rank among the classics in medical literature, 
and has ever since been quoted by surgeons the 
world over as an authority upon the topics of 
which it treats. The surgeon, if one can be found 
who does not already know the work, will find it 
scientific, forcible and scholarly in text, exhaustive 
in detail, and ever marked by a spirit of wise con- 
servatism. — Louisville Medical News, Jan. 10, 1885. 

For a quarter of a century the author has been 
elaborating and perfecting his work, so that it 
now stands as the best of its kind in any lan- 
guage. As a text-hook and as a book of reference 
and guidance for practitioners it i3 simply invalu- 
able. — New Orleans Med, and Surg, Journal, Nov. 1884. 



JTTLEM, HEJVHY E., F. M. C. S., 

Senior Ass't Surgeon, Royal Westminster Ophthabnic Hosp. ; late Clinical Ass't, Moorfields, London. 

A Handbook of Ophthalmic Science and Practice. In one handsome 
octavo volume of 460 pages, with 125 woodcuts, 27 colored plates, and selections from the 
Test-types of Jaeger and Snellen. Cloth, $4.50 ; leather, $5.50. Just ready. 

and typical illustrations of all important eye 
affections, placed in juxtaposition, so as to be 

f rasped at a glance. Beyond a doubt it is the 
est illustrated handbook of ophthalmic science 
which ha&- ever appeared. Then, what is still 
better, these illustrations are nearly all original. 
We have examined this entire work with great 
care, and it represents the commonly accepted 
views of advanced ophthalmologists. We can most 
heartily commend this book to all medical stu- 
dents, practitioners and specialists. — Detroit 
Lancet, Jan. 1885. 



This work is distinguished by the great num- 
ber of colored plates which appear in it for illus- 
trating various pathological conditions. They are 
very beautiful in appearance, and have been 
executed with great care as to accuracy. An ex- 
amination of the work shows it to be one of high 
standing, one that will be regarded as an authority 
among ophthalmologists. The treatment recom- 
mended is such as the author has learned from 
actual experience to be the best. — Cincinnati Medi- 
cal News, Dec. 1884. 

It presents to the student concise descriptions 



WELLS, J. SOELBEMG, E. It. C. S., 

Professor of Ophthalmology in King's College Hospital, London, etc. 

A Treatise on Diseases of the Eye. Fourth American from the third London 

edition. Thoroughly revised, with copious additions, by Charles S. Bull, M. D., Surgeon 

and Pathologist to the New York Eye and Ear Infirmary. In one large octavo volume of 

822 pages, with 257 illustrations on wood, six colored plates, and selections from the Test- 



types of Jaeger and Snellen. Cloth, $5.00 ; leather, $6.00 ; half Eussia, $6.50 

The present edition appears in less than three 
years since the publication of the last American 
edition, and yet, from the numerous recent inves- 
tigations that have been made in this branch of 
medicine, many changes and additions have been 
required to meet the present scope of knowledge 
upon this subject. A critical examination at once 



shows the fidelity and thoroughness with which 
the editor has accomplished his part of the work. 
The illustrations throughout are good. This edi- 
tion can be recommended to all as a complete 
treatise on diseases of the eye, than which proba- 
bly none better exists.— Medical Record, Aug. 18, '83. 



NETTLESHIP, EDWARD, F. M. C. $., 

Ophthalmic Surg, and Led. on Ophth. Surg, at St. Thomas' Hospital, London. 

The Student's Guide to Diseases of the Eye. Second edition. With a chap- 
ter on the Detection of Color-Blindness, by William Thomson, M. D., Ophthalmologist 
to the Jefferson Medical College. In one royal 12mo. volume of 416 pages, with 138 
illustrations. Cloth, $2.00. 

This admirable guide bids fair to become the 
favorite text-book on ophthalmic surgery with stu- 
dents and general practitioners. It bears through- 
out the imprint of sound judgment combined with 
vast experience. The illustrations are numerous 



and well chosen. This book, within the short com- 
pass of about 400 pages, contains a lucid exposition 
of the modern aspect of ophthalmic science.— 
Medical Record, June 23, 1883. 



BMOWNE, EDGAM A., 

Surgeon to the Liverpool Eye and Ear Jnfirmary and to the Dispensary for Skin Diseases. 
How to Use the Ophthalmoscope. Being Elementary Instructions in Oph- 
thalmoscopy, arranged for the use of Students. In one small royal 12mo. volume of 116 
pages, with 35 illustrations. Cloth, $1.00. 



LAWSON ON INJURIES TO THE EYE, ORBIT 
AND EYELIDS : Their Immediate and Remote 
Effects. 8 vo., 404 pp., 92 illus. Cloth, $3.50. 

LAURENCE AND MOON'S HANDY BOOK OF 
OPHTHALMIC SURGERY, for the use of Prac- 



titioners. Second edition. In one octavo vol- 
ume of 227 pages, with 65 illust. Cloth, $2.75. 
CARTER'S PRACTICAL TREATISE ON DISEAS- 
ES OF THE EYE. Edited by John Gbeen, M. D. 
In one handsome octavo volume. 



i^^^HBH 



24 Lea Brothers & Co.'s Publications — OtoL, Urin. Dis.,Dent. 
BURNETT, CHARLES H., A. M., M. D., 

Professor of Otology in the Philadelphia Polyclinic ; President of the American Otological Society. 

The Ear, Its Anatomy, Physiology and Diseases. A Practical Treatise 
for the use of Medical Students and Practitioners. New (second) edition. In one handsome 
octavo volume of 580 pages, with 107 illustrations. Cloth, $4.00 ; leather, $5.00. Just ready. 



We note with pleasure the appearance of a second 
edition of this valuable work. When it first came 
out it was accepted by the profession as one of 
the standard works on modern aural surgery in 
the English language; and in his second edition 
Dr. Burnett has fully maintained his reputation, 
for the book is replete with valuable information 
and suggestions. The revision has been carefully 



carried out, and much new matter added. Dr. 
Burnett's work must be regarded as a very valua- 
ble contribution to aural surgery, not only on 
account of its comprehensiveness, but because it 
contains the results of the careful personal observa- 
tion and experience of this eminent aural surgeon. 
—London Lancet, Feb. 21, 1885. 



BOLITZER, ADAM, 

Imperial-Royal Prof, of Aural Therap. in the Univ. of Vienna. 

A Text-Book of the Ear and its Diseases. Translated, at the Author's re- 
quest, by James Patterson Cassells, M. D., M. E. C. S. In one handsome octavo vol- 
ume of 800 pages, with 257 original illustrations. Cloth, $5.50. 



The work itself we do not hesitate to pronounce 
the best upon the subject of aural diseases which 
has ever appeared, systematic without being too 
diffuse on obsolete gubjects, and eminently prac- 
tical in every sense. The anatomical descriptions 
of each separate division of the ear are admirable, 
and profusely illustrated by woodcuts. They are 
followed immediately by the physiology of the 



section, and this again by the pathological physi- 
ology, an arrangement which serves to keep up the 
interest of the student by showing the direct ap- 
plication of what has preceded to the study of dis- 
ease. The whole work can be recommended as a 
reliable guide to the student, and an efficient aid 
to the practitioner in his treatment. — Boston Med- 
ical and Surgical Journal, June 7, 1883. 



ROBERTS, WILLIAM, M. D., 

Lecturer on Medicine in the Manchester School of Medicine, etc. 

A Practical Treatise on Urinary and Renal Diseases, including Uri- 
nary Deposits. Fourth American from the fourth London edition. In one hand- 
some octavo volume of about 650 pages, with 81 illustrations. Cloth, $3.50. Just ready. 

cerely to be congratulated that he has been able 
amidst his many public and private duties to pre- 
sent a new edition of this standard work, 
thoroughly brought up to the present date. — Lon- 
don Medical Record, May 15, 1885. 



This excellent book has now reached its fourth 
edition, and not too soon, for the third has been 
exhausted for some years, and it is one of those 
works which no good physician's or surgeon's 
library should be without. The profession is sin- 



GROSS, S. &., M. JD., LL. JD., JD. C. L., etc. 

A Practical Treatise on the Diseases, Injuries and Malformations 
of the Urinary Bladder, the Prostate Gland and the Urethra. Third 
edition, thoroughly revised by Samuel W. Gross, M. D., Professor of the Principles of 
Surgery and of Clinical Surgery in the Jefferson Medical College, Philadelphia. In one 
octavo volume of 574 pages, with 170 illustrations. Cloth, $4.50. 

MORRIS, HENRY, M. B., F. R. C. S., 

Surgeon to and Lecturer on Surgery at Middlesex Hospital, London. 

Surgical Diseases of the Kidney. In one 12mo. volume. Preparing. See 
Series of Clinical Manuals, page 3. 

LUCAS, CLEMENT, M. B., B. S., F. R. C. S., 

Senior Assistant Surgeon to Guy's Hospital, London. 
Diseases of the Urethra. In one 12mo. volume. Preparing. See Series 
of Clinical Manuals, page 3. 

THOMPSON, SIR HENRY, 

Surgeon and Professor of Clinical Surgery to University College Hospital, London. 

Lectures on Diseases of the Urinary Organs. Second American from the 
third English edition. In one 8vo. volume of 203 pp., with 25 illustrations. Cloth, $2.25. 

By the Same Author. 
On the Pathology and Treatment of Stricture of the Urethra and 
Urinary Fistulse. From the third English edition. In one octavo volume of 359 
pages, with 47 cuts and 3 plates. Cloth, $3.50. 

COLEMAN, A., L.R. C. P., F. R. C. S., Exam. L. D. S., 

Senior Dent. Surg, and Lect. on Dent. Surg, at St. Bartholomew's Hosp. and the Dent. Hosp., London. 

A Manual of Dental Surgery and Pathology. Thoroughly revised and 
adapted to the use of American Students, by Thomas C. Stellwagen, M. A., M. D., 
D. D. S., Prof, of Physiology at the Philadelphia Dental College. In one handsome octavo 
volume of 412 pages, with 331 illustrations. Cloth, $3.25. 

BASHAM ON RENAL DISEASES: A Clinical I ome 12mo. vol. of 304 pages, with 21 illustrations. 
Guide to their Diagnosis and Treatment. In | Cloth, $2.00. 



Lea Brothers & Co.'s Publications — Venereal, Impotence. 



25 



BUMSTFAD, F. J., 

M. JD., XX. D., 

Late Professor of Venereal Diseases 
at the College of Physicians and 
Surgeons, New York, etc. 



and TAYLOR, R. W., 

A. M., M. D. 9 

Surgeon to Charity Hospital, New York, Prof, of 
Venereal and Skin Diseases in the University of 
Vermont, Pres. of the Avi. Dermatological Ass'n. 



The Pathology and Treatment of Venereal Diseases. Including the 
results of recent investigations upon the subject. Fifth edition, revised and largely re- 
written, by Dr. Taylor. In one large and handsome octavo volume of 898 pages with 
139 illustrations, and thirteen chromo-lithographic figures. Cloth, $4.75; leather, $5.75; 
very handsome half Russia, $6.25. 



It is a splendid record of honest labor, wide 
research, just comparison, careful scrutiny and 
original experience, which will always be held as 
a high credit to American medical literature. This 
is not only the best work in the English language 
upon the subjects of which it treats, but also one 
which has no equal in other tongues for its clear, 
comprehensive and practical handling of its 
themes. — American Journal of the Medical Sciences, 
Jan, 1884. 

It is certainly the best single treatise on vene- 
real in our own, and probably the best in any lan- 
guage. — Boston Medical and Surgical Journal, April 
3, 1884. 



The character of this standard work is so well 
known that it would be superfluous here to pass in 
review its general or special points of excellence. 
The verdict of the profession has been passed; it 
has been accepted as the most thorough and com- 
plete exposition of the pathology and treatment of 
venereal diseases in the language. Admirable as a 
model of clear description, an exponent of sound 
pathological doctrine, and a guide for rational and 
successful treatment, it is an ornament to the medi- 
cal literature of this country. The additions made 
to the present edition are eminently judicious, 
from the standpoint of practical utility. — Journal oj 
Cutaneous and Venereal Diseases, Jan. 1884. 



mutcmlnsojst, Jonathan, f. r. $., f. r. c. s., 

Consulting Surgeon to the London Hospital. 
Syphilis. In one 12mo. volume. Preparing. See Series of Clinical Manuals, page 3. 



CORJSTIL, v., 

Professor to the Faculty of Medicine of Paris, and Physician to the Lour cine Hospital. 

Syphilis, its Morbid Anatomy, Diagnosis and Treatment. Specially 
revised by the Author, and translated with notes and additions by J. Henry C. Simes, 
M. D., Demonstrator of Pathological Histology in the University of Pennsylvania, and 
J. William White, M. D., Lecturer on Venereal Diseases and Demonstrator of Surgery 
in the University o f Pennsylvania. In one handsome octavo volume of 461 pages, with 
84 very beautiful illustrations. Cloth, $3.75. 
The anatomical and histological characters of the 



hard and soft sore are admirably described. The 
multiform cutaneous manifestations of the disease 
are dealt with histologically in a masterly way, as 
we should indeed expect them to be, and the 
accompanying illustrations are executed carefully 
and well. The various nervous lesions which are 
the recognized outcome of the syphilitic dyscrasia 
are treated with care and consideration. Syphilitic 
epilepsy, paralysis, cerebral syphilis and locomotor 
ataxia are subjects full of interest; and nowhere in 



the whole volume is the clinical experience of the 
author or the wide acquaintance of the translators 
with medical literature more evident. The anat- 
omy, the histology, the pathology and the clinical 
features of syphilis are represented in this work in 
their best, most practical and most instructive 
form, and no one will rise from its perusal without 
the feeling that his grasp of the wide and impor- 
tant subject on which it treats is a stronger and 
surer one. — The London Practitioner, Jan. 1882. 



GROSS, SAMUEL W., A. M., M. D., 

Professor of the Principles of Surgery and of Clinical Surgery in the Jefferson Medical College. 

A Practical Treatise on Impotence, Sterility, and Allied Disorders 
of the Male Sexual Organs. Second edition, thoroughly revised. In one very hand- 
some octavo volume of 168 pages, with 16 illustrations. Cloth, $1.50. 



The author of this monograph is a man of posi- 
tive convictions and vigorous style. This is justi- 
fied by his experience and by his study, which has 
gone hand in hand with his experience. In regard 
to the various organic and functional disorders of 
the male generative apparatus, he has had ex- 
ceptional opportunities for observation, and his 
book shows that he has not neglected to compare 
his own views with those of other authors. The 
result is a work which can be safely recommended 
to both physicians and surgeons as a guide in the 
treatment of the disturbances it refers to. It is 
the best treatise on the subject with which we are 
acquainted. — The Medical News, Sept. 1, 1883. 



This work will derive value from the high stand- 
ing of its author, aside from the fact of its passing 
so rapidly into its second edition. This is, indeed, 
a book that every physician will be glad to place 
in his library, to be read with profit to himself, 
and with incalculable benefit to his patient. Be- 
sides the subjects embraced in the title, which are 
treated of in their various forms and degrees, 
spermatorrhoea and prostatorrhcea are also fully 
considered. The work is thoroughly practical in 
character, and will be especially useful to the 
general practitioner. — Medical Record, Aug. 18, 
1883. 



CULLFRIFR, A., & BUMSTFAD, F. J., M.L>., LL.D., 

Surgeon to the Hdpital du Midi. Late Professor of Venereal Diseases in the College of Physicians 

and Surgeons, New York. 

An Atlas of Venereal Diseases. Translated and edited by Freeman J. Bum- 
stead, M. D. In one imperial 4to. volume of 328 pages, double-columns, with 26 plates, 
containing about 150 figures, beautifully colored, many of them the size of life. Strongly 
bound in cloth, $17.00. A specimen of the plates and text sent by mail, on receipt of 25 cts. 

HILL ON SYPHILIS AND LOCAL CONTAGIOUS j FORMS OF LOCAL DISEASE AFFECTING 
DISORDERS. In one 8vo vol. of 479 p. Cloth, $3.25. PRINCIPALLY THE ORGANS OF GENERA- 
LEE'S LECTURES ON SYPHILIS AND SOME | TION. In one 8vo. vol. of 246 pages. Cloth, $2.25. 



26 



Lea Brothers & Co.'s Publications — Diseases of Skin. 



SYJDE, J. JSFVINS, A. M-, M. JD., 

Professor of Dermatology and Venereal Diseases in Rush Medical College, Chicago. 

A Practical Treatise on Diseases of the Skin. For the use of Students and 
Practitioners. In one handsome octavo volume of 570 pages, with 66 beautiful and elab- 
orate illustrations. Cloth, §4.25 ; leather, §5.25. 



The author has given the student and practi- 
tioner a work admirably adapted to the wants of 
each. We can heartily commend the book as a 
valuable addition to our literature and a reliable 
guide to students and practitioners in their studies 
and practice. — Am. Journ. of Med. Sci., July, 1883. 

Especially to be praised are the practical sug- 
gestions as to what may be called the common- 
sense treatment of eczema. It is quite impossible 
to exaggerate the judiciousness with which the 
formulas for the external treatment of eczema are 
selected, and what is of equal importance, the full 
and clear instructions for their use. — London Medi- 
cal Times and Gazette, July 28, 1883. 

The work of Dr. Hyde will be awarded a high 
position. The student of medicine will find it 
peculiarly adapted to his wants. Notwithstanding 
the extent of the subject to which it is devoted, 
yet it is limited to a single and not very large vol- 
ume, without omitting a proper discussion of the 
topics. The conciseness of the volume, and the 
setting forth of only what can be held as facts will 
also make it acceptable to general practitioners. 
— Cincinnati Medical News, Feb. 1883. 

The aim of the author has been to present to his 
readers a work not only expounding the most 
modem conceptions of his subject, but presenting 
what is of standard value. He has more especially 
devoted its pages to the treatment of disease, and 
by his detailed descriptions of therapeutic meas- 
ures has adapted them to the needs of the physi- 



cian in active practice. In dealing with these 
questions the author leaves nothing to the pre- 
sumed knowledge of the reader, but enters thor- 
oughly into the most minute description, so that 
one is not only told what should be done under 
given conditions but how to do it as well. It is 
therefore in the best sense " a practical treatise." 
That it is comprehensive, a glance at the index 
will show. — Maryland Medical Journal, July 7, 1883, 
Professor Hyde has long been known as one of 
the most intelligent and enthusiastic representa- 
tives of dermatology in the west. His numerous 
contributions to the literature of this specialty 
have gained for him a favorable recognition as a 
careful, conscientious and original observer. The 
remarkable advances made in our knowledge of 
diseases of the skin, especially from the stand- 
point of pathological histology and improved 
methods of treatment, necessitate a revision of 
the older text-books at short intervals in order to 
bring them up to the standard demanded by the 
march of science. This last contribution of Dr. 
Hyde is an effort in this direction. He has at- 
tempted, as he informs us, the task of presenting 
in a condensed form the results of the latest ob- 
servation and experience. A careful examination 
of the work convinces us that he has accomplished 
his task with painstaking fidelity and with a cred- 
itable result. — Journal of Cutaneous and Venereal 
Diseases, June, 1883. 



FOX, T., M.D., F.JEt. C. P., and FOX, T. €., B.A., M.B. C.S., 



Physician to the Department for Skin Diseases, 
llec 



Physician for Diseases of the Skin to the 
Westminster Hospital, London. 



University College Hospital, London. 

An Epitome of Skin Diseases. With Formulae. For Students and Prac- 
titioners. Third edition, revised and enlarged. In one very handsome 12mo. volume 
of 238 pages. Cloth, $1.25. 



The third edition of this convenient handbook 
calls for notice owing to the revision anl expansion 
which it has undergone. The arrangement of skin 
diseases in alphabetical order, which is the method 
of classification adopted in this work, becomes a 
positive advantage to the student. The book is 
one which we can strongly recommend, not only 
to students but also to practitioners who require a 
compendious summary of the present state of 
dermatology. — British Medical Journal, July 2, 1883. 

We cordially recommend Fox's Epitome to those 
whose time is limited and who wish a handy 



manual to lie upon the table for instant reference. 
Its alphabetical arrangement is suited to this use, 
for all one has to know is the name of the disease, 
and here are its description and the appropriate 
treatment at hand and ready for instant applica- 
tion. The present edition has been very carefully 
revised and a number of new diseases are de- 
scribed, while most of the recent additions to 
dermal therapeutics find mention, and the formu- 
lary at the end of the book has been considerably 
augmented.— The Medical News, December, 1883. 



MOBBIS, MALCOLM, M. D., 

Joint Lecturer on Dermatology at St. Mary's Hospital Medical School, London. 
Skin Diseases ; Including their Definitions, Symptoms, Diagnosis, Prognosis, Mor- 
bid Anatomy and Treatment. A Manual for Students and Practitioners. In one 12mo. 
volume of 316 pages, with illustrations. Cloth, $1.75. 



To physicians who would like to know something 
about skin ^.diseases, so that when a patient pre- 
sents himself for relief they can make a correct 
diagnosis and prescribe a rational treatment, we 
unhesitatingly recommend this little book of Dr. 
Morris. The affections of the skin are described 
in a terse, lucid manner, and their several charac- 
teristics so plainly set forth that diagnosis will be 
easy. The treatment in each case is such as the 
experience of the rnosteminent dermatologists ad- 
vises. — Cincinnati Medical News, April, 1880. 

This is emphatically a learner's book; for we 
can safely say, that in the whole range of medical 
literature there is no book of alike scope which 



for clearness of expression and methodical ar- 
rangement is better adapted to promote a rational 
conception of dermatology — a branch confessedly 
difficult and perplexing to the beginner.— ££. Louis 
Courier of Medicine, April, 1880. 

The writer has certainly given in a small compass 
a large amount of well-compiled information, and 
his little book compares favorably with any other 
which has emanated from England, while in many 
points he has emancipated himself from the stub- 
bornly adhered to errors of others of his country- 
men. There is certainly excellent material in the 
book which will well repay perusal. — Boston Med. 
and Surg. Journ., March, 1880. 



WILSON, FBASMUS, F. B. S. 

The Student's Book of Cutaneous Medicine and Diseases of the Skin. 
In one handsome small octavo volume of 535 pages. Cloth, $3.50. 

HILLIFB, THOMASTM-Io^r 

Physician to the Skin Department of University College, London. 

Handbook of Skin Diseases; for Students and Practitioners, Second Ameri- 
can edition. In one 12mo. volume of 853 pag< s, with plates. Cloth, $2.25. 



Lea Brothers & Co.'s Publications — Dis. of Women. 



27 



AN AMERICAN SYSTEM OF GYNECOLOGY, 

A System of Gynaecology, in Treatises by Various Authors. Edited 
by Matthew D. Masn, M. D., Professor of Obstetrics and Gynaecology in the Uni- 
versity of Buffalo, N. Y. In two handsome octavo volumes, richly illustrated. In active 
preparation. 

LIST OF CONTRIBUTORS. 



FORDYCE BARKER, M. D., 
ROBERT BATTEY, M. D., 
SAMUEL C. BUSEY, M. D., 
HENRY F. CAMPBELL, M. D., 
BENJAMIN F. DAWSON, M. D., 
WILLIAM G00DELL, M. D., 
HENRY F. GARRIGUES, M. D., 
SAMUEL W. GROSS, M. D., 
JAMES B. HUNTER, M. D., 
WILLIAM T. HOWARD, M. D., 
A. REEVES JACKSON, M. D., 
EDWARD W. JENKS, M. D., 

WILLIAM H. 



CHARLES CARROLL LEE, M. D., 
WILLIAM T. LUSK, M. D., 
MATTHEW D. MANN, M. D., 
ROBERT B. MAURY, M. D., 
C. D. PALMER, M. D., 
WILLIAM M. POLK, M. D., 
THADDEUS A. REAMY, M. D., 
A. D. ROCKWELL, M. D., 
ALBERT H. SMITH, M. D., 
R. STANSBURY SUTTON, A. M., M. D. 
T. GAILLARD THOMAS, M. D., 
CHARLES S. WARD, M. D., 
WELCH, M. D. 



TMOMAS, T. GAILLARD, M. D., 

Professor of Diseases of Women in the College of Physicians and Surgeons, N. Y. 

j A Practical Treatise on the Diseases of Women. Fifth edition, thoroughly 
revised and rewritten. In one large and handsome octavo volume of 810 pages, with 266 
illustrations. Cloth, $5.00 ; leather, $6.00 ; very handsome half Eussia, raised bands, $6.50. 

The words which follow "fifth edition" are in 
this case no mere formal announcement. The 
alterations and additions which have been made are 
both numerous and important. The attraction 
and the permanent character of this book lie in 
the clearness and truth of the clinical descriptions 
of diseases; the fertility of the author in thera- 
peutic resources and the fulness with which the 
details of treatment are described; the definite 
character of the teaching; and last, but not least, 
the evident candor which pervades it. We would 
also particularize the fulness with which the his- 
tory of the subject is gone into, which makes the 
book additionally interesting and gives it value as 
a work of reference. — London Medical Times and 
Gazette, July 30, 1881. 

The determination of the author to keep his 
book foremost in the rank of works on gynaecology 
is most gratifying. Recognizing the fact that this 
can only be accomplished by frequent and thor- 
ough revision, he has spared no pains to make the 
present edition more desirable even than the pre- 



vious one. As a book of reference for the busy 
practitioner it is unequalled. — Boston Medical any 
Surgical Journal, April 7, 1880. 

It has been enlarged and carefully revised. It is 
a condensed encyclopaedia of gynaecological medi- 
cine. The style of- arrangement, the masterly 
manner in which each subject is treated, and the 
honest convictions derived from probably the 
largest clinical experience in that specialty of any 
in this country, all serve to commend it in the 
highest terms to the practitioner. — Nashville Jour, 
of Med. and Surg., Jan. 1881. 

That the previous editions of the treatise of Dr. 
Thomas were thought worthy of translation into 
German, French, Italian and Spanish, is enough 
to give it the stamp of genuine merit. At home it 
has made its way into the library of every obstet- 
rician and gynaecologist as a safe guide to practice. 
No small number of additions have been made to 
the present edition to make it correspond to re- 
cent improvements in treatment. — Pacific Medical 
and Surgical Journal, Jan. 1881. 



MJDIS, AMTHUtt W., M, D., Lond., F.M. O..P., M.M. C. S., 

Assist. Obstetric Physician to Middlesex Hospital, late Physician to British Lying-in Hospital. 
The Diseases of Women. Including their Pathology, Causation, Symptoms, 
Diagnosis and Treatment. A Manual for Students and Practitioners. In one handsome 
octavo volume of 576 pages, with 148 illustrations. Cloth, $3.00 ; leather, $4.00. 



It is a pleasure to read a book so thoroughly 
good as this one. The special qualities which are 
conspicuous are thoroughness in covering the 
whole ground, clearness of description and con- 
ciseness of statement. Another marked feature of 
the book is the attention paid to the details of 
many minor surgical operations and procedures, 
as, for instance, the use of tents, application of 
leeches, and use of hot water injections. These 
are among the more common methods of treat- 
ment, and yet very little is said about them in 
many of the textbooks. The book is one to be 
warmly recommended especially to students and 
general practitioners, who need a concise but com- 
plete resume of the whole subject. Specialists, too, 
will find many useful hints in its pages. — Boston 
Med. and Surg. Journ., March 2, 1882. 



The greatest pains have been taken with the 
sections relating to treatment. A liberal selection 
of remedies is given for each morbid condition, 
the strength, mode of application and other details 
being fully explained. The descriptions of gynae- 
cological manipulations and operations are full, 
clear and practical. Much care has also been be- 
stowed on the parts of the book which deal with 
diagnosis — we note especially the pages dealing 
with the differentiation, one from another, of the 
different kinds of abdominal tumors. The prac- 
titioner will therefore find in this book the kind 
of knowledge he most needs in his daily work, and 
he will be pleased with the clearness and fulness 
of the information there given. — The Practitioner, 
Feb. 1882. 



P., 



BARNES, ROBERT, M. D., F. R. C. 

Obstetric Physician to St. Thomas' Hospital, London, etc. 

A Clinical Exposition of the Medical and Surgical Diseases of Women. 

In one handsome octavo volume, with numerous illustrations. New edition. Preparing. 

WEST, CMAMLES, M. J>. 

Lectures on the Diseases of Women. Third American from the third Lon- 
don edition. In one octavo volume of 543 pages. Cloth, $3.75 ; leather, $4.75. 

CHURCHILL ON THE PUERPERAL FEVER I MEIGS ON THE NATURE, SIGNS AND TREAT- 
AND OTHER DISEASES PECULIAR TO WO- MENT OF CHILDBED FEVER. In one 8vo. 
MEN. In one 8vo. vol. of 464 pages. Cloth, $2.50. | volume of 346 pages. Cloth, $2.00. 



M 



28 Lea Brothers & Co.'s Publications — Dis. of Women, Midwfy. 
EMMET, THOMAS AL>JDIS, M. D., LL. !>., 

Surgeon to the Woman's Hospital, New York, etc. 

The Principles and Practice of Gynecology ; For the use of Students and 
Practitioners of Medicine. New (third) edition, thoroughly revised. In one large and very 
handsome octavo volume of 880 pages, with 150 illustrations. Cloth, $5 ; leather, $6. 

(Just ready.) 

Excerpt from the Author's Preface to the Second Edition. 

So great have been the advance and change of views during the past four years in 
Gynaecology, that the preparation of this edition has necessitated almost as much labor as 
to have rewritten the volume. Every portion has been thoroughly revised, a great deal 
ha9 been left out, and much new matter added. 

The chapters on the relation of education and social condition to development, those 
on pelvic cellulitis, the diseases of the ovary and on ovariotomy, together with that on 
stone in the bladder, have been nearly rewritten. 

The chapters on prolapse of the vaginal walls and lacerations of the vaginal outlet, 
the methods of partial and complete removal of the uterus for malignant disease, the 
surgical treatment of fibrous tumors, diseases of the Fallopian tubes, and the diseases of 
the urethra, are essentially new, with the views and experience of the author in a form 
which has not been presented to the profession before. To these chapters not less than 
one hundred and seventy-five pages of new material have been added. 



We are in doubt whether to congratulate the 
author more than the profession upon the appear- 
ance of the third edition of this well-known work. 
Embodying, as it does, the life-long experience of 
one who has conspicuously distinguished himself 
as a bold and successful operator, and who has 
devoted so much attention to the specialty, we 
feel sure the profession will not fail to appreciate 
the privilege thus offered them of perusing the 
views and practice of the author. His earnestness 
of purpose and conscientiousness are manifest. 
H9 gives not only his individual experience but 



endeavors to represent the actual state of gynae- 
cological science and art. — British Medical Jour- 
nal, May 16, 1885. 

Any work on gynaecology by Emmet must 
always have especial interest and value. He has 
for many years been an exceedingly busy prac- 
titioner in this department. Few men have had 
his experience and opportunities. As a guide 
either for the general practitioner or specialist, 
it is second to none other. No one can read 
Emmet without pleasure, instruction and profit. 
— Cincinnati Lancet and Clinic, Jan 31, 1885. 



JDVNCAN, J. MATTHEWS, M.D., LL. D., F. It. S. E., etc. 

Clinical Lectures on the Diseases of Women ; Delivered in Saint Bar- 
tholomew's Hospital. In one handsome octavo volume of 175 pages. Cloth, $1.50. 

stamp of individuality that, if widely read, as they 



They are in every way worthy of their author ; 
indeed, we look upon them as among the most 
valuable of his contributions. They are all upon 
matters of great interest to the general practitioner. 
Some of them deal with subjects that are not, as a 
rule, adequately handled in the text-books; others 
of them, while bearing upon topics that are usually 
treated of at length in such works, yet bear such a 



certainly deserve to be, they cannot fail to exert a 
wholesome restraint upon the undue eagerness 
with which many young physicians seem bent 
upon following the wild teachings which so infest 
the gynaecology of the present day.— IV. Y. Medical 
Journal, March, 1880. 



HOJDGE, HVGHL., M. L>., 

Emeritus Professor of Obstetrics, etc., in the University of Pennsylvania. 

On Diseases Peculiar to Women; Including Displacements of the Uterus. 
Second edition, revised and enlarged. In one beautifully printed octavo volume of 519 
pages, with original illustrations. Cloth, $4.50. 

By the Same Author. 

The Principles and Practice of Obstetrics. Illustrated with large litho- 
graphic plates containing 159 figures from original photographs, and with numerous wood- 
cuts. In one large quarto volume of 542 double-columned pages. Strongly bound in 
cloth, $14.00. 

* * * Specimens of the plates and letter-press will be forwarded to any address, free by 
mail, on receipt of six cents in postage stamps. 

TAIiNIEB, S., and CHAJSTTBEUIL, G. 

A Treatise on the Art of Obstetrics. Translated from the French. In 

two large octavo volumes, richly illustrated. 

BAMSBOTHAM, FRANCIS H., M. D. 

The Principles and Practice of Obstetric Medicine and Surgery: 
In reference to the Process of Parturition. A new and enlarged edition, thoroughly revised 
by the Author. With additions by W. V. Keating, M. D., Professor of Obstetrics, etc., 
in the Jefferson Medical College of Philadelphia. In one large and handsome imperial 
octavo volume of 040 pages, with 04 full-page plates and 43 woodcuts in the^ text, contain- 
ing in all nearly 200 beautiful figures. Strongly bound in leather, with raised bands, $7. 



ASHWELL'S PRACTICAL TREATISE ON THE l American from the third and revised London 
DISEASES PECULIAR TO WOMEN. Third I edition. In one 8vo. vol., pp. 520. Cloth, 83.50. 



Lea Brothers & Co.'s Publications — Midwifery. 29 

PLAYFAIH, W. S., M. B. 9 F. B. C. B., 

Professor of Obstetric Medicine in King's College, London, etc. 

A Treatise on the Science and Practice of Midwifery. New (fourth) 
American edition, revised by the Author. Edited, with additions, by Eobebt P. Har- 
ris, M. D. In one handsome octavo volume of about 700 pages, with 183 illustrations 
and 3 plates. Cloth, $4 ; leather, $5 ; half Kussia, $5.50". Just ready. 

A few notices of the previous edition are appended: 

of the subject are omitted.— Cincinnati Medical 



if inquired of by a medical student what work 
on obstetrics we should recommend for him, par 
excellence, we would undoubtedly advise him to 
choose Playfair's. It is of convenient size, but 
what is of chief importance, its treatment of the 
various subjects is concise and plain. While the 
discussions and descriptions are sufficiently elabo- 
rate to render a very intelligible idea of them, yet 
all details not nece'ssary for a full understanding 



News, Jan., 1880. 

It certainly is an admirable exposition of the 
science and practice of midwifery. Of course the 
additions made by the American editor, Dr. R. P. 
Harris, who never utters an idle word, and whose 
studious researches in some special departments 
of obstetrics are so well known to the profession, are 
of great value.— The Amer. Practitioner, April, 1880. 



BABKFB, FOBBYCE, A. M., M. D., XX. B. Bdin., 

Clinical Professor of Midwifery and the Diseases of Women in the Bellevue Hospital Medical College, 
New York, Honorary Fellow of the Obstetrical Societies of London and Edinburgh, etc., etc. 

Obstetrical and Clinical Essays. In one handsome 12mo. volume of about 
300 pages. Preparing. 

KING, A. F. A., M B., 

Professor of Obstetrics and Diseases of Women in the Medical Department of the Columbian Univer- 
sity, Washington, D. C., and in the University of Vermont, etc. 

A Manual of Obstetrics. New edition. In one very handsome 12mo. volume 
of 331 pages, with 59 illustrations. Cloth, $2.00. 



In a series of short paragraphs and by a con- 
densed style of composition, the writer has pre- 
sented a great deal of what it is well that every 
obstetrician should know and be ready to practice 
or prescribe. The fact that the demand for the 
volume has been such as to exhaust the first 
edition in a little over a year and a half speaks 
well for its popularity. — American Journal of the 
Medical Sciences, April, 1884. 

This little work upon obstetrics will be highly 
valued by medical students. We feel quite sure 
that it will be in great demand by them, so suited 
is it to their wants. Of a size that it can be easily 
carried, yet it contains all of the main points in 
obstetrics sufficiently elaborated to give a full and 



correct idea of them. The general practitioner 
will also find it very useful for reference, for the 
purpose of refreshing the mind. We can confi- 
dently assert that it will be found to be the best 
class text-book upon obstetrics that has been 
issued from the press. — Cincinnati Medical News, 
March, 1884. 

It must be acknowledged that this is just what 
it pretends to be — a sound guide, a portable epit- 
ome, a work in which only indispensable matter 
has been presented, leaving out all padding and 
chaff, and one in which the student will find pure 
wheat or condensed nutriment. — New Orleans Med- 
ical and Surgical Journal, May, 1884. 



BABWES, BOBEBT, 31. B., and FAJSTCOUBT, M.J}., 

Phys. to the General Lying-in Hosp., Lond. Obstetric Phys. to St. Thomas' Hosp., Lond. 

A System of Obstetric Medicine and Surgery, Theoretical and Clin- 
ical. For the Student and the Practitioner. The Section on Embryology contributed by 
Prof. Milnes Marshall. In one handsome octavo volume of about 1000 pages, profusely 
illustrated. Cloth, $5 ; leather, $6. In press. 

BABJSTES, FAJSTCOUBT, 31. B., 

Obstetric Physician to St. Thomas' Hospital, London. 

A Manual of Midwifery for Midwives and Medical Students. In one 

royal 12mo. volume of 197 pages, with 50 illustrations. Cloth, $1.25. 

BABVHST, THEOBHILTJS, 31. B., LL. B., 

Professor of Obstetrics and the Diseases of Women and Children in the Jefferson Medical College. 
A Treatise on Midwifery. In one very handsome octavo volume of about 550 
pages, with numerous illustrations. In 



BABBY, JOHN S., M. D., 

Obstetrician to the Philadelphia Hospital, Vice-President oj the Obstet. Society of Philadelphia. 
Extra - Uterine Pregnancy : Its Clinical History, Diagnosis, Prognosis and 
Treatment. In one handsome octavo volume of 272 pages. Cloth, $2.50. 

TAJSWEB, THOMAS BCAWKES, M. B. 

On the Signs and Diseases of Pregnancy. First American from the second 
English edition. In one handsome octavo volume of 490 pages, with 4 colored plates and 
16 woodcuts. Cloth, $4.25. 



WINCKEL, F. 

A Complete Treatise on the Pathology and Treatment of Childbed, 

For Students and Practitioners. Translated, with the consent of the Author, from the 
second German edition, by James Read Chad wick, M. D. In one octavo volume of 484 
pages. Cloth, $4.00. 



30 



Lea Brothers & Co.'s Publications — Miclwfy., Dis. Childn. 



LEISHMAJT, WILLIAM, M. L>., 

Regius Professor of Midwifery in the University of Glasgow, etc. 

A System of Midwifery, Including the Diseases of Pregnancy and the 

Puerperal State. Third American edition, revised by the Author, with additions by 
John 8. Parry, M. D., Obstetrician to the Philadelphia Hospital, etc. In one large and 
very handsome octavo volume of 740 pages, with 205 illustrations. Cloth, $4.50 ; leather, 
$5.50; very handsome half Russia, raised bands, §6.00. 
The author is broad in his teachings, and dis- preparation of the present edition the author has 



cusses briefly the comparative anatomy of the pel- 
vis and the mobility of the pelvic articulations. 
The second chapter is devoted especially to 
the Svudy of the pelvis, while in the third the 
female organs of generation are introduced. 
The structure and development of the ovum are 
admirably described. Then follow chapters upon 
the various subjects embraced in the study of mid- 
wifery. The descriptions throughout the work are 
plain and pleasing. It is sufficient to state that in 
this, the last edition of this well-known work, every 
recent advancement in this field has been brought 
forward. — Physician and Surgeon, Jan. 1S80. 

We gladly welcome the new edition of this ex- 
cellent text-book of midwifery. The former edi- 
tions have been most favorably received by the 
profession on both sides of the Atlantic. In the 



made such alterations as the progress of obstetri- 
cal science seems to require, and we cannot but 
admire the ability with which the task has been 
performed. We consider it an admirable text- 
book for students during their attendance upon 
lectures, and have great pleasure in recommend- 
ing it. As an exponent of the midwifery of the 
present day it has no superior in the English lan- 
guage. — Canada Lancet, Jan. 1880. 

To the American student the work before us 
must prove admirably adapted. Complete in all its 
parts, essentially modern in its teachings, and with 
demonstrations noted for clearness ana precision, 
it will gain in favor and be recognized as a work 
of standard merit. The work cannot fail to be 
popular and is cordially recommended. — N. O. 
Med. and Surg. Journ., March, 1880. 



SMITH, J. LEWIS, 31. JD., 

Clinical Professor of Diseases of Children in the Bellevue Hospital Medical College, N. Y. 

A Complete Practical Treatise on the Diseases of Children. Fifth 
edition, thoroughly revised and rewritten. In one handsome octavo volume of 83G pages,- 
with illustrations. Cloth, $4.50 ; leather, $5.50 ; very handsome half Kussia, raised bands, f 



This is one of the best books on the subject with 
which we have met and one that has given us 
satisfaction on every occasion on which we have 
consulted it, either as to diagnosis or treatment. 
It is now in its fifth edition and in its present, form 



which we venture to say will be a favorable one. — 
Dublin Journal of Medical Science, March, 1883. 

There is no book published on the subjects of 
which this one treats that is its equal in value to 
the physician. While he has said just enough to 



is a very adequate representation of the subject it J impart the information desired by general practi- 
treatsof as at present understood. The important j tioners on such questions as etiology, pathology, 
subject of infant hygiene is fully dealt with in the ! prognosis, etc., he has devoted more attention to 
early portion of the book. The great bulk of the the diagnosis and treatment of the ailments which 
work is appropriately devoted to the diseases of he so accurately describes ; and such information 
infancy and childhood. We would recommend ! is exactly what is wanted by the vast majority of 
any one in need of information on the subject to "family physicians." — Va. Med. Monthly, Feb. 1882. 
procure the work and form his own opinion on it, | 



in 



KEATING, JOHNM., M. !>., 

Lecturer on the Diseases tf CJiildren at the University of Pennsylvania, etc. 

The Mother's Guide in the Management and Feeding of Infants 

one handsome 12mo. volume of 118 pages. Cloth, $1.00. 

Works like this one will aid the physician im- ! the employment of a wet-nurse, about the proper 
mensely, f«»r it saves the time he is constantly giv- * 
Ing his patients in instructing them on the sub- 
jects here dwelt upon so thoroughly and prac 
tically. Dr. Keating has written a practical book 



has carefully avoided unnecessary "repetition, and 

fully instructed the mother in .such details 

. her child as devolve upon her. 

B . '.1,-iy omitted giving prescriptions, 

the mother when to call upon the 

totally distinct from hers. 

-1, October, 1881. 

Dr. K lear of the common fault 



food for a nursing mother, about the tonic effects 
of a bath, about the perambulator versus the nurses, " 
arms, and on many other subjects concerning 
which the critic might say, "surely this is obvi- 
ous," but which experience teaches us are exactly 
the things needed to be insisted upon, with the rich 
as well as the poor. — London Lancet, January, 28 1882 
A book small in size, written in pleasant style, in 
language which can be readily understood by any 
mot her, and eminently practical and safe; in fact 
a book for which we have been waiting a long 
time, and which we can most heartily recommend 
: .is sort, viz., mixing the duties of to mothers as the book on this subject. — New York 

or with those proper to the doctor. There I MedicalJournal and Obstetrical Review, Feb. 1882. 
. the remarks about I 



.>b 



OWEN, EDMUND, 31. B., F. B. C. S., 

v.s Hospital, (in at. Ormond St., London. 
Surgical Diseases of Children. In one 12mo. volume. Preparing. See Serie* 

Of t ,d 

WEST, CHARLES, 31. I)., 

Hoepital for Sick ( "Ion, etc. 

Lectures on the Diseases of Infancy and Childhood. Fifth Amei -i. » 
from 6tl | [ n one octavo volume of 68 6 pagea. Cloth, $4.50 ; leather, $5.51© 

— — 

By the Same Author. 
On Some Disorders of tho Nervous System in Childhood. In one small 

( 'loth, $1.00. 



ISE ON 'I 



: ! 



nted. In one octavo volume of 



\ 



Lea Brothers & Co.'s Publications — Med. Juris., Miscel. 



31 



TIDY, CHAMLE8 MEYMOTT, M. B., E. & 8., 

Professor of Chemistry and of Forensic Medicine and Public Health at the London Hospital, etc. 
Legal Medicine. Volume II. Legitimacy and Paternity, Pregnancy, Abor- 
tion, Rape, Indecent Exposure, Sodomy, Bestiality, Live Birth., Infanticide, Asphyxia, 
Drowning, Hanging, Strangulation, Suffocation. Making a very handsome imperial oc- 
tavo volume of 529 page*. Cloth, $6.00; leather, $7.00. 



Volume I. Containing 864 imperial 
plates. Cloth, $6.00 ; leather, $7.00. 

The satisfaction expressed with the first portion 
of this work is in no wise lessened by a perusal of 
the second volume. We find it characterized by 
the same fulness of detail and clearness of ex- 
pression which we had occasion so highly to com- 
mend in our former notice, and which render it so 
valuable to the medical jurist. The copious 



octavo pages, with, two beautiful colored 

tables of cases appended to each division of the 
subject, must have cost the author a prodigious 
amount of labor and research, but they constitute 
one of the most valuable features of the book, 
especially for reference in medico-legal trials. — 
American Journal of the Medical Sciences, April, 1884. 



TAYZOM, ALFMBJy 8., M. &., 

Lecturer on Medical Jurisprudence and Chemistry in Gutfs Hospital, London. 

A Manual of Medical Jurisprudence. Eighth American from the tenth Lon- 
don edition, thoroughly revised and rewritten. Edited by John J. Eeese, M. D., Professor 
of Medical Jurisprudence and Toxicology in the University of Pennsylvania. In one 
large octavo volume of 937 pages, with 70 illustrations. Cloth, $5.00 ; leather, $6.00 ; half 
Russia, raised bands, $6.50. 

The American editions of this standard manual j only have to seek for laudatory terms.— American 
have for a long time laid claim to the attention of j Journal of the Medical Sciences, Jan. 1881. 
the profession in this country; and the eighth | This celebrated work has been the standard au- 
comes before us as embodying the latest thoughts j thority in its department for thirty-seven years, 
and emendations of Dr. Taylor upon the subject both in England and America, in both the profes- 
r-o which he devoted his life with an assiduity and s ions which it concerns, and it is improbable that 
success which made him facile princeps among jt will be superseded in many years. The work is 
English writers on medical jurisprudence. Both | simply indispensable to every physician, and nearly 
the author and the book have made a mark too j so to every liberally-educated lawyer, and we 
deep to be affected by criticism, whether it be | heartily commend the present edition to both pro- 

- ~ -Albany Law Journal, March 26, 1881. 



censure or praise, 



whether it be 
In this case, however, we should 



fessions. 



By the Same Author. 

The Principles and Practice of Medical Jurisprudence. Third edition. 
In two handsome octavo volumes, containing 1416 pages, with 188 illustrations. Cloth, $10 ; 
leather, $12. Just ready. 



For years Dr. Taylor was the highest authority 
in England upon the subject to which he gave 
especial attention. His experience was vast, his 
judgment excellent, and his skill beyond cavil. It 
is therefore well that the work of one who, as Dr. 
Stevenson says, had an "enormous grasp of all 



matters connected with the subject," should be 
brought up to the present day and continued in 
its authoritative position. To accomplish this re- 
sult Dr. Stevenson has subjected it to most careful 
editing, bringing it well up to the times.— Ameri- 
can Journal of the Medical Sciences, Jan. 1884. 



By the Same Author. 

Poisons in Relation to Medical Jurisprudence and Medicine. Third 
American, from the third and revised English edition. In one large octavo volume of 788 
pages. Cloth, $5.50 ; leather, $6.50. 

PEPPEM, AUGUSTUS J., M. 8., M. B., F. M. C. 8., 

Examiner in Forensic Medicine at the University of London. 
Forensic Medicine. In one pocket-size 12mo. volume. Preparing. See Students' 
Series of Manuals, page 3. 

IEA, SENMY C. 

. Superstition and Force : Essays on The Wager of Law, The Wager of 
Battle, The Ordeal and Torture. Third revised and enlarged edition. In one 



handsome royal 12mo. volume of 552 pages. 
This valuable work is in reality a history of civ- 
ilization as interpreted by the progress of jurispru- 
[ mce. . . In " Superstition and Force " we have a 
{ hilosophic survey of the long period intervening 
1 primitive barbarity and civilized enlight- 
. There is not a chapter in the work that 



uween 
snment 



Cloth, $2.50. 
should not be most carefully studied ; and however 
well versed the reader may be in the science of 
jurisprudence, he will find much in Mr. Lea's vol- 
ume of which he was previously ignorant. The 
book is a valuable addition to the literature of so- 
cial science. — Westminster Review, Jan. 1880. 



By the Same Author. 
Studies in Church History. The Kise of the Temporal Power 



-Ben- 



it of Clergy — Excommunication. 

tavo volume of 605 pages. Cloth, $2.50. 

The author is pre-eminently a scholar. He takes 
up every topic allied with the leading theme, and 
traces it out to the minutest detail with a wealth 
of knowledge and impartiality of treatment that 
compel admiration. The amount of information 
compressed into the book is extraordinary. In no 
.. ther single volume is the development of the 



New edition. In one very handsome royal 

Just ready. 

primitive church traced with so much clearness, 
and with so definite a perception of complex or 
conflicting sources. The fifty pages on the growth 
of the papacy, for instance, are admirable for con- 
ciseness and freedom from prejudice. — Boston 
Traveller, May 3, 1883. 



Allen's Anatomy .... 

American Journal of the Medical Sciences 
American System of Gynaecology . 
American System of Practical Medicine 
*Ashliurst's Surgery .... 
Ash well on Diseases of Women 
AttSeid's Chemistry .... 
Ball nn the Rectum and Anus 
Barker's Obstetrical and Clinical Fssays. 
Barlow's Practice of Medicine 
Barnes' Midwifery 
*Barnes on Diseases of Women 
Barnes' System of Obstetric Medicine 
Bartholow on Electricity 
Basham on Penal Diseases . 
Bell's Comparative Physiology and Anatomy 
Bellamy's Operative Surgery 
Bellamy's Surgical Anatomy 
Blandford on Insanity 
Bloxanrs Chemistry . ... 

Bowman's Practical Chemistry . . 

*Bristowe's Practice of Medicine . 
Broadbent on the Pulse 
Browne on the Ophthalmoscope . . 

Browne on the Throat 
Brace's Materia Medica and Therapeutics 
Brunton's Materia Medica and Therapeutics 
Bryant on the Breast .... 
*Bryant's Practice of Surgery 
*Burastead on Venereal Diseases , , 

*Burnett on the Ear .... 
Butlin on the Tongue .... 
Carpenter on the Use and Abuse of Alcohol 
*Carpenter's Human Physiology . , 

Carter on the Eye , 

Century of American Medicine 
Chambers on Diet and Regimen 
Charles' Physiological and Pathological Chem 
Churchill on Puerperal Fever 
Clarke and Lockwood's Dissectors' Manual 
Classen's Quantitative Analysis 
Cleland's Dissector . 

Clouston on Insanity . . , 

Clowes' Practical Chemistry 
Coats' Pathology .... 

Cohen on the Throat .... 
Coleman's Dental Surgery . 
Condie on Diseases of Children 
Cooper's Lectures on Surgery 
Cornil on Syphilis .... 

*Cornil and Ranvier's Pathological Histology 
Cullerier's Atlas of Venereal Diseases 
Curnow's Medical Anatomy 
Dalton on the Circulation 
'Dalton's HumanPhysiology 
Dalton's Topographical Anatomy of the Brain 
Davis' Clinical Lectures 
Draper's Medical Physics 
Druitt's Modern Surgery 
Duncan on Diseases of "Women 
*Dunglison's Medical Dictionary . 
Edison Diseases of Women . 
Ellis' Demonstrations of Anatomy 
Emmet's Gynaecology 
*Erichsen's System of Surgery 
Esmarchs Early Aid in Injuries and Accid'ts 
Farquharson's Therapeutics and Mat. Med. 
Fenwick's Medical Diagnosis 
Finlayson's Clinical Diagnosis . . 

Flint on Auscultation and Percussion 
Flint on Phthisis .... 

Elint on Physical Exploration of the Lungs 
Flint on Respiratory Organs 
Flint on the Heart 
*Flint's Clinical Medicine 
Flint's Essays . . . 

*Flint's Practice of Medicine 
Folsom's Laws of U. S. on Custody of Insane 
Foster's Physiology .... 
♦Fothergill's Handbook of Treatment . 
Fownes' Elementary Chemistry 
Fox on Diseases of the Skin . 
Frankland and Japp's Inorganic Chemistry 
Fuller on the Lungs and Air Passages . 
Galloway's Analysis .... 
Gibney's Orthopeedic Surgery 

q's surgery .... 

Gluge'a Pathological Histology, by Leidy 
Surgical Diagnosis ... 
*Gray's Anatomy ... 
' rreene a Medical Chemistry . 
Green's Pathology and Morbid Anatomy 
Griffith's Universal Formulary 

.i) Foreign Uodi^s in Air- Passages 

on Impotence and Sterility . 

• .'i Orfnary < >; gang 
ol ry 

Habershonon the Abdomen 
•Hamilton on Fractun :<nd Dislocations 
Hamilton on Nervous Diseases 

'line's Anatomy and 1'h wsiology . 
ECartehorne's Conspectus of the Med. Sciences 
Hurt- | ntials of Medicine 

Hermann's Experimental Pharmacology 

Hill on Syphilis 

Hillier'a 'Hand hook ofSkin Diseases 

Hoblyn'a Medical Dictionary 

Hodge on Women .... 

Books marked * are 



6 Hodge's Obstetrics .... 
3 Hoffmann and Power's Chemical Analysis 

27 Holden's Landmarks .... 

15 Holland's Medical Notes and Reflections 

20 ^Holmes' System of Surgery 

28 Horner's Anatomy and Histology 
9 Hudson on Fever 

21 Hutchinson on Syphilis 

29 Hyde on the Diseases of the Skin . 

17 Jones (C. Handheld) on Nervous Disorders 
29 Juler's Ophthalmic Science and Practice 
27 . Keating on Infants .... 
29 King's Manual of Obstetrics . 

17 Klein's Histology 

24 ' La Roche on Pneumonia, Malaria, etc. . 
,7 I La Roche on Yellow Fever . 

20 i Laurence and Moon's Ophthalmic Surgery 
6 : Lawson on the Eye, Orbit and Eyelid 

19 Lea's Studies in Church History 

9 Lea's Superstition and Force 

Q Lee on Syphilis 
14 ! Lehmann's Chemical Physiology . 

16 j *Leishman's Midwifery 

23 i Lucas on Diseases of the Urethra . 

18 I Ludlow's Manual of Examinations 

11 Lyons on Fever ..... 
11 Maisch's Organic Materia Medica . 

21 Marsh on the Joints .... 
21 Medical News . ... 

25 | Meigs on Childbed Fever 

24 " 
21 



Miller's Practice of Surgery . 

Miller's Principles of Surgery 

Mitchell's Nervous Diseases of Women . 

Morris on Diseases of the Kidneys 

Morris on Skin Diseases 

Neill and Smith's Compendium of Med. Sci. 

Nettleship on Diseases of the Eye . 

Owen on Diseases of Children 

*Parrish's Practical Pharmacy 

Parry on Extra-Uterine Pregnancy 

Parvin's Midwifery .... 

Pavy on Digestion and its Disorders 

Pepper's Forensic Medicine . 

Pepper's Surgical Pathology 

Pick on Fractures and Dislocations 

Pirrie's System of Surgery 

Playfair on Nerve Prostration and Hysteria 

*Playfair's Midwifery . 

Politzer on the Ear and its Diseases 

Power's Human Physiology . 

Ralfe's Clinical Chemistry 

Ramsbotham on Parturition 

Remsen's Theoretical Chemistry . 

*Reynolds' Svst em of Medicine 

Richardson's'Preventive Medicine 

Roberts On Urinary Diseases 

Roberts' Principles and Practice of Surgery 

Robertson's Physiological Physics 

Rod well's Dictionary of Science 

Sargent's Minor and" Military Surgery . 

Savage on Insanity, including Hysteria . 

Schafer's Essentials of Histology, 

Schafer's Histology 

Schreiber on Massage . 

Seiler on the Throat, Nose and Naso-Pharynx 

Series of Clinical Manuals 

Simon's Manual of Chemistry 

Skey's Operative Surgery 

Slade on Diphtheria .... 

Smith (Edward) on Consumption . 

Smith (H. H.) and Horner's Anatomical Atlas 

*Smith (J. Lewis) on Children 

Stllle on Cholera .... 

*Still6 <& Maisch's National Dispensatory 

*Still6's Therapeutics and Materia Medica 

Stimson on Fractures .... 

Stimson's Operative Surgery 

Stokes on Fever ..... 

Students* Series of Manuals . 

Sturges' Clinical Medicine . 

Tanner on Signs and Diseases of Pregnancy 

Tanner's Manual of Clinical Medicine . 

Tarnier and Chantreuil's Obstetrics 

Taylor on Poisons .... 

*Tavlor's Medical Jurisprudence . 

Taylor's Prin. and Prac. of Med. Jurisprudence 
20 I *Thomas on Diseases of Women . 
13 I Thompson on Stricture 
20 Thompson on Urinary Organs 
5 I Tidv's Legal Medicine .... 
in Toad on Acute Diseases 
13 1 Treves' Applied Anatomy 
11 Treves on Intestinal Obstruction . 
18 Tukeonthe IniluenceofMindon theBody 

Walshe on l he Heart .... 

Wilson's Practice of Physic . 

; Weils (in iin' Eye 

West on Diseases of Childhood 

Weal '■!! Dl eases ofWomen 

vwst on Nervous Disorders in Childhood 

Williams on Consumption . 

Wilson's Handbook of Cutaneous Medicine 

Wilson's Human Anatomy . • - •„_ 

Winckel on Pathol, and Treatmentof Childbed 

Wfthler's Organic Chemistry 

Woodhead's Practical Pathology . 

Year-Book of Treatment . • 



also bound in half Russia. 



LEA BROTHERS & CO., Philadelphia. 



- ■ ■ 



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